Review

. 2023 Sep 1;78(3):976-990.

doi: 10.1097/HEP.0000000000000430. Epub 2023 May 1.

Pathway to global elimination of hepatitis B: HBV cure is just the first step

Jessica Howell^{1

2

3

4}, Chris Seaman^{1

4}, Jack Wallace¹, Yinzong Xiao¹, Nick Scott¹, Jane Davies⁵, Teresa de Santis⁵, Danjuma Adda⁶, Manal El-Sayed⁷, Jordan J Feld⁸, Edward Gane⁹, Karine Lacombe¹⁰, Olufunmilayo Lesi¹¹, Rosmawati Mohamed¹², Marcelo Silva¹³, Thomas Tu^{14

15}, Peter Revill¹⁶, Margaret E Hellard^{1

4

17

18}

Affiliations

¹ Disease Elimination, Burnet Institute, Melbourne, Victoria, Australia.
² Department Gastroenterology, St Vincent's Hospital, Melbourne, Victoria, Australia.
³ Department Medicine, University of Melbourne, Melbourne, Victoria, Australia.
⁴ Department Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
⁵ Department Global Health and Infectious diseases, Menzies School of Public Health, Darwin, Northern Territory, Australia.
⁶ World Hepatitis Alliance, Geneva, Switzerland.
⁷ Department Paediatrics, Ain Shams University, Cairo, Egypt.
⁸ Toronto Centre for Liver Disease, University Health Network, University of Toronto, Toronto, Ontario, Canada.
⁹ Department Medicine, University of Auckland, Auckland, New Zealand.
¹⁰ Sorbonne Université, IPLESP, Saint-Antoine Hospital, AP-HP, Paris, France.
¹¹ Global HIV, Hepatitis, and STI Programme, World Health Organisation, Geneva, Switzerland.
¹² Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
¹³ Department Hepatology and Liver Transplantation, Austral University Hospital, Buenos Aires, Argentina.
¹⁴ Storr Liver Centre, The Westmead Institute for Medical Research, The University of Sydney and Westmead Hospital, Sydney, New South Wales, Australia.
¹⁵ University of Sydney Institute for Infectious Diseases, University of Sydney, Sydney, New South Wales, Australia.
¹⁶ Victorian Infectious Diseases Reference Laboratory (VIDRL), Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.
¹⁷ Department Infectious Diseases, Alfred Hospital, Melbourne, Victoria, Australia.
¹⁸ Department Infectious Diseases, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.

PMID: 37125643
PMCID: PMC10442143
DOI: 10.1097/HEP.0000000000000430

Review

Pathway to global elimination of hepatitis B: HBV cure is just the first step

Jessica Howell et al. Hepatology. 2023.

. 2023 Sep 1;78(3):976-990.

doi: 10.1097/HEP.0000000000000430. Epub 2023 May 1.

Authors

Affiliations

¹ Disease Elimination, Burnet Institute, Melbourne, Victoria, Australia.
² Department Gastroenterology, St Vincent's Hospital, Melbourne, Victoria, Australia.
³ Department Medicine, University of Melbourne, Melbourne, Victoria, Australia.
⁴ Department Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
⁵ Department Global Health and Infectious diseases, Menzies School of Public Health, Darwin, Northern Territory, Australia.
⁶ World Hepatitis Alliance, Geneva, Switzerland.
⁷ Department Paediatrics, Ain Shams University, Cairo, Egypt.
⁸ Toronto Centre for Liver Disease, University Health Network, University of Toronto, Toronto, Ontario, Canada.
⁹ Department Medicine, University of Auckland, Auckland, New Zealand.
¹⁰ Sorbonne Université, IPLESP, Saint-Antoine Hospital, AP-HP, Paris, France.
¹¹ Global HIV, Hepatitis, and STI Programme, World Health Organisation, Geneva, Switzerland.
¹² Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
¹³ Department Hepatology and Liver Transplantation, Austral University Hospital, Buenos Aires, Argentina.
¹⁴ Storr Liver Centre, The Westmead Institute for Medical Research, The University of Sydney and Westmead Hospital, Sydney, New South Wales, Australia.
¹⁵ University of Sydney Institute for Infectious Diseases, University of Sydney, Sydney, New South Wales, Australia.
¹⁶ Victorian Infectious Diseases Reference Laboratory (VIDRL), Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.
¹⁷ Department Infectious Diseases, Alfred Hospital, Melbourne, Victoria, Australia.
¹⁸ Department Infectious Diseases, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.

PMID: 37125643
PMCID: PMC10442143
DOI: 10.1097/HEP.0000000000000430

Abstract

Hepatitis B (HBV) is a major cause of global morbidity and mortality, and the leading cause of liver cancer worldwide. Significant advances have recently been made toward the development of a finite HBV treatment that achieves permanent loss of HBsAg and HBV DNA (so-called "HBV cure"), which could provide the means to eliminate HBV as a public health threat. However, the HBV cure is just one step toward achieving WHO HBV elimination targets by 2030, and much work must be done now to prepare for the successful implementation of the HBV cure. In this review, we describe the required steps to rapidly scale-up future HBV cure equitably. We present key actions required for successful HBV cure implementation, integrated within the World Health Organization (WHO) Global Health Sector Strategy (GHSS) 2022-2030 framework. Finally, we highlight what can be done now to progress toward the 2030 HBV elimination targets using available tools to ensure that we are preparing, but not waiting, for the cure.

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Conflict of interest statement

Jessica Howell received grants from Gilead and Eisai. Danjuma Adda received grants from Pfizer, Viatris, and Gilead. Jordan J. Feld consults for and received grants from Enanta, GSK, Janssen, Gilead, Vir, and Roche. He consults for Bluejay. He received grants from Eiger. Edward J. Gane advises Gilead, AbbVie, and Aligos. Karine Lacombe consults for and received grants from Gilead. Margaret E. Hellard received grants from Gilead and AbbVie. The remaining authors have no conflicts to report.

Figures

**FIGURE 1**
SDs framework for hepatitis B elimination. Abbreviation: SD, Strategic Direction.

**FIGURE 2**
Summary of key actions to achieve hepatitis B elimination and impact on the hepatitis B cascade of care.

See this image and copyright information in PMC

References

1. Polaris Observatory Collaborators. Global prevalence, treatment, and prevention of hepatitis B virus infection in 2016: a modelling study. Lancet Gastroenterol Hepatol. 2018;3:383–403. - PubMed
1. World Health Organisation. Global Hepatitis Report 2017; 2017. Accessed December 22, 2022. http://appswhoint/iris/bitstream/handle/10665/255016/9789241565455-engpd....
1. World Health Organisation. Progress Report on HIV, Viral Hepatitis and Sexually Transmitted Infections, 2019 Accountability for the Global Helath Sector Strategies, 2016-2021. World Health Organisation. 2019.
1. World Health Organisation. Global health sector strategy on viral hepatitis 2016-2021; 2016. Accessed December 22, 2022. http://wwwwhoint/hepatitis/strategy2016-2021/ghss-hep/en/.
1. Wong GLH, Gane E, Lok ASF. How to achieve functional cure of HBV: Stopping NUCs, adding interferon or new drug development? J Hepatol. 2022;76:1249–1262. - PubMed

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Pathway to global elimination of hepatitis B: HBV cure is just the first step

Affiliations

Pathway to global elimination of hepatitis B: HBV cure is just the first step

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

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Substances

Grants and funding

LinkOut - more resources

Full Text Sources

Medical