Viral hepatitis is largely asymptomatic. It is estimated that just under 10 million Europeans from European
Union and European Economic Area (EU/EEA) countries are infected with
chronic hepatitis B and C infection.
In 2016, a regional action plan for Europe contributing to the
implementation of the global viral hepatitis elimination strategy was
developed by the WHO Regional Office for Europe.
‘A closer look at where Europe stands in the elimination of hepatitis B and C has been provided by an article published in Eurosurveillance.’
In an article published in Eurosurveillance
, the authors take a closer look at how
Europe is doing according to the ten indicators and targets outlined in
this plan. In short: Europe still has some way to go if it wants to
eliminate viral hepatitis by 2030.
In light of this, the regional
WHO action plan from 2016 can be an important driver to help European countries in their fight against the hepatitis B and C epidemics.
The authors of the article "Towards
elimination of hepatitis B and C in European Union and European
Economic Area countries: monitoring the World Health Organization's
global health sector strategy core indicators and scaling up key
interventions" agree that "European countries have already made
progress in recent years implementing primary and secondary prevention
measures. Indeed, measures aimed at reducing injecting-drug-related harm
among people who inject drugs, such as OST (opioid substitution
treatment) and NSP (needle and syringe programs), now reach many of
those who need them [such as people who inject drugs, migrants or men
who have sex with men] and most countries have in place a hepatitis B
vaccination program with high levels of coverage (95%). These measures
have had an impact on the epidemiology of hepatitis B and C." This
impact mainly affects the incidence of new infections argues the
But only if those that are already infected with viral hepatitis are
identified and linked to treatment and care will a drop in mortality
also be possible - at a time when an estimated 96,000 Europeans die from
hepatitis-related liver disease each year.
Learning from HIV continuum of care?
However, the authors from ECDC, the European Center for Drugs and
Drug Addiction (EMCDDA) and the WHO Regional Office for Europe found in
their analysis of the epidemiological and programmatic indicators of
the action plan "that current data sources in most EU/EEA countries are
insufficient, particularly for assessing the epidemiological burden and
for monitoring the different steps along the cascade of care". Which
hampers the successful monitoring of Europe's progress toward
elimination of viral hepatitis.
ECDC has been working with the EU/EEA countries to improve the
quality of the epidemiological data to get a clearer picture of the
burden of viral hepatitis across Europe. Screening, care and treatment
of the disease could learn from existing models in HIV, the authors
find. With a monitoring approach for interventions including diagnosis
and treatment along the continuum of care.