Viral hepatitis

In the WHO European Region, an estimated 15 million people are living with chronic hepatitis B infection and an estimated 14 million people with hepatitis C infection. Because the disease is often asymptomatic and left untreated, chronic hepatitis is a major cause of liver cirrhosis and primary liver cancer in people infected. Hepatitis B and C virus (HBV and HCV) are transmitted through contact with blood, semen or other body fluids of an infected person.

Hepatitis B causes an estimated 56 000 deaths every year in the WHO European Region [1]. Most of the people living with HBV in the Region are adults born before the hepatitis B vaccine became available in the 1990s. By 2019, 49 of the 53 countries in the WHO European Region will have implemented universal childhood hepatitis B vaccination [1]. Infection at birth or early childhood often results in chronic infection. Chronic HBV infection can be treated and usually requires life-long treatment. Treatment coverage data are not available for the WHO European Region.

Hepatitis C infection can be acute or chronic. Chronic hepatitis C can lead to serious complications such as cirrhosis, liver cancer and death. About 15 – 45% of infected people spontaneously clear the virus within six months of infection without treatment; the remaining 55 – 85% will develop chronic infection. An estimated 112 500 people die from hepatitis C-related liver disease each year in the WHO European Region [2]. Prevalence of HCV in the general population is lower than 0.5% in most western, northern and central European countries [3] and as high as 3 – 6% in many countries of eastern Europe and central Asia [2]. People who inject drugs are particularly vulnerable to hepatitis C, and co-infection with both viral hepatitis and HIV is common. There is no vaccine against HCV and prevention is based on reducing exposure to the virus in health care settings and in high-risk populations, such as people who inject drugs. Direct-acting antiviral (DAA) medicines can cure more than 95% of people with hepatitis C infection and can reduce the risk of complications and death, however, availability and coverage with DAA remains very low in the eastern part of the WHO European Region.

References:

1. WHO Regional Office for Europe. Fact sheet on Hepatitis B in the WHO European Region.
2. WHO Regional Office for Europe. Fact sheet on Hepatitis C in the WHO European Region.
3. European Centre for Disease Prevention and Control. Systematic review on hepatitis B and C prevalence in the EU/EEA. Stockholm: ECDC; 2016.