Strategies to control hepatitis B: Public policy, epidemiology, vaccine and drugs.
The last 50 years of hepatitis B research has resulted in the development of effective screening assays for surveillance, vaccines for prevention and antiviral drugs that significantly improve patient clinical outcomes. Not surprisingly then, the global epidemiology of hepatitis B virus (HBV) is set to change dramatically over the next decade. For example, the success and the high coverage of universal HBV vaccination and the ageing cohorts of patients with chronic hepatitis B (CHB) will result in reductions of incidence and prevalence of chronic hepatitis, cirrhosis and probably hepatocellular carcinoma. This will be further accelerated by the impressive progress in the treatment outcomes for patients with CHB. In spite of this success, challenges remain, such as planning for the impact of migration from countries with high prevalence rates to those countries with low rates of HBV infection. The recent establishment of the World Health Organisation Global Hepatitis Program with the provision of a framework for global action has become the cornerstone for all countries to now frame their own particular national responses to control hepatitis B. An effective policy framework can prevent new infections, ensure people can access clinical care, and in doing so reduce the burden of infection at an individual, country and regional level. These developments present a real opportunity to reduce the significant, social and economic burden of global hepatitis B, ultimately the critical next steps to render the world hepatitis B free.
Research & Molecular Development, Victorian Infectious Diseases Reference Laboratory, Melbourne, Australia. Electronic address: Stephen.Locarnini@mh.org.au.
Stephen
S
Locarnini
Department of Hygiene & Epidemiology & Medical Statistics, Athens University Medical School, Athens, Greece.
Angelos
A
Hatzakis
Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Genomics Research Center, Academia Sinica, Taipei, Taiwan.
Ding-Shinn
DS
Chen
Division of Gastroenterology, University of Michigan Medical Centre, Ann Arbor, MI, USA.
Anna
A
Lok
D006509:Hepatitis B / Q000453:epidemiology / Q000517:prevention & control*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D017325:Hepatitis B Vaccines / Q000276:immunology*; D006513:Hepatitis B e Antigens / Q000097:blood; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D011640:Public Policy; D014611:Vaccination
D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines; D006513:Hepatitis B e Antigens; D007372:Interferons
Acute hepatitis B; Chronic hepatitis B; Chronic liver disease; Epidemiology; Hepatitis B vaccine; Hepatocellular carcinoma; Prevention; Public policy; Treatment; WHO