ARTICLE: Global Elimination of Chronic Hepatitis
AUTHOR: David L. Thomas
JOURNAL: N Engl J Med. 2019 May 23;380(21):2041-2050. doi: 10.1056/NEJMra1810477.
Major advances have been made in the prevention and treatment of chronic hepatitis C virus (HCV) and hepatitis B virus (HBV) infections. Nonetheless, by causing cirrhosis, hepatocellular cancer, or both, HCV and HBV infections kill more than 1 million persons each year, accounting for as many global deaths as those due to human immunodeficiency virus (HIV) infection, tuberculosis, or malaria (Figure 1).1 In fact, by 2040, deaths from chronic hepatitis are projected to exceed the combined mortality associated with HIV infection, tuberculosis, and malaria.2 Recognizing both the advances that have been made and the continuing threat, the United Nations included the goal of combating viral hepatitis in its 2015 sustainable development goals, and in 2016, the World Health Assembly adopted the Global Health Sector Strategy on viral hepatitis that called for its elimination as a public health threat by 2030.3,4 In 2017, the World Health Organization (WHO) published a report defining hepatitis elimination and outlining a strategy to achieve that goal by 2030.5,6 This review considers the goal, the interventions and targets needed to achieve the goal, the progress that has been made, the challenges that remain, and future directions.
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