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The Case for Simplifying and Using Absolute Targets for Viral Hepatitis Elimination Goals Publisher Pubmed



Razavi H1 ; Blach S1 ; Razavishearer D1 ; Abaalkhail F2 ; Abbas Z3 ; Abdallah A4 ; Abrao Ferreira P5 ; Abu Raddad LJ6 ; Adda D7 ; Agarwal K8 ; Aghemo A9 ; Ahmed A10 ; Albusafi SA11 ; Alhamoudi W12 Show All Authors
Authors
  1. Razavi H1
  2. Blach S1
  3. Razavishearer D1
  4. Abaalkhail F2
  5. Abbas Z3
  6. Abdallah A4
  7. Abrao Ferreira P5
  8. Abu Raddad LJ6
  9. Adda D7
  10. Agarwal K8
  11. Aghemo A9
  12. Ahmed A10
  13. Albusafi SA11
  14. Alhamoudi W12
  15. Alkaabi S13
  16. Alromaihi H14
  17. Aljarallah B15
  18. Alnaamani K16
  19. Alqahtani S17
  20. Alswat K18
  21. Altraif I19
  22. Asselah T20
  23. Bacon B21
  24. Bessone F22
  25. Bizri AR23
  26. Block T24
  27. Bonino F25
  28. Brandaomello CE26
  29. Brown K27
  30. Bruggmann P28
  31. Brunetto MR29
  32. Buti M30
  33. Cabezas J31
  34. Calleja JL32
  35. Castro Batanjer E33
  36. Chan HLY34
  37. Chang H35
  38. Chen CJ36
  39. Christensen PB37
  40. Chuang WL38
  41. Cisneros L39
  42. Cohen C24
  43. Colombo M40
  44. Conway B41
  45. Cooper C42
  46. Craxi A43
  47. Crespo J44, 45
  48. Croes E46
  49. Cryer D47
  50. Cupertino De Barros FP48
  51. Derbala M13
  52. Dillon J49
  53. Doss W50
  54. Dou X51
  55. Doyle J52
  56. Duberg AS53
  57. Dugan E1
  58. Dunn R1
  59. Dusheiko G54
  60. El Khayat H55
  61. Elsayed MH56
  62. Eshraghian A57
  63. Esmat G50
  64. Esteban Mur R30
  65. Ezzat S4
  66. Falconer K58
  67. Fassio E59
  68. Ferrinho P60
  69. Flamm S61
  70. Flisiak R62
  71. Foster G63
  72. Fung J64
  73. Garciasamaniego J65
  74. Gish RG66
  75. Goncales F67
  76. Halota W68
  77. Hamoudi W69
  78. Hassany M70
  79. Hatzakis A71
  80. Hay S72
  81. Himatt S73
  82. Hoepelman IM74
  83. Hsu YC75
  84. Hui YT76
  85. Hunyady B77
  86. Jacobson I78
  87. Janjua N79
  88. Janssen H80
  89. Jarcuska P81
  90. Kabagambe K82
  91. Kanto T83
  92. Kao JH84
  93. Kaymakoglu S85
  94. Kershenobich D86
  95. Khamis F87
  96. Kim DJ88, 89
  97. Kim DY90
  98. Kondili LA91
  99. Kottilil S92
  100. Kramvis A93
  101. Kugelmas M94
  102. Kurosaki M95
  103. Lacombe K96
  104. Lagging M97
  105. Lao WC98
  106. Lavanchy D99
  107. Lazarus JV100
  108. Lee A101
  109. Lee SS102
  110. Levy M103
  111. Liakina V104, 105
  112. Lim YS106
  113. Liu S107
  114. Maddrey W108
  115. Malekzadeh R109
  116. Marinho RT110
  117. Mathur P92
  118. Maticic M111
  119. Mendes Correa MC112
  120. Mera J113
  121. Merat S114
  122. Mogawer S50
  123. Mohamed R115
  124. Muellhaupt B116
  125. Muljono D117
  126. Mostafa I118
  127. Nahum MS119
  128. Nawaz A120
  129. Negro F121
  130. Ninburg M122
  131. Ning Q123
  132. Ntiri Reid B124
  133. Nymadawa P125
  134. Oevrehus A126
  135. Ormeci N127
  136. Orrego M128
  137. Osman A4
  138. Oyunsuren T129
  139. Pan C130
  140. Papaevangelou V131
  141. Papatheodoridis G71
  142. Popping S132
  143. Prasad P133
  144. Prithiviputh R134
  145. Qureshi H135
  146. Ramji A136
  147. Razavishearer K1
  148. Reddy R137
  149. Remak W138
  150. Richter C139
  151. Ridruejo E140
  152. Robaeys G141, 142, 143
  153. Roberts S144
  154. Roberts L145
  155. Roudotthoraval F146
  156. Saab S147
  157. Said S148
  158. Salamat A149
  159. Sanai F150
  160. Sanchezavila JF151
  161. Schiff E152
  162. Schinazi R153
  163. Sebastiani G154
  164. Seguindevaux C155
  165. Shanmugam RP156
  166. Sharara A157
  167. Shilton S158
  168. Shouval D159
  169. Sievert W160
  170. Simonova M161
  171. Sohrabpour AA162, 163
  172. Sonderup M164
  173. Soza A165
  174. Wendy Spearman C164
  175. Steinfurth N166
  176. Sulkowski M17
  177. Tan SS165
  178. Tanaka J166
  179. Tashi D167
  180. Thein HH168
  181. Thompson P169
  182. Tolmane I170
  183. Toy M171
  184. Valantinas J172
  185. Van De Vijver D173
  186. Velezmoller P174
  187. Vince A175
  188. Waked I4
  189. Wang S176
  190. Wedemeyer H177
  191. Wong V178
  192. Xie Q179
  193. Yamada S180
  194. Yang HI181
  195. Yesmembetov K182
  196. Yilmaz Y183
  197. Younossi Z184
  198. Yu ML185
  199. Yuen MF186
  200. Yurdaydin C187
  201. Yusuf A188
  202. Zekry A189
  203. Zeuzem S190
Show Affiliations
Authors Affiliations
  1. 1. Center for Disease Analysis Foundation, Lafayette, United States
  2. 2. King Faisal Specialist Hospital & Research Center & College of Medicine, Alfaisal university, Riyadh, Saudi Arabia
  3. 3. Department of Gastroenterology, Ziauddin University, Karachi, Pakistan
  4. 4. National liver Institute, Menoufiya, Egypt
  5. 5. Escola Paulista de Medicina, Unifesp, Sao Paulo, Brazil
  6. 6. Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Doha, Qatar
  7. 7. CFID/CCT Taraba, Jalingo, Nigeria
  8. 8. Institute of Liver Studies, Kings College Hospital, London, United Kingdom
  9. 9. Department of Biomedical Sciences, Humanitas University, Milan, Italy
  10. 10. Chronic Liver Disease Foundation, Stanford University School of Medicine, Stanford, United States
  11. 11. College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
  12. 12. King Saud University, Riyadh, Saudi Arabia
  13. 13. Hamad Medical Corporation, Doha, Qatar
  14. 14. Ministry of Public Health, Doha, Qatar
  15. 15. Qassim University, College of Medicine, Riyadh, Saudi Arabia
  16. 16. The Armed Forces Hospital, Muscat, Oman
  17. 17. Johns Hopkins Hospital, Baltimore, United States
  18. 18. Liver Disease Research Center, Department of Medicine, College of Medicine, King Saud University, Saudi Arabia
  19. 19. King Abdulaziz Medical City, King Abdullah international Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
  20. 20. Hepatology Department, INSERM UMR1149, University of Paris, Beaujon Hospital, Paris, France
  21. 21. Chronic Liver Disease Foundation, Saint Louis University School of Medicine, St Louis, United States
  22. 22. University of Rosario School of Medicine, Rosario, Argentina
  23. 23. American University Hospital, Beirut, Lebanon
  24. 24. Baruch S. Blumberg Institute, Hepatitis B Foundation, Doylestown, United States
  25. 25. University of Pisa, Pisa, Italy
  26. 26. College of Medicine & Surgery, University of Rio de Janeiro, Rio de Janeiro, Brazil
  27. 27. Chronic Liver Disease Foundation, Wayne State University, Henry Ford Hospital, Detroit, United States
  28. 28. Arud Centres for Addiction Medicine, Zurich, Switzerland
  29. 29. Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
  30. 30. Vall d'Hebron University Hospital, Barcelona, Spain
  31. 31. University Hospital Marques de Valdecilla, Santander, Spain
  32. 32. Hospital Universitario Puerta de Hierro, Universidad Autonoma de Madrid, Madrid, Spain
  33. 33. Medecine tropicale Suivi integre de l’addiction et de maladies transmissibles, Lausanne, Switzerland
  34. 34. The Chinese University of Hong Kong, Hong Kong
  35. 35. Hepatitis Business Solutions, New York, United States
  36. 36. Academia Sinica, Taipei, Taiwan
  37. 37. Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
  38. 38. Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
  39. 39. Hospital San Jose Tec Salud Monterrey N.L., Mexico
  40. 40. University of Milan, Milan, Italy
  41. 41. Vancouver Infectious Diseases Centre, Vancouver, Canada
  42. 42. University of Ottawa, Ottawa, Canada
  43. 43. University of Palermo, Palermo, Italy
  44. 44. President of Spanish Society of Gastroenterology, Santander, Spain
  45. 45. Gastroenterology and Hepatology Department, University Hospital Marques de Valdecilla, Research Institute Valdecilla, School of Medicine, University of Cantabria, Santander, Spain
  46. 46. Trimbos Institute, Utrecht, Netherlands
  47. 47. Global Liver Institute, Washington, DC, United States
  48. 48. Universidade Federal de Goias, Goiania, Brazil
  49. 49. School of Medicine, University of Dundee, Dundee, United Kingdom
  50. 50. Cairo University, Cairo, Egypt
  51. 51. Shengjing Hospital of China Medical University, Shenyang, China
  52. 52. Burnet Institute, Melbourne, Australia
  53. 53. Orebro University, Orebro, Sweden
  54. 54. University College London Medical School, London, United Kingdom
  55. 55. Theodor Bilharz Research Institute, Giza, Egypt
  56. 56. Ain Shams University, Cairo, Egypt
  57. 57. Shiraz Transplant Center, Abu-Ali Sina Hospital, Shiraz, Iran
  58. 58. Infectious Diseases Dept, Karolinska University Hospital, Stockholm, Sweden
  59. 59. Hospital Nacional Profesor Alejandro Posadas, El Palomar, provincia de Buenos Aires, Argentina
  60. 60. Universidade Nova de Lisboa, Instituto de Higiene e Medicina Tropical, Research Center on Global Health and Tropical Medicine, Lisbon, Portugal
  61. 61. Chronic Liver Disease Foundation, Northwestern Feinberg School of Medicine, Chicago, United States
  62. 62. Medical University of Bialystok, Bialystok, Poland
  63. 63. Queen Mary University of London, London, United Kingdom
  64. 64. Queen Mary Hospital, The University of Hong Kong, Hong Kong
  65. 65. Hospital Universitario La Paz, CIBERehd, IdiPAZ, Madrid, Spain
  66. 66. Hepatitis B Foundation, Doylestown, United States
  67. 67. State University of Campinas, Sao Paulo, Brazil
  68. 68. Tadeusz Browicz Provincial Observation and Infection Hospital, Bydgoszcz, Poland
  69. 69. Department of Gastroenterology & Hepatology, Al Basir Hospital, Amman, Jordan
  70. 70. National Hepatology and Tropical Medicine Research Institute (NHTMRI), Cairo, Egypt
  71. 71. Medical School of National & Kapodistrian University of Athens, Athens, Greece
  72. 72. The Hepatitis Foundation of New Zealand, Whakatane, New Zealand
  73. 73. Public Health Department, Doha, Qatar
  74. 74. University Medical Center, Utrecht, Netherlands
  75. 75. E-Da Hospital, I-Shou University, National Yang-Ming University, Taipei, Taiwan
  76. 76. Department of Medicine, Queen Elizabeth Hospital, Hong Kong
  77. 77. Somogy County Kaposi Mor Teaching Hospital, Kaposvar, Hungary
  78. 78. Chronic Liver Disease Foundation, NYU Langone Health, New York, United States
  79. 79. School of Population & Public Health, University of British Columbia, Vancouver, Canada
  80. 80. University of Toronto, Toronto General Hospital, Toronto, Canada
  81. 81. University Hospital, University PJ Safarik, Kosice, Slovakia
  82. 82. Africa Hepatitis Initiative (AHI), Kampala, Uganda
  83. 83. The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Chiba, Japan
  84. 84. Division of Gastroenterology and Hepatology, National Taiwan University Hospital, Taipei, Taiwan
  85. 85. Dept. of Gastroenterohepatology, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey
  86. 86. National University of Mexico (UNAM), Mexico City, Mexico
  87. 87. Royal Hospital, Ministry of Health, Muscat, Oman
  88. 88. Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea
  89. 89. Institute for Liver and Digestive Diseases, Hallym University, Chuncheon, South Korea
  90. 90. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
  91. 91. National Center for Global Health, Istituto Superiore di Sanita, Rome, Italy
  92. 92. Institute of Human Virology, University of Maryland School of Medicine, Baltimore, United States
  93. 93. Hepatitis Virus Diversity Research Unit, University of the Witwatersrand, Johannesburg, South Africa
  94. 94. Chronic Liver Disease Foundation, South Denver Gastroenterology, Englewood, United States
  95. 95. Musashino Red Cross Hospital, Tokyo, Japan
  96. 96. Sorbonne Universite, Inserm, Infectious and tropical diseases department, Saint-Antoine Hospital (AP-HP), Paris, France
  97. 97. Department of Infectious Diseases / Virology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
  98. 98. Pamela Youde Nethersole Eastern Hospital, Hong Kong
  99. 99. Denges VD, Switzerland
  100. 100. Barcelona Institute for Global Health (ISGlobal), Hospital Clinic, University of Barcelona, Barcelona, Spain
  101. 101. University of Sydney, Macquarie University, Sydney, Australia
  102. 102. University of Calgary, Calgary, Canada
  103. 103. Department of Gastroenterology, Liverpool Hospital, Sydney, Australia
  104. 104. Centre of Hepatology, Gastroenterology and Dietetics, Vilnius University, Vilnius, Lithuania
  105. 105. Department of Chemistry and Bioengineering, Faculty of Fundamental Science, Vilnius Gediminas Technical University, Vilnius, Lithuania
  106. 106. Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
  107. 107. Beijing Youan Hospital, Capital Medical University, Beijing, China
  108. 108. Chronic Liver Disease Foundation, University of Texas Southwestern Medical Center, Dallas, United States
  109. 109. Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
  110. 110. Centro Hospitalar Lisboa Norte, Hospital Santa Maria, Universidade de Lisboa, Lisbon, Portugal
  111. 111. Clinic for Infectious Diseases and Febrile Illnesses, University Medical Centre Ljubljana, University of Ljubljana, Ljubljana, Slovenia
  112. 112. Sao Paulo University, Sao Paulo, Brazil
  113. 113. Cherokee Nation Health Service, Tahlequah, United States
  114. 114. Liver and Pancreatobiliary Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
  115. 115. University of Malaya Medical Centre, Kuala Lumpur, Malaysia
  116. 116. Swiss HPB (Hepato-Pancreato-Biliary) Center and Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland
  117. 117. Department of Hepatitis & Emerging Infectious Diseases, Eijkman Institute for Molecular Biology, Jakarta, Indonesia
  118. 118. Cairo training center, World Gastroenterology Organization, Cairo, Egypt
  119. 119. AGAF Liver Research UnitMedi ca Sur Clinic, National University of Mexico (UNAM), Mexico City, Mexico
  120. 120. FMH College of Medicine & Dentistry, Lahore, Pakistan
  121. 121. Divisions of Gastroenterology and Hepatology and of Clinical Pathology, University Hospital, Geneva, Switzerland
  122. 122. Hepatitis Education Project, Seattle, United States
  123. 123. Department and Institute of Infectious Disease, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
  124. 124. NASTAD, Washington, DC, United States
  125. 125. Mongolian Academy of Medical Sciences, Ulaanbaatar, Mongolia
  126. 126. Department of Infectious Diseases, Odense University Hospital, Denmark
  127. 127. Ankara University, Ankara, Turkey
  128. 128. Colombian Hepatology Association, Bogota, Colombia
  129. 129. Institute of Biology, Mongolian Academy of Sciences, Ulaanbaatar, Mongolia
  130. 130. Division of Gastroenterology and Hepatology, NYU School of Medicine, New York, United States
  131. 131. Third Department of Pediatrics, National and Kapodistrian University of Athens, University Hospital ATTIKON, Athens, Greece
  132. 132. Erasmus Medical Centre, Rotterdam, Netherlands
  133. 133. Auckland Hospital, Auckland, New Zealand
  134. 134. HepSupport, Mauritius
  135. 135. Focal Point Hepatitis, Government of Pakistan, Islamabad, Pakistan
  136. 136. University of British Columbia, Vancouver, Canada
  137. 137. University of Pennsylvania, Philadelphia, United States
  138. 138. International Association of Hepatitis Task Forces, Petaluma, United States
  139. 139. HIV/TB/Hepatitis, Amsterdam, Netherlands
  140. 140. Hepatology Section, Department of Medicine, Centro de Educacion Medica e Investigaciones Clinicas Norberto Quirno “CEMIC�, Ciudad Autonoma de Buenos Aires, Argentina
  141. 141. Faculty of Health and Life Sciences, Hasselt University, Diepenbeek, Belgium
  142. 142. Department of Gastroenterology and Hepatology, Ziekenhuis Oost Limburg Genk, Genk, Belgium
  143. 143. Department of Gastroenterology and Hepatology, University Hospitals KU, Leuven, Belgium
  144. 144. Alfred Health, Melbourne, Australia
  145. 145. Mayo Clinic, Rochester, United States
  146. 146. Service d'Hepatologie, Hospital Henri Mondor, Paris, France
  147. 147. Chronic Liver Disease Foundation, David Geffen School of Medicine at UCLA, Los Angles, United States
  148. 148. School of Health and Medical Sciences, State University of Zanzibar, Zanzibar, Tanzania
  149. 149. Department of Gastroenterology, Military Hospital, Rawalpindi, Pakistan
  150. 150. Division of Gastroenterology, Dept. of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
  151. 151. Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Mexico
  152. 152. Chronic Liver Disease Foundation, University of Miami School of Medicine, Miami, United States
  153. 153. Emory University School of Medicine, Atlanta, United States
  154. 154. McGill University Health Centre, Montreal, Canada
  155. 155. Luxembourg Institute of Health, Luxembourg, Luxembourg
  156. 156. Chennai Liver Foundation, Chennai, India
  157. 157. American University of Beirut Medical Center, Beirut, Lebanon
  158. 158. FIND, Geneva, Switzerland
  159. 159. Hadassah-Hebrew University Hospital, Jerusalem, Israel
  160. 160. Monash Health, Monash University, Melbourne, Australia
  161. 161. Department of Gastroenterology, HPB Surgery and Transplantology, Military Medical Academy, Sofia, Bulgaria
  162. 162. Iranian Hepatitis Network, Tehran, Iran
  163. 163. The Liver, Pancreatic, and Biliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  164. 164. Department of Medicine and Division of Hepatology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
  165. 165. Pontificia Universidad Catolica de Chile, Santiago, Chile
  166. 166. Liver Health Connection, Denver, United States
  167. 167. Gaden Jang Tse Hospital, Gaden Jang Tse, India
  168. 168. Toronto Health Economics and Technology Assessment (THETA) Collaborative, Toronto General Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada
  169. 169. University of North Carolina, Chapel Hill, United States
  170. 170. University of Latvia, Riga East University Hospital, Riga, Latvia
  171. 171. Stanford University, Stanford, United States
  172. 172. Centre of Hepatology, Gastroenterology and Dietetics, Vilnius University Hospital, Vilnius, Lithuania
  173. 173. Viroscience Department, Erasmus Medical Centre, Rotterdam, Netherlands
  174. 174. Guatemalan Liver Association and Medical School, Universidad de San Carlos de Guatemala, Guatemala
  175. 175. School of Medicine, University of Zagreb, Zagreb, Croatia
  176. 176. Center for Asian Health, Saint Barnabas Medical Center, Livingston, United States
  177. 177. Hannover Medical School, Hannover, Germany
  178. 178. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
  179. 179. Shanghai Ruijin Hospital, Jiao Tong University School of Medicine, Shanghai, China
  180. 180. University of Hawaii, Honolulu, United States
  181. 181. Genomics Research Center, Academia Sinica, Taipei, Taiwan
  182. 182. National Research Center for Oncology and Transplantation, Astana, Kazakhstan
  183. 183. Department of Gastroenterology, School of Medicine, Marmara University, Istanbul, Turkey
  184. 184. Chronic Liver Disease Foundation, Inova Health System, Falls Church, United States
  185. 185. Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
  186. 186. Department of Medicine, The University of Hong Kong, Hong Kong
  187. 187. Koc University Medical School, Istanbul, Turkey
  188. 188. Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH & RC), Lahore, Pakistan
  189. 189. St. George Hospital, Sydney, Australia
  190. 190. Goethe University Hospital, Frankfurt, Germany

Source: Journal of Viral Hepatitis Published:2021


Abstract

The 69th World Health Assembly endorsed the Global Health Sector Strategy for Viral Hepatitis, embracing a goal to eliminate hepatitis infection as a public health threat by 2030. This was followed by the World Health Organization's (WHO) global targets for the care and management of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. These announcements and targets were important in raising awareness and calling for action; however, tracking countries’ progress towards these elimination goals has provided insights to the limitations of these targets. The existing targets compare a country's progress relative to its 2015 values, penalizing countries who started their programmes prior to 2015, countries with a young population, or countries with a low prevalence. We recommend that (1) WHO simplify the hepatitis elimination targets, (2) change to absolute targets and (3) allow countries to achieve these disease targets with their own service coverage initiatives that will have the maximum impact. The recommended targets are as follows: reduce HCV new chronic cases to ≤5 per 100 000, reduce HBV prevalence among 1-year-olds to ≤0.1%, reduce HBV and HCV mortality to ≤5 per 100 000, and demonstrate HBV and HCV year-to-year decrease in new HCV- and HBV-related HCC cases. The objective of our recommendations is not to lower expectations or diminish the hepatitis elimination standards, but to provide clearer targets that recognize the past and current elimination efforts by countries, help measure progress towards true elimination, and motivate other countries to follow suit. © 2020 John Wiley & Sons Ltd