TY - JOUR
T1 - Global prevalence, treatment, and prevention of hepatitis B virus infection in 2016
T2 - a modelling study
AU - Razavi-Shearer, Devin
AU - Gamkrelidze, Ivane
AU - Nguyen, Mindie H.
AU - Chen, Ding Shinn
AU - Van Damme, Pierre
AU - Abbas, Zaigham
AU - Abdulla, Maheeba
AU - Abou Rached, Antoine
AU - Adda, Danjuma
AU - Aho, Inka
AU - Akarca, Ulus
AU - Hasan, Fuad
AU - Al Lawati, Faryal
AU - Al Naamani, Khalid
AU - Al-Ashgar, Hamad Ibrahim
AU - Alavian, Seyed M.
AU - Alawadhi, Sameer
AU - Albillos, Agustin
AU - Al-Busafi, Said A.
AU - Aleman, Soo
AU - Alfaleh, Faleh Z.
AU - Aljumah, Abdulrahman A.
AU - Anand, Anil C.
AU - Anh, Nguyen Thu
AU - Arends, Joop E.
AU - Arkkila, Perttu
AU - Athanasakis, Kostas
AU - Bane, Abate
AU - Ben-Ari, Ziv
AU - Berg, Thomas
AU - Bizri, Abdul R.
AU - Blach, Sarah
AU - Brandão Mello, Carlos E.
AU - Brandon, Samantha M.
AU - Bright, Bisi
AU - Bruggmann, Philip
AU - Brunetto, Maurizia
AU - Buti, Maria
AU - Chan, Henry L.Y.
AU - Chaudhry, Asad
AU - Chien, Rong Nan
AU - Choi, Moon S.
AU - Christensen, Peer B.
AU - Chuang, Wan Long
AU - Chulanov, Vladimir
AU - Clausen, Mette R.
AU - Colombo, Massimo
AU - Cornberg, Markus
AU - Cowie, Benjamin
AU - Hoepelman, Andy
N1 - Funding Information:
This study was funded by the John C Martin Foundation through the Polaris Observatory. We thank the Research on Hepatitis group (H28-kansei-ippan-001 and H25-kanen-ippan-010; led by JT), funded by the Ministry of Health, Labour and Welfare of Japan, for their provision of country-level data for Japan, and Örebro County Council for providing ALF grants (OLL-683801) to A-SD, which allowed collection of country-level data for Sweden.
Publisher Copyright:
© 2018 Elsevier Ltd
PY - 2018/6/1
Y1 - 2018/6/1
N2 - Background: The 69th World Health Assembly approved the Global Health Sector Strategy to eliminate viral hepatitis by 2030. Although no virological cure exists for hepatitis B virus (HBV) infection, existing therapies to control viral replication and prophylaxis to minimise mother-to-child transmission make elimination of HBV feasible. We aimed to estimate the national, regional, and global prevalence of HBsAg in the general population and in the population aged 5 years in 2016, as well as coverage of prophylaxis, diagnosis, and treatment. Methods: In this modelling study, we used a Delphi process that included a literature review in PubMed and Embase, followed by interviews with experts, to quantify the historical epidemiology of HBV infection. We then used a dynamic HBV transmission and progression model to estimate the country-level and regional-level prevalence of HBsAg in 2016 and the effect of prophylaxis and treatment on disease burden. Findings: We developed models for 120 countries, 78 of which were populated with data approved by experts. Using these models, we estimated that the global prevalence of HBsAg in 2016 was 3·9% (95% uncertainty interval [UI] 3·4–4·6), corresponding to 291 992 000 (251 513 000–341 114 000) infections. Of these infections, around 29 million (10%) were diagnosed, and only 4·8 million (5%) of 94 million individuals eligible for treatment actually received antiviral therapy. Around 1·8 (1·6–2·2) million infections were in children aged 5 years, with a prevalence of 1·4% (1·2–1·6). We estimated that 87% of infants had received the three-dose HBV vaccination in the first year of life, 46% had received timely birth-dose vaccination, and 13% had received hepatitis B immunoglobulin along with the full vaccination regimen. Less than 1% of mothers with a high viral load had received antiviral therapy to reduce mother-to-child transmission. Interpretation: Our estimate of HBV prevalence in 2016 differs from previous studies, potentially because we took into account the effect of infant prophylaxis and early childhood vaccination, as well as changing prevalence over time. Although some regions are well on their way to meeting prophylaxis and prevalence targets, all regions must substantially scale-up access to diagnosis and treatment to meet the global targets. Funding: John C Martin Foundation.
AB - Background: The 69th World Health Assembly approved the Global Health Sector Strategy to eliminate viral hepatitis by 2030. Although no virological cure exists for hepatitis B virus (HBV) infection, existing therapies to control viral replication and prophylaxis to minimise mother-to-child transmission make elimination of HBV feasible. We aimed to estimate the national, regional, and global prevalence of HBsAg in the general population and in the population aged 5 years in 2016, as well as coverage of prophylaxis, diagnosis, and treatment. Methods: In this modelling study, we used a Delphi process that included a literature review in PubMed and Embase, followed by interviews with experts, to quantify the historical epidemiology of HBV infection. We then used a dynamic HBV transmission and progression model to estimate the country-level and regional-level prevalence of HBsAg in 2016 and the effect of prophylaxis and treatment on disease burden. Findings: We developed models for 120 countries, 78 of which were populated with data approved by experts. Using these models, we estimated that the global prevalence of HBsAg in 2016 was 3·9% (95% uncertainty interval [UI] 3·4–4·6), corresponding to 291 992 000 (251 513 000–341 114 000) infections. Of these infections, around 29 million (10%) were diagnosed, and only 4·8 million (5%) of 94 million individuals eligible for treatment actually received antiviral therapy. Around 1·8 (1·6–2·2) million infections were in children aged 5 years, with a prevalence of 1·4% (1·2–1·6). We estimated that 87% of infants had received the three-dose HBV vaccination in the first year of life, 46% had received timely birth-dose vaccination, and 13% had received hepatitis B immunoglobulin along with the full vaccination regimen. Less than 1% of mothers with a high viral load had received antiviral therapy to reduce mother-to-child transmission. Interpretation: Our estimate of HBV prevalence in 2016 differs from previous studies, potentially because we took into account the effect of infant prophylaxis and early childhood vaccination, as well as changing prevalence over time. Although some regions are well on their way to meeting prophylaxis and prevalence targets, all regions must substantially scale-up access to diagnosis and treatment to meet the global targets. Funding: John C Martin Foundation.
UR - http://www.scopus.com/inward/record.url?scp=85044540918&partnerID=8YFLogxK
U2 - 10.1016/S2468-1253(18)30056-6
DO - 10.1016/S2468-1253(18)30056-6
M3 - Article
AN - SCOPUS:85044540918
SN - 2468-1253
VL - 3
SP - 383
EP - 403
JO - The Lancet Gastroenterology and Hepatology
JF - The Lancet Gastroenterology and Hepatology
IS - 6
ER -