WHO milestone hit in the battle to eliminate Hepatitis B

By David-Forrest - World Healthcare Journal

The World Health Organisation (WHO) has met its target of reducing infection rates for Hepatitis B to under one per cent for under-fives. This is down from around 5 per cent in the pre-vaccine era (the period between the 1980s and the early 2000s).

WHO is calling for united and stepped-up action from governments to build on this achievement through intensified efforts to prevent mother-to-child transmission of HBV by testing pregnant women. WHO is also asking governments to ensure there is the provision of antiviral prophylaxes for those who need it, and to maintain and expand access to hepatitis B immunisation and the birth dose vaccine.

There are more than 250 million people living with chronic HBV infection around the world. WHO has emphasised that infants are especially vulnerable: about 90 per cent of children infected with HBV in their first year of life become chronic HBV carriers. HBV attacks the liver and claims the lives of nearly 900,000 people each year.

"Preventing mother-to-child transmission of hepatitis B is the most important strategy for controlling the disease and saving lives. Even in the midst of the Covid-19 pandemic, we must ensure that mothers and newborns have access to life-saving services including hepatitis B vaccinations,” says WHO Director General, Dr Tedros Adhanom Ghebreyesus.

Preventing HBV

WHO reiterates that infants can be protected from HBV through a safe and effective vaccine that provides over 95 per cent protection against infection. To be effective, the dose should be administered within 24 hours of birth followed by at least two additional doses.

WHO also states that an additional way to protect children is to provide the pregnant mother with an antiviral treatment to reduce mother-to-child transmission of HBV. WHO is already recommending routine tests of all pregnant mothers for HBV, as well as many other potentially dangerous infections such as HIV and syphilis that can be transmitted between mother and child during pregnancy.

Pregnant mothers who do test positive for hepatitis B infection and have a high level of HBV in the blood should receive preventive antiviral therapy with tenofovir from the 28th week of pregnancy until birth. The antiviral drug is available at low cost in many countries for less than $3 per month.

Current situation

Covid-19 threatens to hamper progress in eliminating HBV. According to a new modelling study conducted by Imperial College London in collaboration with WHO, disruptions to the hepatitis B vaccination programme due to the pandemic could have a serious impact on efforts to reach the targets of the global strategy.

Covid-19 has the potential to threaten the progress made by WHO in the quest to eliminate HBV. With Covid-19 disruption, there is projected to be 5.3 million additional chronic HBV infections among children born between 2020 and 2030, and one million additional HBV-related deaths among those children in the future.

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