Hepatitis B in sub-Saharan Africa: strategies to achieve the 2030 elimination targets.

Abstract

The WHO global health sector strategy on viral hepatitis, created in May, 2016, aims to achieve a 90% reduction in new cases of chronic hepatitis B and C and a 65% reduction in mortality due to hepatitis B and C by 2030. Hepatitis B virus (HBV) is endemic in sub-Saharan Africa, and despite the introduction of universal hepatitis B vaccination and effective antiviral therapy, the estimated overall seroprevalence of hepatitis B surface antigen remains high at 6·1% (95% uncertainty interval 4·6-8·5). In this Series paper, we have reviewed the literature to examine the epidemiology, burden of liver disease, and elimination strategies of hepatitis B in sub-Saharan Africa. This paper reflects a supranational perspective of sub-Saharan Africa, and recommends several priority elimination strategies that address the need both to prevent new infections and to diagnose and treat chronic infections. The key to achieving these elimination goals in sub-Saharan Africa is the effective prevention of new infections via universal implementation of the HBV birth-dose vaccine, full vaccine coverage, access to affordable diagnostics to identify HBV-infected individuals, and to enable linkage to care and antiviral therapy.

• Authors: C Wendy Spearman, Mary Afihene, Reidwaan Ally, Betty Apica, Yaw Awuku, Lina Cunha, Geoffrey Dusheiko, Neliswa Gogela, Chris Kassianides, Michael Kew, Philip Lam, Olufunmilayo Lesi, Marie-Jeanne Lohouès-Kouacou, Papa Saliou Mbaye, Emmanuel Musabeyezu, Betty Musau, Olusegun Ojo, John Rwegasha, Barbara Scholz, Abate B Shewaye, Christian Tzeuton, Mark W Sonderup, Gastroenterology and Hepatology Association of sub-Saharan Africa (GHASSA)
• Journal: The lancet. Gastroenterology & hepatology (Lancet Gastroenterol Hepatol) Vol. 2 Issue 12 Pg. 900-909 (12 2017) ISSN: 2468-1253 [Electronic] Netherlands
• PMID: 29132759 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
• Copyright: Copyright © 2017 Elsevier Ltd. All rights reserved.

Chemical References

• Antiviral Agents
• Hepatitis B Surface Antigens

Topics

• Africa South of the Sahara (epidemiology)
• Antiviral Agents (therapeutic use)
• Coinfection
• HIV Infections (epidemiology)
• Health Services Accessibility
• Hepatitis B (diagnosis, epidemiology, prevention & control, transmission)
• Hepatitis B Surface Antigens (blood)
• Humans
• Infectious Disease Transmission, Vertical
• Mass Screening
• Mass Vaccination
• Prevalence