United States: The World Health Organization (WHO) has unveiled new guidelines on the prevention, diagnosis, and treatment of chronic hepatitis B (HBV) infection at the 2024 Asian Pacific Conference for the Study of Liver Disease (APASL) in Kyoto, Japan. These guidelines aim to simplify and expand eligibility for treatment, addressing barriers in access to HBV testing and treatment.
Chronic hepatitis B affects more than 250 million people worldwide, leading to increasing deaths each year. The majority of cases result from mother-to-child transmission at or shortly after birth. To combat this, WHO’s Global Health Sector Strategy aims to eliminate viral hepatitis by 2030, reducing new infections and deaths globally by 90% and 65%, respectively.
Progress has been made in preventing mother-to-child transmission through universal infant HBV immunization, but global hepatitis B birth-dose coverage remains low at 45%, with less than 20% coverage in the WHO African Region.
Antiviral treatment for CHB infection is highly effective, improving survival rates and reducing liver disease progression and cancer development. However, significant gaps in testing and treatment persist.
The 2024 guidelines prioritize simplified treatment criteria for adults and adolescents, expanded eligibility for antiviral prophylaxis for pregnant women, and improved HBV diagnostics through point-of-care viral load testing. They also address the diagnosis of Delta coinfection, a major cause of HBV-related morbidity and mortality, and strategies for delivering high-quality HBV services.
These new guidelines build upon previous WHO recommendations, updating evidence-based practices from the 2015 Guidelines for the care and treatment of persons diagnosed with chronic hepatitis B infection and the 2017 Guidelines on hepatitis B and C testing. They provide updated guidance on treatment eligibility, antiviral therapy regimens, antiviral prophylaxis for pregnant women, HBV diagnostics, testing for hepatitis delta coinfection, and strategies for promoting adherence to long-term antiviral therapy and retention in care.
The release of these guidelines marks a significant step in the global effort to combat hepatitis B and reduce its burden on public health.