Prevention, testing and treatment of viral hepatitis
A guide for medical professionals
Control of viral hepatitis may be achieved through:
Prevention
- Vaccination against hepatitis B virus;
- Prevention of perinatal and early childhood hepatitis B infection through infant vaccination, including universal immunisation programmes targeting infants;
- Catch-up vaccination and other prevention strategies in key affected populations, including persons who inject drugs (PWID), men who have sex with men (MSM), and sex workers
- Prevention of viral hepatitis transmission in healthcare settings through blood and injection safety;
- Harm reduction services such as syringe and needle distribution to PWID and substitution treatment of drug addiction.
Testing
- Greater access to affordable viral hepatitis tests that have been approved by WHO;
- Screening programmes targeting persons from populations with high seroprevalence or who have a history of risk exposure / behaviour (e.g. HIV-positive persons, PWID, MSM, sex workers, disproportionally affected birth cohorts, as well as other groups such as indigenous peoples, persons who are incarcerated, and persons of transgender);
- The use of simple, non-invasive diagnostic tests to assess the stage of liver disease and eligibility for treatment;
- Linkage-to-care of all persons that tested positive
Treatment
- The use of antiviral agents for hepatitis B to suppress viral replication, prevent progression to cirrhosis, and reduce the risk of hepatocellular carcinoma (HCC) and liver-related deaths; preferentially using nucleos(t)ide analogues with a high barrier to drug resistance as first-line treatment according to the international clinical guidelines.
- The use of direct-acting antivirals (DAAs) for hepatitis C virus treatment, which offer cure rates above 90% and a more tolerable treatment journey (oral administration, shorter treatment duration, and fewer serious adverse events than the previous interferon containing regimens) according to the international guidelines.
- Improved access to treatment through the availability of generics and licensing agreements in accordance with national policies;
- Assessing all adults with chronic hepatitis C infection for antiviral treatment, including PWID;
- Improving care of those with viral hepatitis, specifically:
- Regular monitoring for disease progression and early detection of HCC
- Improving retention in care and adherence to antiviral therapy
- Offering alcohol reduction/cessation interventions to reduce progression of liver disease
Through such interventions, WHO’s Global Health Sector Strategy targets for 2030 can
be achieved.
