WHO: Despite advances in care, deaths from hepatitis increasing
Deaths rose from 1.1 million in 2019 to 1.3 million in 2022
Technologies to prevent, detect, and treat viral hepatitis have advanced considerably in recent decades, but the number of people dying from these infections continues to rise each year.
These are the conclusions of the 2024 Global Hepatitis Report from the World Health Organization (WHO) that was based on information from 187 countries.
According to the report, the estimated number of deaths attributed to viral hepatitis increased from 1.1 million in 2019 to 1.3 million in 2022. This was also the number of deaths caused by tuberculosis in 2022, making viral hepatitis and tuberculosis “the second leading causes of death among [transmissible] diseases in 2022, after COVID-19,” the report states.
“This report paints a troubling picture: despite progress globally in preventing hepatitis infections, deaths are rising because far too few people with hepatitis are being diagnosed and treated,” Tedros Adhanom Ghebreyesus, PhD, director-general of the WHO, said in an organization press release.
Viral hepatitis refers to liver inflammation, or hepatitis, caused by specific viruses that mainly affect the liver. To identify the various types of viral hepatitis, the viruses are named with letters of the alphabet, with hepatitis B and C being the most common.
Hepatitis B and C are transmitted via contact with bodily fluids, and they both can cause chronic, long-lasting infections that set the stage for liver scarring, or cirrhosis, which can cause the liver to fail and increase the risk of liver cancer.
‘Swift action’ needed
According to WHO, hepatitis B accounted for 83% of viral hepatitis deaths in 2022. The remaining 17% were attributed to hepatitis C and both together accounted for 3,500 deaths a day.
According to WHO’s updated estimates, as of 2022, 254 million people worldwide had hepatitis B, and 50 million had hepatitis C. About half of these infections were in adults ages 30-54, though more than one in 10 were in children under 18. Men accounted for 58% of all viral hepatitis cases in 2022.
That year, the incidence of viral hepatitis — that is, the number of new infections — was 2.2 million (1.2 million for hepatitis B, 1 million for hepatitis C). That’s down slightly from 2019, when there were 2.5 million new infections, but it still works out to an average of more than 6,000 new infections every day.
According to WHO, the decrease in incidence is largely attributable to better treatment, including more widespread access to preventive vaccines for hepatitis B and antiviral medications for hepatitis C, as well as safe injection programs and similar efforts to help minimize the risk of exposure to hepatitis viruses.
The U.S. Centers for Disease Control and Prevention (CDC) also reported a decrease in the number of new hepatitis C infections in the U.S. in 2022, providing cautious optimism that preventive efforts are having an effect.
WHO estimates that only 13% of people with chronic hepatitis B were diagnosed in 2022, and only 3% were given antiviral treatment. For hepatitis C, only 36% were diagnosed and just 20% treated. These rates are slightly improved over 2019, but still fall well short of WHO’s goal of providing treatment to at least 80% of chronic hepatitis B and C patients by 2030.
“Reaching the WHO elimination goal by 2030 should still be achievable, if swift actions are taken now,” the release stated.
To achieve that goal, access to treatments and diagnostics must be expanded, especially in parts of the world where viral hepatitis is most common.
Nearly two-thirds of new hepatitis B infections in 2022 occurred in Africa, but fewer than one in five babies there are vaccinated shortly after birth as recommended by WHO for all newborns.
Disparities in pricing remain a barrier for patients in many countries, according to WHO. For example, the hepatitis B treatment tenofovir disoproxil fumarate is available in generic forms at a global benchmark price of just $2.40 per month, but less than a third of reporting countries could actually access the medicine at that price. Similar disparities were seen for hepatitis C treatments.
The price of diagnostics can also be a barrier as only 60% of countries assessed provide any public support to help cover the cost of testing.
WHO is calling for international policy efforts to improve access to hepatitis diagnostics and treatments, with the goal being to curb deaths from the disease.
“WHO is committed to supporting countries to use all the tools at their disposal — at access prices — to save lives and turn this trend around,” Ghebreyesus said.
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