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. 2023 Feb 9:12:e81070.
doi: 10.7554/eLife.81070.

The forgotten people: Hepatitis B virus (HBV) infection as a priority for the inclusion health agenda

Emily Martyn  1   2   3 , Sarah Eisen  3 , Nicky Longley  2   3   4 , Philippa Harris  5 , Julian Surey  5   6   7 , James Norman  5 , Michael Brown  2   4   5 , Binta Sultan  5   8 , Tongai G Maponga  9 , Collins Iwuji  10   11 , Stuart Flanagan  8 , Indrajit Ghosh  5   8 , Alistair Story #  5   12 , Philippa C Matthews #  1   4   8   13
Affiliations

The forgotten people: Hepatitis B virus (HBV) infection as a priority for the inclusion health agenda

Emily Martyn et al. Elife. .

Abstract

Hepatitis B virus (HBV) infection represents a significant global health threat, accounting for 300 million chronic infections and up to 1 million deaths each year. HBV disproportionately affects people who are under-served by health systems due to social exclusion, and can further amplify inequities through its impact on physical and mental health, relationship with stigma and discrimination, and economic costs. The 'inclusion health' agenda focuses on excluded and vulnerable populations, who often experience barriers to accessing healthcare, and are under-represented by research, resources, interventions, advocacy, and policy. In this article, we assimilate evidence to establish HBV on the inclusion health agenda, and consider how this view can inform provision of better approaches to diagnosis, treatment, and prevention. We suggest approaches to redress the unmet need for HBV interventions among excluded populations as an imperative to progress the global goal for the elimination of viral hepatitis as a public health threat.

Keywords: elimination; epidemiology; global health; health inequality; hepatitis b virus; homelessness; inclusion health; infectious disease; microbiology; public health; refugee health; sustainable development goals.

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Conflict of interest statement

EM, SE, NL, PH, JS, JN, BS, TM, IG, AS No competing interests declared, MB MB has led local research studies funded by Gilead (an HIV testing study in 2009 or so, and COVID trials 2020-22) and has provided (unfunded) consultancy to Gilead wrt COVID therapeutics, CI CI has received support for conference attendance and research grant paid to his institution from Gilead Sciences Ltd, SF SF has received travel and conference bursaries from AbbVie, Gilead, Bristol-Myers-Squibb, IMS Health, PM PCM holds a Wellcome Fellowship and NIHR funding, and receives funding to her research team from GSK

Figures

Figure 1.
Figure 1.. Characteristics of HBV in inclusion health populations.
(A) Illustration of the overlapping characteristics that may be present among different inclusion populations and people living with HBV infection. (B) Relationship between migrancy and asylum-seeking status as a risk factor for HBV infection. (C) Representation of complex relationship between HBV infection and PEH, where other factors include for example injecting drug use, transactional sex, mental illness (Freeland et al., 2021; Ly et al., 2021a). HBV – hepatitis B virus; PEH - People experiencing homelessness. Figure created in BioRender.com with a licence to publish.
Figure 2.
Figure 2.. Solutions for service development to overcome barriers for people living with hepatitis B virus (HBV) infection in inclusion health populations, applying framework suggested by Charania et al., 2020.
Figure created in BioRender.com with a licence to publish.
See this image and copyright information in PMC

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