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Current Hepatology Reports
Published in: Current Hepatology Reports 3/2023

Open Access 29-07-2023 | Hepatitis B

Evidence-Based Strategies for Micro-elimination of Chronic Hepatitis B Virus Infection

Authors: Katerina Roma, Mark Hsu, Adam Khattak, Robert Gish

Published in: Current Hepatology Reports | Issue 3/2023

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Abstract

Purpose of Review

Hepatitis B (HBV) remains a health threat around the world. Hepatitis C is closer to meeting the World Health Organization’s 2030 elimination goal compared to HBV. To achieve a successful micro-elimination and macro-elimination, there are certain objectives that need to be met.

Recent Findings

HBV infects more than 262 million people worldwide and is associated with significant morbidity and increased mortality. There have been previous HBV and hepatitis C virus micro-elimination trials with varying success. Micro-elimination programs should be designed to move services forward with a plethora of avenues for monitoring, testing, and treatment.

Summary

Ultimately, successful and maintained micro-elimination is needed to achieve macro-elimination of HBV. Here, we propose 5 core tenets of micro-elimination that can be expanded to macro-elimination; these 5-line guidelines provide for 5 pillars of HBV management that support a path to a successful global elimination of HBV.
Literature
1.
2.
Wong RJ, Brosgart CL, Welch S, Block T, Chen M, Cohen C, et al. An updated assessment of chronic hepatitis B prevalence among foreign-born persons living in the United States. Hepatology. 2021;74(2):607–26.PubMedCrossRef
3.
4.
5.
Popping S, Bade D, Boucher C, van der Valk M, El-Sayed M, Sigurour O, et al. The global campaign to eliminate HBV and HCV infection: International Viral Hepatitis Elimination Meeting and core indicators for development towards the 2030 elimination goals. J Virus Erad. 2019;5(1):60–6.PubMedPubMedCentralCrossRef
6.
7.
8.
Liu Z, Li M, Hutton DW, Wagner AL, Yao Y, Zhu W, et al. Impact of the national hepatitis B immunization program in China: a modeling study. Infect Dis Poverty. 2022;11(1):106.PubMedPubMedCentralCrossRef
9.
Kim H, Shin AR, Chung HH, Kim MK, Lee JS, Shim JJ, et al. Recent trends in hepatitis B virus infection in the general Korean population. Korean J Intern Med. 2013;28(4):413–9.PubMedPubMedCentralCrossRef
10.
Périères L, Diallo A, Marcellin F, Nishimwe ML, Ba EH, Coste M, et al. Hepatitis B in Senegal: a successful infant vaccination program but urgent need to scale up screening and treatment (ANRS 12356 AmBASS survey). Hepatol Commun. 2022;6(5):1005–15.PubMedCrossRef
11.
Alaama AS, Khattabi H, Mugisa B, Atta H, Hermez J, Hutin YJ. Progress towards elimination of viral hepatitis by 2030 in the WHO Eastern Mediterranean Region, 2019. Lancet Gastroenterol Hepatol. 2022;7(9):862–70.PubMedCrossRef
12.
Ríos-Hincapié CY, Murad-Rivera R, Tohme RA, Ropero AM, Gómez B, Librado Cardona D, et al. Progress towards the elimination of hepatitis B in children in Colombia: a novel two-phase study approach. J Viral Hepat. 2022;29(9):737–47.PubMedCrossRef
13.
Colombe S, Axelsson M, Aleman S, Duberg AS, Lundberg Ederth J, Dahl V. Monitoring the progress towards the elimination of hepatitis B and C in Sweden: estimation of core indicators for 2015 and 2018. BMC Infect Dis. 2022;22(1):885.PubMedPubMedCentralCrossRef
14.
Lazarus JV, Wiktor S, Colombo M, Thursz M, Foundation EIL. Micro-elimination - a path to global elimination of hepatitis C. J Hepatol. 2017;67(4):665–6.PubMedCrossRef
15.
Lazarus JV, Safreed-Harmon K, Thursz MR, Dillon JF, El-Sayed MH, Elsharkawy AM, et al. The micro-elimination approach to eliminating hepatitis C: strategic and operational considerations. Semin Liver Dis. 2018;38(3):181–92.PubMedCrossRef
16.
Mangia A, Cotugno R, Cocomazzi G, Squillante MM, Piazzolla V. Hepatitis C virus micro-elimination: where do we stand? World J Gastroenterol. 2021;27(16):1728–37.PubMedPubMedCentralCrossRef
17.
McMahon BJ, Rhoades ER, Heyward WL, Tower E, Ritter D, Lanier AP, et al. A comprehensive programme to reduce the incidence of hepatitis B virus infection and its sequelae in Alaskan natives. Lancet. 1987;2(8568):1134–6.PubMedCrossRef
18.
McMahon BJ, Bulkow LR, Singleton RJ, Williams J, Snowball M, Homan C, et al. Elimination of hepatocellular carcinoma and acute hepatitis B in children 25 years after a hepatitis B newborn and catch-up immunization program. Hepatology. 2011;54(3):801–7.PubMedCrossRef
19.••
Conners EE, Panagiotakopoulos L, Hofmeister MG, Spradling PR, Hagan LM, Harris AM, et al. Screening and testing for hepatitis B virus infection: CDC recommendations — United States, 2023. MMWR Recomm Rep. 2023;72(1):1–25. Most recent MMWR advised testing all adults who are 18 years or older with a triple panel (HBsAg, anti-HBc, and anti-HBs) at least once in their lifetimePubMedPubMedCentralCrossRef
20.•
Toy M, Hutton D, Harris AM, Nelson N, Salomon JA, So S. Cost-effectiveness of 1-time universal screening for chronic hepatitis B infection in adults in the United States. Clin Infect Dis. 2022;74(2):210–7. Screening all with HBsAg at least once is more cost-saving compared to AASLD treatment recommendation alone and prevents an additional 23,000 deaths from liver disease and liver cancer with an estimated savings of $596,000,000PubMedCrossRef
21.
McNaughton AL, Lemoine M, van Rensburg C, Matthews PC. Extending treatment eligibility for chronic hepatitis B virus infection. Nat Rev Gastroenterol Hepatol. 2021;18(3):146–7.PubMedCrossRef
22.
Dieterich D, Graham C, Wang S, Kwo P, Lim Y-S, Liu C-J, et al. It is time for a simplified approach to hepatitis B elimination. Gastro Hep Advances. 2023;2(2):209–18.CrossRef
23.•
Khalili M, Leonard KR, Ghany MG, Hassan M, Roberts LR, Sterling RK, et al. Racial disparities in treatment initiation and outcomes of chronic hepatitis B virus infection in North America. JAMA Netw Open. 2023;6(4):e237018-e. https://​doi.​org/​10.​1001/​jamanetworkopen.​2023.​7018. Treatment initiation rates were higher among Asians and Caucasians compared to AA or Blacks because Africa-born AA or Black participants had lower prevalence of HBeAg compared to US-born participants which may be why they did not meet the treatment criteriaCrossRef
24.••
Zhang S, Wang C, Liu B, Lu Q-B, Shang J, Zhou Y, et al. Cost-effectiveness of expanded antiviral treatment for chronic hepatitis B virus infection in China: an economic evaluation. Lancet Reg Health West Pac. 2023; https://​doi.​org/​10.​1016/​j.​lanwpc.​2023.​100738. Expanding chronic HBV therapy to those with elevated ALT levels versus HBsAg-positive individuals found that treating HBsAg-positive, regardless of ALT levels, with 80% coverage allowed them to achieve WHO’s 2030 goal. Also, this was more cost effective in the long run by 2025
25.
Thomas HC. Best practice in the treatment of chronic hepatitis B: a summary of the European Viral Hepatitis Educational Initiative (EVHEI). J Hepatol. 2007;47(4):588–97.PubMedCrossRef
26.
de Almeida NAA, de Paula VS. Occult Hepatitis B virus (HBV) infection and challenges for hepatitis elimination: a literature review. J Appl Microbiol. 2022;132(3):1616–35.PubMedCrossRef
27.
Dindoost P, Chimeh N, Hollinger BF, Saberfar E, Norouzi M, Jazayeri SM. The pigeonhole of occult hepatitis B. Acta Med Iran. 2014;52(8):582–90.PubMed
28.
29.
Wang Y, Liu Y, Liao H, Deng Z, Bian D, Ren Y, et al. Serum HBV DNA plus RNA reflecting cccDNA level before and during NAs treatment in HBeAg positive CHB patients. Int J Med Sci. 2022;19(5):858–66.PubMedPubMedCentralCrossRef
30.
Nassal M. HBV cccDNA: viral persistence reservoir and key obstacle for a cure of chronic hepatitis B. Gut. 2015;64(12):1972–84.PubMedCrossRef
31.
32.
33.
Cacoub P, Terrier B. Hepatitis B-related autoimmune manifestations. Rheum Dis Clin North Am. 2009;35(1):125–37.PubMedCrossRef
34.
Baig S, Alamgir M. The extrahepatic manifestations of hepatitis B virus. J Coll Physicians Surg Pak. 2008;18(7):451–7.PubMed
35.
Li M, Gan Y, Fan C, Yuan H, Zhang X, Shen Y, et al. Hepatitis B virus and risk of non-Hodgkin lymphoma: an updated meta-analysis of 58 studies. J Viral Hepat. 2018;25(8):894–903.PubMedCrossRef
36.
37.
Sarin S, Kumar M, Lau G, Abbas Z, Chan H, Chen C, et al. Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update. Hepatology Int. 2016;10:1–98.CrossRef
38.
EASL 2017 clinical practice guidelines on the management of hepatitis B virus infection. J Hepatol. 2017;67(2):370–98.
39.
Terrault NA, Bzowej NH, Chang KM, Hwang JP, Jonas MM, Murad MH. AASLD guidelines for treatment of chronic hepatitis B. Hepatology. 2016;63(1):261–83.PubMedCrossRef
40.
41.
Zijlstra MK, Fidel Nague K, Louie P, Imas P, Sonnenberg A, Fimmel CJ. Successful hepatitis C birth cohort screening and linkage to care in a US community health system. J Public Health Manag Pract. 2022;28(6):E825–E30.PubMedPubMedCentralCrossRef
42.
43.
44.
Kleinman SH, Lelie N, Busch MP. Infectivity of human immunodeficiency virus-1, hepatitis C virus, and hepatitis B virus and risk of transmission by transfusion. Transfusion. 2009;49(11):2454–89.PubMedCrossRef
45.
Yotsuyanagi H, Yasuda K, Moriya K, Shintani Y, Fujie H, Tsutsumi T, et al. Frequent presence of HBV in the sera of HBsAg-negative, anti-HBc-positive blood donors. Transfusion. 2001;41(9):1093–9.PubMedCrossRef
46.
Bremer CM, Saniewski M, Wend UC, Torres P, Lelie N, Gerlich WH, et al. Transient occult hepatitis B virus infection in a blood donor with high viremia. Transfusion. 2009;49(8):1621–9.PubMedCrossRef
47.
48.
Pronier C, Candotti D, Boizeau L, Bomo J, Laperche S, Thibault V. The contribution of more sensitive hepatitis B surface antigen assays to detecting and monitoring hepatitis B infection. J Clin Virol. 2020;129:104507.PubMedCrossRef
49.
Chevaliez S, Roudot-Thoraval F, Hezode C, Pawlotsky JM, Njouom R. Performance of rapid diagnostic tests for hepatitis B surface antigen detection in serum or plasma. Diagn Microbiol Infect Dis. 2021;100(2):115353.PubMedCrossRef
50.
Amini A, Varsaneux O, Kelly H, Tang W, Chen W, Boeras DI, et al. Diagnostic accuracy of tests to detect hepatitis B surface antigen: a systematic review of the literature and meta-analysis. BMC Infect Dis. 2017;17(Suppl 1):698.PubMedPubMedCentralCrossRef
51.
Abbas Z, Abbas M. Challenges in formulation and implementation of hepatitis B elimination programs. Cureus. 2021;13(4):e14657.PubMedPubMedCentral
52.
Lim J, Singal AG. Surveillance and diagnosis of hepatocellular carcinoma. Clin Liver Dis. 2019;13(1):2–5.CrossRef
53.
54.
World Health Organization. Hepatitis B vaccines: WHO position paper-July 2017. Wkly Epidemiol Rec. 2017;92(27):369–92.
55.
Blach S, Razavi-Shearer D, Mooneyhan E, Estes C, Razavi-Shearer K, Gamkrelidze I, et al., editors. Updated evaluation of global progress towards HBV and HCV elimination, preliminary data through 2021. Hepatology. 2022;76(S1):S1–564.
56.
Collaborators PO. Global prevalence, treatment, and prevention of hepatitis B virus infection in 2016: a modelling study. Lancet Gastroenterol Hepatol. 2018;3(6):383–403.CrossRef
57.
Spearman CW, Afihene M, Ally R, Apica B, Awuku Y, Cunha L, et al. Hepatitis B in sub-Saharan Africa: strategies to achieve the 2030 elimination targets. Lancet Gastroenterol Hepatol. 2017;2(12):900–9.PubMedCrossRef
58.
Khetsuriani N, Lesi O, Desai S, Armstrong PA, Tohme RA. Progress toward the elimination of mother-to-child transmission of hepatitis B virus - worldwide, 2016-2021. MMWR Morb Mortal Wkly Rep. 2022;71(30):958–63.PubMedPubMedCentralCrossRef
59.
Pham TND, Le DH, Dao DVB, Phan LTB, Pham TTT, Nguyen TB, et al. Establishing baseline framework for hepatitis B virus micro-elimination in Ho Chi Minh City, Vietnam - a community-based seroprevalence study. Lancet Reg Health West Pac. 2023;30:100620.PubMedCrossRef
60.
Heyward WL, Kyle M, Blumenau J, Davis M, Reisinger K, Kabongo ML, et al. Immunogenicity and safety of an investigational hepatitis B vaccine with a Toll-like receptor 9 agonist adjuvant (HBsAg-1018) compared to a licensed hepatitis B vaccine in healthy adults 40-70 years of age. Vaccine. 2013;31(46):5300–5.PubMedCrossRef
61.
62.
Smith-Palmer J, Cerri K, Sbarigia U, Chan EKH, Pollock RF, Valentine WJ, et al. Impact of stigma on people living with chronic hepatitis B. Patient Relat Outcome Meas. 2020;11:95–107.PubMedPubMedCentralCrossRef
63.
Modabbernia A, Poustchi H, Malekzadeh R. Neuropsychiatric and psychosocial issues of patients with hepatitis C infection: a selective literature review. Hepat Mon. 2013;13(1):e8340.PubMedPubMedCentralCrossRef
64.
Mokaya J, McNaughton AL, Burbridge L, Maponga T, O’Hara G, Andersson M, et al. A blind spot? Confronting the stigma of hepatitis B virus (HBV) infection - a systematic review. Wellcome Open Res. 2018;3:29.PubMedPubMedCentralCrossRef
65.
Li G, Wang G, Hsu FC, Xu J, Pei X, Zhao B, et al. Effects of depression, anxiety, stigma, and disclosure on health-related quality of life among chronic hepatitis B patients in Dalian, China. Am J Trop Med Hyg. 2020;102(5):988–94.PubMedPubMedCentralCrossRef
66.
Mahajan AP, Sayles JN, Patel VA, Remien RH, Sawires SR, Ortiz DJ, et al. Stigma in the HIV/AIDS epidemic: a review of the literature and recommendations for the way forward. AIDS. 2008;22(Suppl 2):S67–79.PubMedCrossRef
67.
Zacharias T, Wang W, Dao D, Wojciechowski H, Lee WM, Do S, et al. HBV outreach programs significantly increase knowledge and vaccination rates among Asian Pacific Islanders. J Community Health. 2015;40(4):619–24.PubMedPubMedCentralCrossRef
68.
Bailey MB, Shiau R, Zola J, Fernyak SE, Fang T, So SK, et al. San Francisco hep B free: a grassroots community coalition to prevent hepatitis B and liver cancer. J Community Health. 2011;36(4):538–51.PubMedCrossRef
69.
Haider M, Flocco G, Lopez R, Carey W. Retrospective observational study of temporal trends and outcomes of hepatitis B screening in patients receiving rituximab. BMJ Open. 2020;10(12):e043672.PubMedPubMedCentralCrossRef
70.
71.
72.
Yi P, Chen R, Huang Y, Zhou R-R, Fan X-G. Management of mother-to-child transmission of hepatitis B virus: Propositions and challenges. J Clin Virol. 2016;77:32–9.PubMedCrossRef
73.
Wiseman E, Fraser MA, Holden S, Glass A, Kidson BL, Heron LG, et al. Perinatal transmission of hepatitis B virus: an Australian experience. Med J Aust. 2009;190(9):489–92.PubMedCrossRef
74.
Thio CL, Guo N, Xie C, Nelson KE, Ehrhardt S. Global elimination of mother-to-child transmission of hepatitis B: revisiting the current strategy. Lancet Infect Dis. 2015;15(8):981–5.PubMedCrossRef
75.
Bierhoff M, Rijken MJ, Yotyingaphiram W, Pimanpanarak M, van Vugt M, Angkurawaranon C, et al. Tenofovir for prevention of mother to child transmission of hepatitis B in migrant women in a resource-limited setting on the Thailand-Myanmar border: a commentary on challenges of implementation. Int J Equity Health. 2020;19(1):156.PubMedPubMedCentralCrossRef
76.
Thompson P, Morgan CE, Ngimbi P, Mwandagalirwa K, Ravelomanana NLR, Tabala M, et al. Arresting vertical transmission of hepatitis B virus (AVERT-HBV) in pregnant women and their neonates in the Democratic Republic of the Congo: a feasibility study. Lancet Glob Health. 2021;9(11):e1600–e9.PubMedPubMedCentralCrossRef
77.
McCullough J, Alter HJ, Ness PM. Interpretation of pathogen load in relationship to infectivity and pathogen reduction efficacy. Transfusion. 2019;59(3):1132–46.PubMedCrossRef
78.
Allain JP, Mihaljevic I, Gonzalez-Fraile MI, Gubbe K, Holm-Harritshøj L, Garcia JM, et al. Infectivity of blood products from donors with occult hepatitis B virus infection. Transfusion. 2013;53(7):1405–15.PubMedCrossRef
79.
Terrault NA, Lok ASF, McMahon BJ, Chang KM, Hwang JP, Jonas MM, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology. 2018;67(4):1560–99.PubMedCrossRef
80.
81.
82.
Hann HW, Chae HB, Dunn SR. Tenofovir (TDF) has stronger antiviral effect than adefovir (ADV) against lamivudine (LAM)-resistant hepatitis B virus (HBV). Hepatol Int. 2008;2(2):244–9.PubMedPubMedCentralCrossRef
83.
Lange CM, Bojunga J, Hofmann WP, Wunder K, Mihm U, Zeuzem S, et al. Severe lactic acidosis during treatment of chronic hepatitis B with entecavir in patients with impaired liver function. Hepatology. 2009;50(6):2001–6.PubMedCrossRef
84.
Lok AS, Zoulim F, Dusheiko G, Ghany MG. Hepatitis B cure: from discovery to regulatory approval. Hepatology. 2017;66(4):1296–313.PubMedCrossRef
85.
86.
Simonetti J, Bulkow L, McMahon BJ, Homan C, Snowball M, Negus S, et al. Clearance of hepatitis B surface antigen and risk of hepatocellular carcinoma in a cohort chronically infected with hepatitis B virus. Hepatology. 2010;51(5):1531–7.PubMedCrossRef
87.
Cacoub P, Asselah T. Hepatitis B virus infection and extra-hepatic manifestations: a systemic disease. Am J Gastroenterol. 2022;117(2):253–63.PubMedCrossRef
88.
Cho IY, Chang Y, Sung E, Sohn W, Kang JH, Shin H, et al. Depressive symptoms and risk of liver-related mortality in individuals with hepatitis B virus infection: a cohort study. Sci Rep. 2020;10(1):20812.PubMedPubMedCentralCrossRef
89.
90.
Scott J, Fagalde M, Baer A, Glick S, Barash E, Armstrong H, et al. A population-based intervention to improve care cascades of patients with hepatitis C virus infection. Hepatol Commun. 2021;5(3):387–99.PubMedCrossRef
91.
Kay ES, Batey DS, Craft HL, McCormick LC, Burkholder GA, Burdge J, et al. Practice transformation in HIV primary care: perspectives of coaches and champions in the Southeast United States. J Prim Care Community Health. 2021;12:2150132720984429.PubMedPubMedCentralCrossRef
92.
Taye BW, Valery PC, Clark PJ. Targeted antiviral treatment of hepatitis B virus in culturally and linguistically diverse populations to achieve elimination targets in Australia. J Viral Hepat. 2022;29(10):868–78.PubMedPubMedCentralCrossRef
93.
Martin P, Nguyen MH, Dieterich DT, Lau DT, Janssen HLA, Peters MG, et al. Treatment algorithm for managing chronic hepatitis B virus infection in the United States: 2021 update. Clin Gastroenterol Hepatol. 2022;20(8):1766–75.PubMedCrossRef
94.
Smolders EJ, Burger DM, Feld JJ, Kiser JJ. Review article: clinical pharmacology of current and investigational hepatitis B virus therapies. Aliment Pharmacol Ther. 2020;51(2):231–43.PubMedCrossRef
95.
96.
Urban S, Bartenschlager R, Kubitz R, Zoulim F. Strategies to inhibit entry of HBV and HDV into hepatocytes. Gastroenterology. 2014;147(1):48–64.PubMedCrossRef
97.
Asselah T, Loureiro D, Tout I, Castelnau C, Boyer N, Marcellin P, et al. Future treatments for hepatitis delta virus infection. Liver Int. 2020;40(Suppl 1):54–60.PubMedCrossRef
98.
Yuen MF, Schiefke I, Yoon JH, Ahn SH, Heo J, Kim JH, et al. RNA interference therapy with ARC-520 results in prolonged hepatitis B surface antigen response in patients with chronic hepatitis B infection. Hepatology. 2020;72(1):19–31.PubMedCrossRef
99.
Yuen MF, Heo J, Jang JW, Yoon JH, Kweon YO, Park SJ, et al. Safety, tolerability and antiviral activity of the antisense oligonucleotide bepirovirsen in patients with chronic hepatitis B: a phase 2 randomized controlled trial. Nat Med. 2021;27(10):1725–34.PubMedPubMedCentralCrossRef
100.
101.
Yuen MF, Berliba E, Sukeepaisarnjaroen W, Ahn SH, Tanwandee T, Lim YS, et al. Safety, pharmacokinetics, and antiviral activity of the capsid inhibitor AB-506 from Phase 1 studies in healthy subjects and those with hepatitis B. Hepatol Commun. 2022;6(12):3457–72.PubMedPubMedCentralCrossRef
102.
Gane E, Verdon DJ, Brooks AE, Gaggar A, Nguyen AH, Subramanian GM, et al. Anti-PD-1 blockade with nivolumab with and without therapeutic vaccination for virally suppressed chronic hepatitis B: a pilot study. J Hepatol. 2019;71(5):900–7.PubMedCrossRef
103.
Bazinet M, Pântea V, Placinta G, Moscalu I, Cebotarescu V, Cojuhari L, et al. Safety and efficacy of 48 weeks REP 2139 or REP 2165, tenofovir disoproxil, and pegylated interferon alfa-2a in patients with chronic HBV infection naïve to nucleos(t)ide therapy. Gastroenterology. 2020;158(8):2180–94.PubMedCrossRef
Metadata
Title
Evidence-Based Strategies for Micro-elimination of Chronic Hepatitis B Virus Infection
Authors
Katerina Roma
Mark Hsu
Adam Khattak
Robert Gish
Publication date
29-07-2023
Publisher
Springer US
Keyword
Hepatitis B
Published in
Current Hepatology Reports / Issue 3/2023
Electronic ISSN: 2195-9595
DOI
https://doi.org/10.1007/s11901-023-00610-x

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WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

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