Abstract
In 2016 the World Health Organization set the goal of eliminating hepatitis B globally by 2030. Horizontal transmission has been greatly reduced in most countries by scaling up coverage of the infant HBV vaccine series, and vertical transmission is therefore becoming increasingly dominant. Here we show that scaling up timely hepatitis B birth dose vaccination to 90% of new-borns in 110 low- and middle-income countries by 2030 could prevent 710,000 (580,000 to 890,000) deaths in the 2020 to 2030 birth cohorts compared to status quo, with the greatest benefits in Africa. Maintaining this could lead to elimination by 2030 in the Americas, but not before 2059 in Africa. Drops in coverage due to disruptions in 2020 may lead to 15,000 additional deaths, mostly in South-East Asia and the Western Pacific. Delays in planned scale-up could lead to an additional 580,000 deaths globally in the 2020 to 2030 birth cohorts.
Highlights
We show that scaling up timely HepB-BD vaccination coverage to 90% by 2030 results in immediate reductions in incident chronic hepatitis B virus (HBV) cases and HBV surface antigen (HBsAg) prevalence in fiveyear-olds, but delayed reductions in HBV-related deaths and disability adjusted life years (DALYs)
Each country model was calibrated to data (Supplementary Table 1) on HBsAg and HBV e antigen (HBeAg) seroprevalence, HBV-related deaths due to cirrhosis and hepatocellular carcinoma (HCC), and national data on coverage of vaccinations and treatment (Fig. 1a–d)
We apply a set of scenarios for the future coverage of the timely HepB-BD in each country (Table 1) and quantify impact with reference to the infections and deaths that would occur in a scenario in which the coverage of timely HepB-BD
Summary
Horizontal transmission has been greatly reduced in most countries by scaling up coverage of the infant HBV vaccine series, and vertical transmission is becoming increasingly dominant. 710,000 (580,000 to 890,000) deaths in the 2020 to 2030 birth cohorts compared to status quo, with the greatest benefits in Africa. Maintaining this could lead to elimination by in the Americas, but not before 2059 in Africa. Drops in coverage due to disruptions in may lead to 15,000 additional deaths, mostly in South-East Asia and the Western. Delays in planned scale-up could lead to an additional 580,000 deaths globally in the to 2030 birth cohorts.
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