Monitoring progress towards elimination of hepatitis B and C in the EU/EEA

Abstract

This paper presents data on selected indicators to show progress towards elimination goals and targets for hepatitis B and hepatitis C in the 31 countries of the European Union (EU) and European Economic Area (EEA). A monitoring system was developed by the European Centre for Disease Prevention and Control, which combined newly collected data from EU/EEA countries along with relevant data from existing sources. Data for 2017 were collected from the EU/EEA countries via an online survey. All countries provided responses. In 2017, most countries reporting data had not reached prevention targets for childhood hepatitis B vaccination and for harm reduction services targeting people who inject drugs (PWID). Four of 12 countries had met the target for proportion of people living with chronic HBV diagnosed and seven of 16 met this target for hepatitis C. Data on diagnosed cases treated were lacking for hepatitis B. Of 12 countries reporting treatment data for hepatitis B, only Iceland met the target. This first collection of data across the EU/EEA highlighted major issues with data completeness and quality and in the indicators that were used, which impairs a clear overview of progress towards the elimination of hepatitis. The available data, whilst incomplete, suggest that as of 2017, the majority of the EU/EEA countries were far from meeting most of the 2020 targets, in particular those relating to harm reduction and diagnosis. It is critical to improve the data collected in order to develop more effective services for hepatitis prevention, diagnosis, and treatment that are needed in order to meet the 2030 elimination targets.

Changing Epidemiological Patterns of Infection and Mortality Due to Hepatitis C Virus in Poland

“…The introduction of screening tests in general practitioners’ offices gives some hope, but these activities are carried out on a small scale. In addition, the COVID-19 pandemic has significantly reduced the chances of achieving the goals set by the WHO [ 14 , 15 , 16 , 17 ].…”

HBV elimination in Europe: Current status and challenges

“…This will enable targeted actions, especially in relation to efforts to reduce the undiagnosed population to ensure that infected individuals receive a prompt diagnosis and linkage to care, thereby minimizing associated morbidity and mortality. To achieve this, it is essential to reinforce screening programs, particularly in at-risk populations and across age-specific cohorts of the population in countries where the epidemiological context justifies such an approach 9 . However, a scaling up of testing alone is not the solution; linkage to care and assessment of eligibility for antiviral therapy are of utmost importance.…”

“…Additional challenges included incomplete or unreliable reporting, with many data sources outdated or of suboptimal quality. In the second data collection in 2021, data were less complete with only 12 countries reporting data on the number of individuals who were HBV-infected, 9 data on diagnosed cases, and 8 on treated patients 9 . This decline may be related to the effect of the COVID-19 pandemic in the region which was reported to have a huge impact on the work of health professionals and clinical activity in 2020 and 2021, 10,11 but it also highlights the weaknesses and lack of maturity of existing data collection systems.…”

Trends of infections and mortality due to hepatitis B virus (2005-2022) and the potential impact of the COVID-19 pandemic: a population-based study in Poland

“…To eliminate the HBV infection as a global public threat, the World Health Organization (WHO) endorsed the Global Health Sector Strategy on Viral Hepatitis, which set goals to be achieved in 2030, of reducing new infections by 90%, decreasing mortality by 65% compared to 2015 and, among other objectives, detecting 90% of all chronically infected, and achieving 90% vaccination status of children with three doses of hepatitis B vaccine [ 7 ]. Currently, many countries are unable to meet the targets set by the WHO, especially concerning HBV infection diagnosis rates [ 8 , 9 ]. The lack of national screening programs in 38% of WHO member countries remains a problem, complicating the achievement of HBV infection elimination [ 10 ].…”

“…Highly developed countries, including Western Europe and North America, have a low endemicity and prevalence (< 2%) [ 2 , 9 , 11 , 12 ]. According to the most recent data, 14 million people are living with chronic HBV infection in the WHO European Region, while an estimated 4.7 million such individuals live in the countries of the European Union (EU) and the European Economic Area (EEA) [ 8 ]. Data estimating the incidence of HBV infection in Poland indicate a 0.4-1.0% prevalence of hepatitis B surface antigen in the population, implying that approximately 339,000 individuals are chronically infected [ 1 , 2 , 11 ].…”