Last update:

   05-Aug-2017
 

Arch Hellen Med, 34(4), July-August 2017, 515-523

SPECIAL ARTICLE

Elimination of viral hepatitis B: A myth or reality?

S.J. Hadziyannis
Second Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

Morbidity and mortality from liver disease due to infection with the hepatitis B virus (HBV) constitute a major public health problem, with more than 600,000 annual deaths globally from HBV-induced cirrhosis and/or hepatocellular carcinoma (HCC). Recent advances, both in the prevention of vertical ΗΒV transmission by vaccination and in the treatment of hepatitis B, together with the breakthrough development of curative forms of treatment for hepatitis C, have raised hopes for eliminating both these infectious diseases. In the 2016 General Assembly of WHO a document calling for the control of hepatitis B and C by 2020 and their elimination by 2030 was been compiled and agreed upon unanimously. Considering viral hepatitis B specifically, the prerequisites for the elimination of an infectious disease, namely: (a) easy and reliable screening and, (b) a highly protective vaccine are already fulfilled. The third prerequisite, curative therapy, has not yet been achieved, but current long-term treatment can achieve 100% suppression of HBV replication and there are major expectations for curative HBV therapy. This paper describes the WHO goals for HBV elimination and the worldwide activities required for their achievement. Reference is made to the supportive activities of Liver Associations worldwide, specific efforts in certain countries, such as those in Taiwan and China, the realistic USA plan, and other relevant activities. It is concluded that elimination of viral hepatitis B is currently neither a Myth nor a Reality, but a Perspective and a Hope for the future, and that similar considerations apply also to hepatitis C.

Key words: Elimination, Eradication, Hepatitis B, Treatment, Vaccine.


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