HBV elimination in Europe: Current status and challenges

Abstract

In 2016, an estimated 3.6 million people were living with chronic HBV infection in the 30 countries of the European Union (EU) and European Economic Area (EEA). Together with HCV infection, HBV is responsible for ~55% of all deaths related to liver cancer and 45% of deaths due to cirrhosis and other chronic liver conditions. Notably, deaths from HCC continue to increase, with hepatitis-specific deaths in the EU exceeding those attributed to either tuberculosis or HIV. [1,2] The epidemiological status of HBV infection in EU/EEA countries exhibits marked geographical differences and varying burdens of disease among key affected groups, such as men who have sex with men, people who inject drugs (PWID), and some migrant populations. [3] The prevalence of HBV is low in most EU/EEA countries with the virus affecting <0.1% of the population, especially among countries in the North West part of the region where a high proportion of cases are reported among migrants from countries with a higher endemicity and incomplete vaccination programs. [3] Nonetheless, a recent systematic review of HBV prevalence across EU/EEA countries found studies with prevalence estimates up to 8% among key risk groups such as specific migrant populations (eg, refugees) and people in prison. However, prevalence among most population groups has actually decreased in line with changes in prevalence among the general population, which reflects the impact of highly effective vaccination programs.