World Hepatitis Day is recognized annually on July 28 to expand education initiatives among healthcare providers and patients about the significance of implementing patient-centered approaches to prevent hepatitis virus infections. The theme for 2024 is “It’s Time for Action,” with the goal of spreading awareness about better prevention, diagnosis, and treatment to save more lives and improve clinical outcomes.

Viral hepatitis is a global health issue that contributes to varying degrees of liver inflammation, resulting in acute or chronic infections. While the majority of acute viral hepatitis infections resolve spontaneously, some cases progress to chronic hepatitis, leading to further complications, including cirrhosis and liver failure. Viral hepatitis is also recognized as one of the leading causes of hepatocellular carcinoma and contributes to significant rates of premature mortality. According to the World Hepatitis Alliance, hepatitis is now the deadliest virus after COVID-19, and over 2 million new cases of hepatitis occur annually.

Despite safe and effective vaccines, prevention strategies, and medications, mortalities related to hepatitis and its complications continue to increase in various parts of the world. The CDC, the World Health Organization (WHO), and other healthcare organizations across the United States and globally continue implementing collaborative efforts with the goals of eliminating viral hepatitis and expanding awareness, screening, modes of transmission, the efficacy and safety of preventative strategies such as vaccination, and current treatment options.

A study conducted by WHO discovered that with vaccination, diagnostic tests, medicines, and education campaigns, an estimated 4.5 million premature mortalities in low- and middle-income countries could be prevented by 2030. WHO’s global hepatitis strategy, supported by all WHO member states, aims to diminish new cases of hepatitis infections by 90% and reduce mortalities by 65% between 2016 and 2030.

Globally, there are five primary hepatotropic viruses: A, B, C, D, and E.  According to the National Foundation for Infectious Diseases, the most common types of viral hepatitis in U.S. are hepatitis A (HAV), hepatitis B (HBV), and hepatitis C (HCV). The CDC notes that in the U.S., HBV and HCV are the most common strains, accounting for over 90% of hepatitis-related mortalities. HAV is usually a short-term infection and does not develop into a chronic infection. HBV and HCV can begin as short-term, acute infections but also have the potential to lead to chronic disease, long-term liver issues, and death.

Although each virus may cause comparable symptoms, the viruses have different modes of transmission and can affect the liver to varying degrees. For example, HAV is typically transmitted via contaminated food and water, while examples of HBV transmission include direct contact with infected body fluids or sharing personal items from infected individuals or contaminated needles. Transmission of HCV can be via infected blood, direct contact with infected body fluids, and contaminated or unsterile needles. Some individuals infected with viral hepatitis may remain asymptomatic, especially during the early stages of the disease. Moreover, while viral hepatitis can affect anyone, certain patient populations appear to be at greater risk for each type.

Viral hepatitis affects more than 350 million individuals worldwide and leads to more than 1 million mortalities annually, and even more alarmingly, nine in every 10 individuals are unaware that they are infected with viral hepatitis. According to a report released by the WHO in April 2024, across the globe, the number of mortalities related to viral hepatitis infections continues to increase and accounts for 3,550 mortalities per day and more than 6,000 individuals are newly infected with viral hepatitis each day. Most recent WHO statistics indicate that during 2022:

• 1.2 million individuals were newly infected with HBV
• 1 million individuals were newly infected with HCV
• About 254 million individuals have chronic HBV
• An estimated 50 million individuals have chronic HCV
• An estimated 1.3 million deaths occur annually due to hepatic disease and cancer related to chronic HBV and chronic HCV.

The Hepatitis B Foundation indicates that in the U.S., up to 2.4 million individuals have chronic infections, and acute HBV infections have increased 50% to 450% depending on the state, especially due to the ongoing opioid crisis. Additionally, only 25% of infected individuals are diagnosed, highlighting the need to expand awareness of the importance of screening and preventive measures such as vaccination. According to the American Liver Foundation, an estimated 2.7 to 3.9 million individuals in the U.S. have chronic hepatitis C, and there are nearly 17,000 new hepatitis C cases annually. Furthermore, as many as 75% of those with chronic HCV infection in the U.S. are unaware that they are infected with the virus.

Fortunately, safe and effective vaccines are available for the prevention of HAV and HBV, and FDA-approved antivirals are available for treating chronic HBV, but no cure exists, so vaccination against HBV is the optimal approach to prevent HBV infections. An abundance of research has established that vaccinations are the optimal means of preventing HAV and HBV. Although no vaccine is available for HCV, highly effective, well-tolerated curative therapies are available for chronic infections, which is why testing, early diagnosis, and clinical intervention are crucial.

Treating viral hepatitis infections such as hepatitis B can slow the progression of cirrhosis, reduce the incidence of hepatocellular cancer, and improve long-term survival; however, vaccination against HBV is the optimal means of prevention. HBV vaccines are available for all age groups. To further decrease the incidence of HBV, the CDC published the 2022 universal HBV adult vaccination recommendation, calling for all individuals aged 19 to 59 years to receive the HBV vaccine, whether they have risk factors or not. In addition, the CDC updated HBV screening recommendations, advising HBV screening for all adults at least once in their lifetime.

Health experts indicate that augmenting rates of vaccination is critical to reducing the health and economic burdens associated with viral hepatitis; however, the rates of vaccination remain low, highlighting the need to expand awareness about the benefits of vaccination. According to the most recent statistics from the CDC, for adults aged older than 19 years, HAV vaccination coverage was greater in 2021 than in 2018 overall (24.8%). It was even higher among travelers (33.8%) compared to nontravelers (19.3%). HBV vaccination coverage in 2021 was 34.2% among adults aged older than 19 years overall and 43.1% among travelers, lower than estimates for 2018.

Barriers that contribute to the low rates of vaccination for HAV and HBV include lack of awareness of the availability of vaccines, lack of recommendations from primary healthcare providers, perceived low risk for infection, myths and misconceptions about efficacy and safety of vaccines, access barriers such as limited or no access to healthcare services, lack of insurance, or financial constraints.

More information about World Hepatitis Day can be found here.

The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.