2024 World Hepatitis Day: It’s Time for Action
Today, July 28, is World Hepatitis Day. This day is dedicated to uplifting national and international hepatitis testing, prevention, surveillance, treatment, and care efforts. In 2016, the World Health Organization (WHO) published the Global Health Sector Strategy on viral hepatitis to reach the goal of eliminating viral hepatitis by 2030. Elimination in these terms is defined as 90% reduction in incidence and 65% reduction in mortality for hepatitis B and C from 2015 to 2030. This year’s World Hepatitis Day theme, “It’s time for action”, calls for the global health community to get back on track towards the viral hepatitis 2030 elimination goals. The main theme “It’s time for action” and the sub-theme, “Global hepatitis response: Closing the gap towards the 2030 elimination goals”, both highlight gaps that need to be addressed to reach the elimination goals.
In 2015, WHO published comprehensive guidelines that addressed hepatitis B prevention, care, and treatment for people living with hepatitis B. In 2024, WHO updated these guidelines and published, “Guidelines for the prevention, diagnosis, care and treatment for people with chronic hepatitis B infection". These new guidelines focus on expanding and simplifying hepatitis B treatment criteria for adults, adolescents, and pregnant persons. A few notable updates to the guidelines include:
- expanding treatment eligibility to capture at least 50% of people living with hepatitis B, compared to 8%-15% previously;
- including options for treating in settings without access to hepatitis B virus (HBV) DNA testing;
- recommending treatment for adolescents and adults aged 12 and over; and
- recommending reflex HBV DNA testing and the use of point of care HBV DNA tests, where available, and include recommendations for hepatitis delta testing.
Additionally, WHO’s goal is to reduce new hepatitis C virus (HCV) infections by 80% by 2030. To reach this goal, data must accurately reflect the number of people living with hepatitis. Estimating hepatitis C prevalence in the United States, 2017–2020, a new paper published by HepVu Fellow Dr. Eric Hall and HepVu Project Director Dr. Heather Bradley, creates new models on how to estimate the number of people living with hepatitis C in the United States. The new models show that hepatitis C prevalence estimates are higher than previously reported. It was previously estimated that 2.4 million people were living with hepatitis C in the United States. Now, when more accurately accounting for people who inject drugs (PWID), the estimated number of people living with hepatitis C is 4 million. These findings emphasize the importance of investing in hepatitis C prevention and treatment resources to address the growing viral hepatitis epidemic.
WHO’s global hepatitis strategy aims to reduce hepatitis C-related deaths by 65% between 2015 and 2030. Hepatitis C can be cured with direct-acting antivirals (DAAs) and access to this treatment is essential to achieve optimal health outcomes for people living with hepatitis C. However, barriers exist that limit access to this life-saving treatment. A 2024 JAMA article documented the association between restrictions implemented by Medicaid programs in the U.S. and hepatitis C treatment rates among Medicaid recipients. The data shows that sobriety and fibrosis restrictions implemented by Medicaid programs are associated with a reduction in hepatitis C treatment rates among Medicaid recipients. The study concludes that removing these restrictions might facilitate treatment of more people living with hepatitis C. Addressing gaps in treatment and removing barriers to care is crucial to achieve the hepatitis elimination goals.
Regarding action towards hepatitis C elimination in the United States, a recently released Congressional Budget Office (CBO) report highlights overall cost savings from expanding Medicaid treatment. The report includes a call for research on the effectiveness of the proposed national HCV initiative, including outreach, testing, and linkage strategies. Comments on the CBO report can be sent to Chapin White, CBO’s Director of Health Analysis.
On this World Hepatitis Day, and every day, it is imperative to prioritize viral hepatitis elimination on local, national, and global levels. To support the WHO’s global viral hepatitis elimination goals, work must continue to be done to address the gaps in hepatitis prevention, surveillance, care, and treatment.
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