When combined, this prevalence corresponded to 248 million people globally in 2010. Within the World Health Organization (WHO) territories, the prevalence of the virus ranged from 0.20% (Mexico) to 13.55% (Haiti) in the Americas, 0.48% in the Seychelles, and 22.38% in the African (South Sudan) region ( 3). A review of published data from 161 countries that were reported between 19 estimated the worldwide prevalence of HBsAg to be 3.61%, with the highest rates being in Africa (8.83%) and the Western Pacific regions (5.26%). Before the universal implementation of vaccination for hepatitis B, the prevalence of hepatitis B surface antigen (HBsAg) globally ranged from 2% to 20%. Thus, to fill these gaps and provide a more comprehensive and relevant document to regions worldwide, we have taken a global approach by using the findings of global experts on HBV as well as citing major guidelines and their various approaches to addressing HBV and its disease burden.ĭue to the various modes of transmission, the geographic prevalence of this infection varies widely as well and is categorized as high, intermediate, or low ( Table 1). This focus leaves a gap for care providers on the other HBV-related issues, which include HBV’s epidemiological profile, its natural history, how it interacts with other viral hepatitis diseases, treatments, and the areas that still need to be addressed in order to achieve HBV elimination by 2030. Despite this knowledge, many of the professional organizations provide guidelines focused only on specific questions related to the treatment of HBV infection. There have also been rapid clinical developments toward a functional cure of HBV infection, with novel compounds currently being in various phases of progress. In the last 5 years, more attention has been focused on the important topics of HBV screening, diagnosis of HBV infection, and appropriate linkage to care. Some reasons for these low rates of surveillance, diagnosis, and treatment include the asymptomatic nature of chronic hepatitis B until the very late stages, a lack of curative therapy with a finite treatment duration, a complex natural history, and a lack of knowledge about the disease by both care providers and patients. In the United States, by CDC estimates, only one-third of HBV-infected patients or less are aware of their infection. Linkage to care is estimated to be very poor both in developing countries and in high-income countries, such as the United States, countries in Western Europe, and Japan. Hepatitis C virus (HCV) and hepatitis B virus (HBV) are the leading causes of liver cancer and overall mortality globally, surpassing malaria and tuberculosis. Currently, despite the use of a preventive vaccine for several decades as well as the use of effective and well-tolerated viral suppressive medications since 1998, approximately 250 million people remain infected with the virus that causes hepatitis B worldwide.
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