The World Health Organization (WHO) announced an update to guidance on the prevention, diagnosis, and treatment of chronic hepatitis B (HBV) infection at the 2024 Asian Pacific Conference for the Study of Liver Disease in Kyoto, Japan. New guidelines will expand eligibility for treatment and simplify access to HBV testing and treatment. This includes alternative antiviral therapy regimens, expanding eligibility for prophylactic antivirals among pregnant women to prevent transmission, improved inclusion of adolescents in treatment, and improved diagnostic testing. Further, new HBV testing technology using DNA assays, reflex hepatitis B virus DNA testing, and point-of-care viral load testing were included in the new guidelines to better detect cases. This includes testing for those coinfected with hepatitis delta, which is a significant source of morbidity and mortality. These new guidelines aim to reduce barriers to testing and treatment of chronic hepatitis B infection.
The new WHO guidelines aim to reduce new infections by 90% and deaths by 65% by 2030. According to GlobalData epidemiologists, diagnosed prevalent cases of HBV are expected to rise from 21,499,000 in 2024 to 22,430,000 cases in 2029 in the 16 major markets (16MM: US, France, Germany, Italy, Spain, the UK, Japan, Australia, Brazil, Canada, China, India, Mexico, Russia, South Africa, South Korea). However, the implementation of these updated guidelines, which primarily focus on treatment and prevention, will likely drive a reduction in cases and fall below current forecast estimates. New guidelines come at a time when more than 250 million people have chronic hepatitis B infection and deaths are increasing each year. This is driven by mother-to-child transmission or infection shortly after birth through infected body fluids. There has been progress to reduce this mode of transmission including timely universal infant HBV vaccination, which is nearly 100% effective against this virus. Immunization coverage, however, is only 45% globally, with notably poor coverage in the WHO Africa Region, where only 20% of infants receive immunisation. Treatment for chronic hepatitis B infection by antivirals is very effective and improves survival and reduces the progression of liver disease and subsequent development of liver cancer.
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The WHO Western Pacific Region and WHO African Region, which are modelled by GlobalData in China and Australia estimates, have notably larger burdens of disease. New guidelines will likely have larger impacts in countries with a higher current prevalence of HBV, but improved testing and treatment will lower the overall prevalence of HBV across markets.
