Chronic hepatitis B virus (HBV) infection is a major public health problem and a cause of chronic liver disease leading to an estimated 1.1 million deaths in 2022, mainly due to cirrhosis and hepatocellular carcinoma (HCC). In 2022, WHO estimated that 254 million people were living with chronic hepatitis B, of whom 65% were in the African and Western Pacific regions. Most of this global burden can be attributed to mother to child transmission (MTCT) at the time of or shortly after birth and horizontal household transmission.
Considerable progress has been made towards eliminating perinatal transmission of HBV through universal infant HBV immunization, including timely hepatitis B birth dose vaccination administered within 24 h of birth. This regimen is 90–95% effective in preventing infection and in reducing new infections among children. However, hepatitis B birth dose coverage is only 45% globally, with particularly low coverage (18%) in the WHO African region. Antiviral prophylaxis during pregnancy can also improve MTCT prevention.
For people with chronic hepatitis B (CHB), nucleoside analogue treatment with tenofovir or entecavir is highly effective, reducing progression of liver disease and incidence of HCC and improving long-term survival.
HBV infection may be asymptomatic for years, and only blood tests can make the diagnosis of infection.
The primary diagnosis of CHB is based on a positive HBsAg test. However, quantifying HBV DNA is critical for determining eligibility for both treatment and antiviral prophylaxis for PMTCT and monitoring treatment response among those receiving antiviral therapy.
Access to HBV DNA testing is increasing in low- and middle-income countries but remains a major impediment outside urban facilities. Having at least one HBV DNA test is strongly encouraged to provide full assessment before treatment and everyone initiating treatment should be monitored annually with HBV DNA, ALT and APRI score and HCC surveillance, with ongoing adherence support and retention in care.
This webinar aims are to provide the basis of HBV diagnosis, assessment of liver disease stage and management of chronic hepatitis B treatment and follow up.
Key Learning Objectives
- Understand the landscape of hepatitis B acute and chronic infection
- Understand the diagnostic of hepatitis B chronic infection and importance of treatment
- Understand the importance of HBV viral load in the clinical management of chronic hepatitis B
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