scholarly journals Global Disparities in Hepatitis B Elimination—A Focus on Africa

Viruses ◽  
2022 ◽  
Vol 14 (1) ◽  
pp. 82
Author(s):  
Mark W. Sonderup ◽  
C. Wendy Spearman
Keyword(s):  
Hepatitis B ◽  
Disease Burden ◽  
Health Sector ◽  
World Health ◽  
Child Transmission ◽  
Third Trimester ◽  
Birth Dose ◽  
The Will ◽  
Transmission Prevention ◽  
Mother To Child

In 2016, WHO member states at the World Health Assembly adopted a Global Health Sector Strategy that included a policy of eliminating viral hepatitis. Clear targets were established to assist in achieving this by 2030. The strategy, while achievable, has exposed existing global disparities in healthcare systems and their ability to implement such policies. Compounding this, the regions with most disparity are also those where the hepatitis B prevalence and disease burden are the greatest. Foundational to hepatitis B elimination is the identification of both those with chronic infection and crucially pregnant women, and primary prevention through vaccination. Vaccination, including the birth dose and full three-dose coverage, is key, but complete mother-to-child transmission prevention includes reducing the maternal hepatitis B viral load in the third trimester where appropriate. Innovations and simplified tools exist in order to achieve elimination, but what is desperately required is the will to implement these strategies through the support of appropriate investment and funding. Without this, disparities will continue.

scholarly journals Global viral hepatitis elimination by the year 2030

2016 ◽  
Vol 35 (3) ◽  
pp. 143
Author(s):  
Richard Tjan
Keyword(s):  
Hepatitis B ◽  
Global Health ◽  
Viral Hepatitis ◽  
Health Sector ◽  
World Health ◽  
Health Coverage ◽  
Treatment Interventions ◽  
Viral Hepatitis B ◽  
Mother To Child ◽  
Universal Health

According to a report by Stanaway et al.(1) in 2016, the absolute burden and relative rank of viral hepatitis increased between 1990 and 2013. For example, the number of global deaths due to viral hepatitis increased from 0.89 million to 1.45 million, indicating a need for its reduction. In this connection, on 28 May 2016 the 69th World Health Assembly adopted the global health sector strategy on viral hepatitis for the period 2016–2021,(2) as outlined in the report A69/32 of the Secretariat,(3) with the goal of eliminating viral hepatitis B and C by the year 2030. The global health sector strategy (GHSS) on viral hepatitis has constructed a roadmap toward the elimination of viral hepatitis B and C, targeting five priority prevention and treatment interventions. Prevention involves universal hepatitis B immunization of infants, prevention of mother-to-child transmission, increased injection safety and blood safety, and increased harm reduction, the implementation of which will contribute toward universal health coverage, which is the target for Goal 3 of the 2030 Agenda for Sustainable Development. In combination with treatment of chronic hepatitis, the goal is to achieve by the year 2030 a reduction in the incidence of viral hepatitis by 90% and mortality by 65%.(3,4)

scholarly journals Efficacy and Safety of Lamivudine or Telbivudine in Preventing Mother-to-Child Transmission of Hepatitis B Virus: A Real-World Study

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Zhenhua Li ◽  
Xuefei Duan ◽  
Yuhong Hu ◽  
Mingfang Zhou ◽  
Min Liu ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Real World ◽  
Control Group ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Third Trimester ◽  
Safety And Efficacy ◽  
Large Sample ◽  
The Third ◽  
Mother To Child

Background. There are few large sample studies evaluating the safety and efficacy of lamivudine (LAM) or telbivudine (LdT) in preventing hepatitis B mother-to-child transmission (MTCT) in highly viremic mothers in the third trimester of pregnancy in real-world settings. The purpose of this study was to analyze a large sample size of HBV-infected mothers to better understand the safety and efficacy of LAM and LdT under the aforementioned criteria. Methods. During the period of November 2008 to November 2017, we retrospectively enrolled mothers with HBV DNA>1×106 IU/mL who received LAM or LdT during the third trimester of pregnancy and compared them to untreated mothers. All mothers were divided into the three following groups: the LAM group, the LdT group, and the control group. Results. A total of 2624 HBV-infected mothers were enrolled in the study, with 363 in the LAM group, 1283 in the LdT group, and 978 in the control group. The MTCT rates were significantly lower in the LAM or LdT group than that in the control group (0.4% or 0.3% versus 9.0%, P<0.001). Infants born to untreated mothers had a significantly higher risk of HBV infection (OR=28.6, 95% CI: 10.4–78.7, P<0.001). There were no significant differences in perinatal complications between the three groups (P>0.05). There were also no differences for gestational age or infants’ height, weight, Apgar scores, or birth defect rates. Postpartum discontinuation of antiviral therapy did not seem to increase the risk of postpartum alanine aminotransferase (ALT) flare. Conclusion. LAM or LdT treatment initiated in the third trimester for mothers with HBV DNA>1×106 IU/mL was equally safe and effective in preventing MTCT.

Update in management of hepatitis B in pregnancy and prevention of mother to child hepatitis B transmission

2018 ◽  
Vol 1 (3) ◽  
pp. 1-8
Author(s):  
Naichaya Chamroonkul
Keyword(s):  
Chronic Hepatitis ◽  
Viral Load ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
High Viral Load ◽  
World Population ◽  
Hepatitis B Infection ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Mother To Child

Even with two decades of widespread using hepatitis B vaccination, chronic hepatitis B remains a major global health problem. In Thailand, the prevalence of chronic hepatitis B infection was down from 8 - 10% in last decade to 5% recently. Failure to control mother to child transmission is one of the important barriers to the total elimination of hepatitis B infection from world population. In the majority, vertical transmission can be prevented with a universal screening program, immunoprophylaxis by administration of hepatitis B vaccine and hepatitis B immunoglobulin (HBIg) for babies born to mothers with HBV. However, in mothers with a high viral load, the chance of immunoprophylaxis failure remains high. To date, there are standard recommendations by all international liver societies including AASLD, EASL and APASL suggest introducing an antiviral agent during the third trimester to CHB pregnant women with a high viral load. Previous US FDA pregnancy category B agents such as Tenofovir and Telbivudine are allowed through all trimesters of pregnancy and are effective for prevention of mother to child transmission. Breastfeeding for patients who receive antiviral agents can be allowed after a risk-benefit discussion with the patient and family.

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