Hepatitis B and C: Strong action needed in Europe

On World Hepatitis Day, the European Center for Disease Prevention and Control (ECDC) is calling for redoubled efforts to combat hepatitis B and C. In total, 3 million new cases are diagnosed each year, resulting in 1.1 million deaths; Around 6 million people are living with chronic hepatitis B and C infection in the European Union alone.

However, hepatitis B cases have decreased due to the effective use of the hepatitis B vaccine. With regard to hepatitis C, some countries also reported a decrease in the number of new transmissions; Factors related to the prevention strategies adopted by some countries. However, the picture is not so rosy: barriers and late treatments still exist in the target population of hepatitis C.

“Over the years, the impact of effective preventive measures such as hepatitis B vaccination has reduced the transmission of hepatitis B and hepatitis C-related diseases. However, the burden of chronic hepatitis B and hepatitis C infection in the EU remains A proportion of people with this disease remain undiagnosed and therefore do not receive the treatment and care they need. To address these issues, we urgently need to increase our efforts to strengthen and introduce new innovative diagnostic and therapeutic approaches.

said ECDC Director Andrea Ammon.

Prevalence of Hepatitis B and C in the European Union

Based on the above report, ECDC compiled estimates of hepatitis B surface antigen (HBsAg) in the general population in EU countries. There are 16 countries with HBsAg prevalence estimates ranging from 0.1% in Ireland to 4.5% in Romania

The latest ECDC report (as of December 2022) shows that, The eradication goal advocated by the World Health Organization is still far from being achieved. For hepatitis B, 27 countries recommend universal childhood vaccination to prevent the disease; three countries do not have a national universal vaccination policy (Denmark, Finland and Iceland). However, only 50% of countries with integrated vaccination strategies met the 95% coverage target.

For hepatitis C, however, the available prevalence data are incomplete. In fact, some countries do not have current information or reliable data on diseases within their borders. ECDC has compiled estimates of hepatitis B surface antigen (HBsAg) in the general population in the European Union. HBsAg prevalence estimates were available for 16 countries, with estimates ranging from 0.1% in Ireland to 4.5% in Romania.

Routes of Transmission of Hepatitis B and C Viruses

The ECDC document provides information on the mechanisms of transmission of the hepatitis B and hepatitis C viruses.

available evidence shows Heterosexual transmission (32%), male-to-male sexual transmission (14%) and healthcare facility transmission (hospital transmission) (12%) accounted for more than half of acute hepatitis B transmission cases.

The most common route of transmission for chronic hepatitis B cases was vertical transmission, accounting for 52% of the reported cases. Notably, however, the majority of these cases (77%) were classified as imported from other countries.

Surprisingly, when it comes to hepatitis C, the ECDC has data for only 31% of cases reported in 2020 (representing 13 countries). In the EU, the C virus – HCV – is transmitted through injecting drug use (55%) and sexual relations between men (18%). In fact, 69% of chronic hepatitis C cases are attributable to injecting drug use.

However, the document reiterates that this information may not be representative of the entire region; Reported data may be affected by diagnostic bias between groups that may be more likely than others to have serial testing and thus be more likely to identify infections, which are often asymptomatic.