Notable Achievements in Hepatitis Elimination during 2020
Michael Houghton, Harvey Alter, and Charles Rice are awarded the Nobel Prize in Physiology or Medicine for their discovery of the hepatitis C virus.
The global achievement of the UN Sustainable Development Goal of Hepatitis B prevalence declining to < 1% among children < 5 years of age -The only SDG target achieved.
WHO releases new guidelines on antiviral prophylaxis in pregnancy for prevention of hepatitis B.
Rwanda, with the support of the First Lady, moved up their HCV elimination goal from within 5 years to 2 years. The program with goals for HCV elimination by 2024 screened over 4.1 M persons, 58% of the target population, and placed 94% of 41,620 HCV infected persons on treatment at a cost of $91 USD.
South Sudan launched a 4-year national strategic plan to combat viral hepatitis: https://mailchi.mp/taskforce.org/cghe-world-hepatitis-day-12966742?fbclid=IwAR1N9sfSKjq_Niw4U6VER6IbOejP13T0StibgQZPwk6itHsQFMX7F5B13BA
In 2020, the newly launched Mexico HCV elimination program increased HCV testing by six fold and treated over 8,000 persons for HCV infection exceeding the total number of persons treated for HCV in all prior years, nationally.
The United States expanded HCV testing to include all adults > 18 years of age including pregnant women, and renewed support for HBV testing for all adolescent and adults at risk for HBV infection
In JAMA Network open, Dr. Jorge Mera and colleagues reported that the Cherokee Nation HCV elimination program, in less than 2 years, screened 41% of target population, linked 84% of HCV infected persons to care and successfully cured 85% of infection.
In the New England Journal of Medicine, Dr. Imam Waked and colleagues reported on Egypt’s remarkable achievements in hepatitis C elimination - a total 49.6 million (79%) of a 62.5 M screened for HCV, 92% of the ~ 1. 15M with current HCV infection started on treatment and 98% cured of HCV at a cost of $131 for identifying and curing a patient of HCV.
Hepatitis Free Pakistan campaign announced free testing and free medicines to 1 million people by 2021.
ECDC published the first report monitoring progress towards the elimination of hepatitis B and C in the EU/EEA
The United Kingdom exceeded by two fold the 2020 interim target of > 10% decline in HCV related mortality by 2020.
In India, the pilot HCV elimination program had screened over 163,00 persons, and placed over 85,000 on treatment with a cure rate of 93%; the government of India announced providing HCV treatment at no charge in Uttar Pradesh a state with 200 million population as continued scale-up toward national hepatitis elimination.
In Thailand, HCV RNA testing and HCV treatment were made available at no-charge to patients and a sub-national HCV elimination program was started in Phetchabun province.
Nine countries in the region achieved ≥90% HepB3 coverage, and three of the eight countries that provide HepB-BD achieved ≥90% HepB-BD coverage. Four countries had been verified to have achieved the hepatitis B control goal.
New Zealand continues to make progress towards HCV elimination with steady treatment uptake.
New elimination project initiated by Hazel Heal in New Zealand will put the Pacific nation of Niue, a total population of 1,200, on the map to be one of the first countries to reach HCV elimination.
Simplification of HCV care and treatment
Multiples studies revealed new strategies to simplify HCV care and treatment
- In Myanmar, a community-based point-of-care HCV testing and treatment delivered by initiated by general practitioners achieved an HCV cure rate of 93%.
- In the US, providing HCV treatment to persons who inject drugs via a patient navigation or directly observed therapy approach achieved a 90% cure of HCV infection.
- In Cambodia, a simplified care model implemented by MSF was found to be cost saving compared to no treatment.
- In four countries, providing one bottle of 84 tablets to complete a 12 week regimen of one tablet/ day of HCV treatment with no laboratory testing during treatment achieved an HCV cure rate of 95%.
Despite progress in scaling up prevention, testing, and treatment, liver cancer continues to rise globally. In the United States, a report from the American Cancer Society showed that from 2006-2017 liver cancer mortality increased the most rapidly of any cancer, by 2-3% annually.
As a result of the response to the COVID-19 pandemic, multiple reports put attention on the declines in hepatitis vaccination, testing and treatment as well as and opportunities, through simplified clinical care and better diagnostic testing access to improve clinical care for hepatitis in the future.
These reports and articles included the following:
- The first drug to treat hepatitis D virus infection, bulevirtide (Hepcludex) was approved by the European Commission.
- FDA approved Epclusa for pediatric patients for all HCV genotypes.
- CHAI releases first-ever Hepatitis C Market Report revealing costs of HCV diagnostics and treatments.