FAQs: Data and Statistics

Where can I find data on the burden of hepatitis B virus and hepatitis C virus for regions of the world?

The Coalition for Global Hepatitis Elimination compiles burden of disease data for Hepatitis B virus and Hepatitis C virus for over 190 countries and for the regions of the world. Regional interim reports are available for the African Region, the Region of the Americas, the South East Asia Region, and the Western Pacific Region. These regional reports include the WHO hepatitis elimination goals, number of deaths averted and cost saving projections, the HBV and HCV disease burden in the region, additional disease burden data, regional progress on health impact targets and service delivery targets and key policy indicators.

The primary data sources used to develop these disease burden reports include:

The Coalition for Global Hepatitis Elimination website has published a global and regional interim reports on progress towards HBV and HCV elimination. If you have more current data, please bring it to our attention by sending us a message at: globalhep [at] taskforce.org     

The CDA Foundation’s Polaris Observatory has developed global maps on HBV and HCV disease prevalence and progress toward elimination goals. Data from the Polaris Observatory were published in the following articles:

The WHO European Region has developed HBV and HCV prevalence estimates for the region.

The ECDC has published the report Monitoring the responses to hepatitis B and C epidemics in the EU/EEA Member States, 2019

The WHO Western Pacific Region has developed HBV and HCV prevalence estimates for the region.

ICAP has hepatitis prevalence data on sub-Saharan Africa in some of their HIV studies.

Where can I find data on the burden of hepatitis B virus in my country?

The Coalition for Global Hepatitis Elimination compiles burden of disease for Hepatitis B virus and Hepatitis C virus together with other information on data dashboards for over 190 countries. Burden of disease data for countries includes modelled estimates from the Institute of Health Metrics and Evaluation Global Burden of Disease, WHO and other sources. The country dashboards also include, when available, data from national surveys, and hepatitis surveillance data. The dashboards include links to the original sources of data. Data tables and figures can be downloaded for closer examination and for presentation. Visit your country's profile on the Coalition for Global Hepatitis Elimination website to see what data sources are currently available. If you have more current data, please bring it to our attention by sending us a message at: globalhep [at] taskforce.org ()     

The CDA Foundation’s Polaris Observatory has HBV disease burden estimates for many countries as well as global maps on disease prevalence and progress toward elimination goals. 

ECDC has developed a Hepatitis B prevalence database which contains peer-reviewed publications of the prevalence of hepatitis B surface antigen (HBsAg) in the general population and various groups.

WHO has developed  Global and country estimates of immunization coverage and chronic HBV infection

Where can I find data on the burden of hepatitis C virus in my country?

The Coalition for Global Hepatitis Elimination compiles burden of disease for Hepatitis B virus and Hepatitis C virus together with other information on data dashboards for over 190 countries. Burden of disease data for countries includes modelled estimates from the Institute of Health Metrics and Evaluation Global Burden of Disease, WHO and other sources. The country dashboards also include, when available, data from national surveys, and hepatitis surveillance data. The dashboards include links to the original sources of data. Data tables and figures can be downloaded for closer examination and for presentation. Visit your country's profile on the Coalition for Global Hepatitis Elimination website to see what data sources are currently available. If you have more current data, please bring it to our attention by sending us a message at: globalhep [at] taskforce.org ()     

The CDA Foundation’s Polaris Observatory has HCV disease burden estimates for many countries as well as global maps on disease prevalence and progress toward elimination goals. 

ECDC has developed a Hepatitis C prevalence database which contains peer-reviewed publications of the prevalence of antibodies against the hepatitis C virus (anti-HCV) in the general population and various groups.

How can I add data to my country’s dashboard?

With the assistance of partners, the Coalition for Global Hepatitis Elimination seeks to keep the data dashboards current. However, we encourage those who believe they have found more current data to bring it to our attention by sending us a message at: globalhep [at] taskforce.org.

Where can I find surveillance data for HBV and HCV?

The first place to check for local or country-level surveillance data is with the country’s Ministry of Health (MoH). The country surveillance staff may be able to provide surveillance reports on HBV and HCV from their disease surveillance system.

The Coalition for Global Hepatitis Elimination is aware of the following resources on hepatitis surveillance:

The ECDC has developed a Surveillance Atlas for hepatitis B and an Epidemiological Report for hepatitis C with surveillance data for countries in the European Region.

The US CDC publishes viral hepatitis surveillance reports each year which include surveillance data on Hepatitis A, Hepatitis B and Hepatitis C.

What are the global trends of liver cancer?

The International Agency for Research on Cancer provides liver cancer incidence rates and mortality rates based on Globocan data.

The World Cancer Research Fund provides liver cancer statistics for countries around the world.

The following article has been published on this topic:

Q: What is the status of HBV elimination in the Western Pacific region (WPR)?

In 2003, the countries in the region committed to the full implementation of HepB vaccination to decrease HBsAg from < 8% pre-vaccination to less than 1% among children < 5 years of age. By 2014, regional infant HepB vaccination was > 90%, and birth dose coverage exceeded 80%. At this stage, immunization programs had prevented 3 million new chronic HBV infections and averted 571,000 deaths among HepB vaccinated children. In 2019, a total of 21 of 36 countries and areas were verified as having achieved the regional target of <1% HBsAg seroprevalence among children under 5 year of age. As a result, HBsAg prevalence in the region declined to 0.93% meeting the regional and global target. 

 

In 2017, WPR established a goal for HBV EMTCT of <0.1% HBsAg prevalence for children < 5 years by 2030.  WPR countries are adopting the triple elimination framework for HIV, HBV and syphilis Although 93% of countries in the Region have a policy for HepB birth dose vaccination, improvements in antenatal HBV testing are needed. Only 20 (56%) countries or areas have a national policy for routine antenatal HBsAg testing including eight countries providing antivirals to HBV infected mothers. Two (6%) countries test ≥95% of pregnant women for HBsAg. China has successfully screened 97% of 127 million pregnant women for HBsAg. Of infants born to HBsAg-positive mothers, 97.7% received HBIG.

 

This information comes from the Hepatitis B chapter of the 8th edition of Plotkin’s Vaccines and select references are provided below. For a full list of references, please refer to the book:

 

Woodring J, Pastore R, Brink A, et al. Progress Toward Hepatitis B Control and Elimination of Mother-to-Child Transmission of Hepatitis B Virus - Western Pacific Region, 2005-2017. MMWR Morb Mortal Wkly Rep. 2019;68:195-200.

What is the status of HBV elimination in the Southeast Asia region (SEAR)?

In 2016, member countries of SEAR set a regional target of < 1% HBsAg prevalence among children aged < 5 years by 2020. In 2019, the region had 54% and 91% coverage of HepB birth dose and third dose (HepB3) immunization, respectively; 9 of 11 countries achieved ≥90% HepB3 coverage nationally. As a result, HBsAg among 5 years old declined to 1.2% prevalence approaching the regional target. Four countries, Bangladesh, Bhutan, Nepal, and Thailand were verified as reaching the regional target. The improvements in health as a result of HepB vaccination are substantial. From 1992-2015, HepB immunization in the region prevented an estimated 16 million chronic HBV infections and averted 2.5 million deaths. The main remaining challenges are to improve vaccination for the > 80% of districts in India and Indonesia with < 80% coverage of three dose HepB infant immunization. 

 

This information comes from the Hepatitis B chapter of the 8th edition of Plotkin’s Vaccines and select references are provided below. For a full list of references, please refer to the book:

 

Sandhu HS, Roesel S, Sharifuzzaman M, et al. Progress Toward Hepatitis B Control - South-East Asia Region, 2016-2019. MMWR Morb Mortal Wkly Rep. 2020;69:988-92.

What is the status of HBV elimination in the Eastern Mediterranean region?

In 2009, the Member States adopted a target for hepatitis B control through childhood vaccination to reduce HBsAg prevalence to < 1% by 2015. In 2014, all countries had introduced infant three dose vaccination with 83% regional coverage. A total of 14 (64%) of 22 countries had introduced universal birth dose vaccination increasing birth dose overage to 71% in these countries; however, HepB birth dose coverage was 24% in the region. The low rate of in facility births (62%) is the major challenge to the scale up of HepB birth dose and adoption of HBV maternal testing. To assess the impact of HepB vaccination, countries are in various stage of conducting serologic surveys. By the end of 2014, preliminary data suggest HBsAg prevalence among children had fallen to < 1% for 15 (68%) of 22 countries in the region. The regional HBsAg prevalence is 1.21% approaching the regional target. Among children born between 2005 and 2014, hepatitis B vaccination prevented 5 million chronic HBV infections and 700,000 future deaths from hepatitis B-related disease.

 

This information comes from the Hepatitis B chapter of the 8th edition of Plotkin’s Vaccines and select references are provided below. For a full list of references, please refer to the book:

 

Allison RD, Teleb N, Al Awaidy S, et al. Hepatitis B control among children in the Eastern Mediterranean Region of the World Health Organization. Vaccine. 2016;34:2403-9.

What is the status of HBV elimination in the European region?

A regional action plan for 2016-2021 set coverage targets for three dose (95%) and birth dose (90%) HepB vaccination, maternal HBV screening (85%) and post exposure prophylaxis with a goal of achieving ≤0.5% HBsAg prevalence in vaccinated cohorts. In 2017, a total of 47 of 53 countries routinely conducted infant HepB vaccination with coverage exceeding the >90% regional target. All countries have implemented strategies to prevent perinatal HBV transmission either via universal newborn vaccination, universal screening of pregnant women followed by vaccination and other strategies. Regional prevalence was 0.4% exceeding the target of ≤0.5% HBsAg prevalence among vaccinated cohorts. Many of the European Union affiliated countries have integrated maternal screening for infectious diseases including syphilis (26/26), HIV (24/26) and hepatitis B (23/26).

 

This information comes from the Hepatitis B chapter of the 8th edition of Plotkin’s Vaccines and select references are provided below. For a full list of references, please refer to the book:

 

World Health Organization. Action plan for the health sector response to viral hepatitis in the WHO European Region.  

 

Duffell EF, Hedrich D, Mardh O, et al. 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.

What is the status of HBV elimination in the Americas region?

In 2015, the Pan American Health Organization (PAHO) recommitted to reducing HBsAg prevalence to < 0.1% among 4- to 6-year-old children. All 52 countries and territories in the region include HepB vaccine in pediatric immunization schedules contributing to 89% coverage of the three HepB vaccination series.  Additionally, 36 (69%) countries/territories include an HBV birth dose including 22 with universal HepB vaccination policies. In countries with universal vaccination policies, 83% of newborns receive HepB vaccination. The regional action plan expands the EMTCT initiative (called "EMTCT Plus") to reduce HBsAg prevalence among 4- to 6-year-old children to 0.1% or less. The strategy sets targets for number of countries with > 95% coverage of infants HepB immunization, > 95% coverage of timely birth dose vaccination. Targets also include testing > 80% of pregnant women for HBsAg and providing HBIG to > 80% of newborns born to HBV-infected mothers. The high proportion of births managed by skilled birth attendants provides the settings for scale up of HepB birth dose vaccination and maternal HBV testing integrated with strategies for prevention of perinatal HIV, syphilis and, where appropriate, Chagas disease. The scale-up of HBV testing is an issue. Only 25 countries have the capacity to perform nucleic acid tests for HBV.

 

This information comes from the Hepatitis B chapter of the 8th edition of Plotkin’s Vaccines and select references are provided below. For a full list of references, please refer to the book:

 

Pan American Health Organization. EMTCT Plus. Framework for elimination of mother-to-child transmission of HIV, Syphilis, Hepatitis B, and Chagas  

What is the status of HBV elimination in the African region (AFR)?

HBV is highly endemic in sub-Saharan Africa with an estimated 8.8% HBV prevalence. Most Member States have a HBsAg prevalence of > 2% and exceeding 8% for some countries particularly in western Africa. The African Region is the only WHO region that has not approached or exceeded the target of reducing HBsAg prevalence rates to less than 1% in children younger than 5 years. In November 2014, the WHO African Regional Committee endorsed a resolution to reduce HBsAg prevalence to < 2% in children less than 5 years of age in all Members States by 2020. All 47 countries in the WHO Africa Region have introduced HepB into the routine infant immunization schedule. By 2015, regional coverage for infant HepB immunization was 76%; a total of 6 (34%) countries reported >90% HepB3 coverage. However, in 2018, only 23% (11/47) of countries had adopted policies to begin HepB birth dose vaccination resulting in < 10% regional HepB birth dose coverage. Algeria, Botswana, Cabo Verde, are exceptional countries in Africa with at least 90% birth dose coverage. As a result, an estimated 2.5% of infants are infected with HBV.

 

There are at least four impediments to hepatitis B birth dose vaccination in AFR including 1) the lack of immunization policies; 2) data to guide new policy development; 3) the large number of home births and 4) unreliable vaccine supply. In sub-Saharan Africa, only 64 per cent of births are attended by a medical doctor, nurse or midwife.

 

The most cost-effective intervention to reduce HBV infection rates in sub-Saharan Africa is timely birth-dose vaccination followed by completion of the 3-dose infant-vaccination series. While assistance for AFR countries to implement HepB birth dose vaccination continue, the integration of maternal HBV and HIV testing affords an additional option for improved prevention of perinatal HBV infection. Some programs in Africa screen expectant mothers for HBsAg and HIV providing tenofovir to interrupt transmission of both infections. Following the achievement of high coverage of HepB birth dose vaccination, expansion of HBsAg testing for all pregnant women and anti-viral prophylaxis for HBsAg-positive women at high risk for transmission based on HBV virologic testing will support EMTCT of HBV in Africa.

 

This information comes from the Hepatitis B chapter of the 8th edition of Plotkin’s Vaccines and select references are provided below. For a full list of references, please refer to the book:

 

Breakwell L, Tevi-Benissan C, Childs L, et al. The status of hepatitis B control in the African region. Pan Afr Med J. 2017;27:17.

 

Dionne-Odom J, Njei B, Tita ATN. Elimination of Vertical Transmission of Hepatitis B in Africa: A Review of Available Tools and New Opportunities. Clin Ther. 2018;40:1255-67.

 

Wilson P, Parr JB, Jhaveri R, et al. Call to Action: Prevention of Mother-to-Child Transmission of Hepatitis B in Africa. J Infect Dis. 2018;217:1180-3.

Last day updated 15 Nov 2021