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April 2018

Hepatitis B under-diagnosed and undertreated in UK

Four out of five people in the UK with hepatitis B (HBV) are unaware of their infection, and three quarters of eligible patients are not receiving treatment, according to a new worldwide study of the epidemiology of the disease.

The research, published in The Lancet Gastroenterology & Hepatology, provides the most detailed analysis of national, regional, and global prevalence of HBV infection around the world to date.

Around 300 million people in 2016 were living with hepatitis B virus (HBV) worldwide, yet just 1 in 20 (5%) eligible patients are getting treatment. Moreover, less than 1% of HBV-infected expectant mothers, who are at high risk of passing the virus on to their children and are the main source of the ongoing epidemic, are receiving the appropriate treatment.

If left untreated, HBV can cause a host of serious, long-term health problems including liver disease, and liver cancer. An estimated 600,000 people die every year from hepatitis-B-related liver disease. The virus is highly contagious and is mainly transmitted from infected mothers to their babies, or between children. Although there is no cure, antiviral drugs and prophylaxis to minimise mother-to-child transmission make elimination of HBV feasible. A highly effective vaccine against HBV became available in 1981, and since 1992, WHO has recommended that all newborns receive their first dose within 24 hours of birth. In 2017, the UK and Norway became two of the last countries in Europe to offer the vaccine to newborns. Babies born to HBV-infected mothers should also be given protective antibodies known as hepatitis B immunoglobulin (HBIG).

Less than half of babies are getting their first vaccination within 24 hours of birth, and only 1 in 10 babies born to HBV-infected mothers are receiving HBIG alongside the full vaccination schedule.

‘Most mother-to-child transmission occurs within days of birth, so the birth dose is vital’, explains primary investigator Dr Homie Razavi from the Center for Disease Analysis Foundation, Lafayette, USA. ‘All children need to receive this life-saving vaccine at birth, not just half of them.’

HBV is most common in east Asia and sub-Saharan Africa, but 0.7% of the UK population is infected with the virus. Only a quarter (27,900) of people in the UK who were eligible for treatment were receiving it.

Lancet Gastroenterol Hepatol 26 March 2018.

April 2018