The global impact of the COVID-19 pandemic on the prevention, diagnosis and treatment of hepatitis B virus (HBV) infection

Abstract

The COVID-19 pandemic caused by the SARS-CoV-2 virus has resulted in a myriad of interventions with the urgent aim of reducing the public health impact of this virus. However, a wealth of evidence both from high-income and low-income countries is accruing on the broader consequences of such interventions on economic and public health inequalities, as well as on pre-existing programmes targeting endemic pathogens. We provide an overview of the impact of the ongoing COVID-19 pandemic on hepatitis B virus (HBV) programmes globally, focusing on the possible consequences for prevention, diagnosis and treatment. Ongoing disruptions to infrastructure, supply chains, services and interventions for HBV are likely to contribute disproportionately to the short-term incidence of chronic hepatitis B, providing a long-term source of onward transmission to future generations that threatens progress towards the 2030 elimination goals.

Keywords: SARS; prevention strategies; public health; viral hepatitis.

Figure 1

Hepatitis B vaccination coverage annotated to show correlation with societal disruption. Panels show the temporal correlation of drops in vaccination coverage with national crises (white line), such as the transfer of presidential duties in Cuba (2006–2008), the civil war in Libya (2014–present), a period of social unrest in Georgia (2009), a recent Ivorian political crisis (2010–2011), the civil war in Syria (2011–present) and the period of military-enforced political reforms in Myanmar (2011–2015). Data source: WHO/UNICEF (apps.who.int/immunization_monitoring/globalsummary).

Figure 2

Top panel: summary of the possible impact of the COVID-19 pandemic on HBV vaccination, transmission, diagnosis and treatment. Overarching factors, including the availability of funding and the ability to conduct advocacy, research, health education and community engagement, affect all levels of HBV control. Bottom panel: table of recommendations for policymakers and for further research to better understand and mitigate the impact of COVID-19 on HBV prevention, diagnosis and treatment. HBV, hepatitis B virus.