Expansion of Access to HBV Treatment

Abstract

Chronic hepatitis B is a substantial burden on health care systems. It will remain a cause of substantial morbidity and mortality for several decades, despite effective vaccination programs. Barriers to expanding therapy for hepatitis B in resource-limited settings include a limited understanding of the prevalence of the disease and its distribution, limited data on treatment efficacy in low income countries, and limited infrastructural resources to perform appropriate diagnostic and monitoring assays. Surveillance for hepatitis B virus (HBV) varies widely in its methods and completeness. Antiviral treatments for hepatitis B have reduced in costs and have become affordable through generic production and subsidies. Antiviral therapy can be targeted to the active phases of CHB when the risk of disease progression is higher. Effective treatments for hepatitis B exist, but a delivery gap exits. As with HIV—AIDS, partners are required to assist countries to implement operational plans to define their hepatitis B treatment programs. There has to be a fundamental acceptance that viral hepatitis, which can be treated, leads to high numbers of deaths annually—despite the advent of HBV vaccination and effective treatments.