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Global Prevalence, Treatment, and Prevention of Hepatitis B Virus Infection in 2016: A Modelling Study Publisher Pubmed



Razavishearer D1 ; Gamkrelidze I1 ; Nguyen MH2 ; Chen DS3, 4 ; Van Damme P5 ; Abbas Z6 ; Abdulla M7 ; Abou Rached A8 ; Adda D9, 10 ; Aho I13 ; Akarca U15 ; Al Ali FH11 ; Lawati FAL16 ; Naamani KAL17 Show All Authors
Authors
  1. Razavishearer D1
  2. Gamkrelidze I1
  3. Nguyen MH2
  4. Chen DS3, 4
  5. Van Damme P5
  6. Abbas Z6
  7. Abdulla M7
  8. Abou Rached A8
  9. Adda D9, 10
  10. Aho I13
  11. Akarca U15
  12. Al Ali FH11
  13. Lawati FAL16
  14. Naamani KAL17
  15. Alashgar HI18
  16. Alavian SM19, 20
  17. Alawadhi S21
  18. Albillos A22, 23
  19. Albusafi SA24
  20. Aleman S26, 27
  21. Alfaleh FZ28
  22. Aljumah AA29
  23. Anand AC30
  24. Anh NT31
  25. Arends JE33
  26. Arkkila P14
  27. Athanasakis K34
  28. Bane A35, 36
  29. Benari Z37
  30. Berg T38
  31. Bizri AR39
  32. Blach S1
  33. Brandao Mello CE41
  34. Brandon SM1
  35. Bright B42
  36. Bruggmann P43
  37. Brunetto M44
  38. Buti M45
  39. Chan HLY46, 47
  40. Chaudhry A49
  41. Chien RN50
  42. Choi MS51
  43. Christensen PB52
  44. Chuang WL53
  45. Chulanov V54, 55
  46. Clausen MR56
  47. Colombo M61
  48. Cornberg M62, 63
  49. Cowie B64
  50. Craxi A65, 66
  51. Croes EA67
  52. Cuellar DA68
  53. Cunningham C70
  54. Desalegn H71
  55. Drazilova S72
  56. Duberg AS73
  57. Egeonu SS74
  58. Elsayed MH75
  59. Estes C1
  60. Falconer K25
  61. Ferraz MLG76
  62. Ferreira PR77
  63. Flisiak R78
  64. Frankova S79
  65. Gaeta GB82
  66. Garciasamaniego J83
  67. Genov J84
  68. Gerstoft J60
  69. Goldis A85
  70. Gountas I86
  71. Gray R87
  72. Guimaraes Pessoa M88
  73. Hajarizadeh B87
  74. Hatzakis A89, 90
  75. Hezode C91
  76. Himatt SM92
  77. Hoepelman A32
  78. Hrstic I93
  79. Hui YTT94
  80. Husa P95
  81. Jahis R96
  82. Janjua NZ97, 98
  83. Jarcuka P81
  84. Jaroszewicz J101
  85. Kaymakoglu S102
  86. Kershenobich D103
  87. Kondili LA104
  88. Konysbekova A105, 106
  89. Krajden M97, 99
  90. Kristian P80
  91. Laleman W107
  92. Lao WCC108
  93. Layden J109
  94. Lazarus JV57, 110
  95. Lee MH111
  96. Liakina V112
  97. Lim YSS113
  98. Loo CKK12
  99. Lukic B115
  100. Malekzadeh R116
  101. Malu AO117
  102. Mamatkulov A118
  103. Manns M62, 119
  104. Marinho RT120
  105. Maticic M121
  106. Mauss S122
  107. Memon MS123
  108. Mendes Correa MC88
  109. Mendezsanchez N124
  110. Merat S116
  111. Metwally AM125
  112. Mohamed R126
  113. Mokhbat JE127
  114. Moreno C128
  115. Mossong J129
  116. Mourad FH40
  117. Mullhaupt B130
  118. Murphy K1
  119. Musabaev E118
  120. Nawaz A131
  121. Nde HM1
  122. Negro F132
  123. Nersesov A133
  124. Nguyen VTT134
  125. Njouom R135
  126. Ntagirabiri R136
  127. Nurmatov Z137
  128. Obekpa S117, 138
  129. Ocama P12
  130. Oguche S139
  131. Omede O140
  132. Omuemu C141
  133. Oparesem O142
  134. Opio CK114
  135. Ormeci N143
  136. Papatheodoridis G144
  137. Pasini K1
  138. Pimenov N54
  139. Poustchi H116
  140. Quang TD146
  141. Qureshi H147
  142. Ramji A100
  143. Razavishearer K1
  144. Redae B36, 71
  145. Reesink HW148
  146. Rios CY69
  147. Rjaskova G80
  148. Robbins S1
  149. Roberts LR149
  150. Roberts SK150, 151
  151. Ryder SD153
  152. Safadi R154
  153. Salupere R155
  154. Sanai FM28, 156
  155. Sanchezavila JF157
  156. Saraswat V158
  157. Sarrazin C160, 161
  158. Schmelzer JD1
  159. Schreter I80
  160. Scott J162
  161. Seguindevaux C163
  162. Shah SR164
  163. Sharara AI40
  164. Sharma M165
  165. Shiha GE166
  166. Shin T167
  167. Sievert W151, 152
  168. Sperl J79
  169. Starkel P168
  170. Stedman C169
  171. Sypsa V145
  172. Tacke F170
  173. Tan SS171
  174. Tanaka J172
  175. Tomasiewicz K173
  176. Urbanek P174
  177. Van Der Meer AJ175
  178. Van Vlierberghe H176
  179. Vella S104
  180. Vince A177
  181. Waheed Y178
  182. Waked I179
  183. Walsh N180
  184. Weis N58, 59
  185. Wong VW46, 48
  186. Woodring J162
  187. Yaghi C181
  188. Yang HI182
  189. Yang CL183
  190. Yesmembetov K184
  191. Yosry A185
  192. Yuen MF186
  193. Yusuf MAM187
  194. Zeuzem S159
  195. Razavi H1

Source: The Lancet Gastroenterology and Hepatology Published:2018


Abstract

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. © 2018 Elsevier Ltd
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