Daijiworld Media Network – Mumbai

Mumbai, Sep 4: Hepatitis B continues to be a major global health concern despite being preventable and treatable, with chronic infection increasing the risk of cirrhosis, chronic liver disease and liver cancer.

Dr Vibha Varma, Consultant and Head of Liver Transplant and Hepato-Pancreato-Biliary Surgery at Lilavati Hospital and Research Centre, Mumbai, said preventing mother-to-child transmission, timely newborn vaccination and proper infection-control measures can significantly reduce the long-term impact of hepatitis B.

Mother-to-child transmission is considered a key route of HBV infection. When an infected mother receives appropriate treatment and the newborn receives the hepatitis B vaccine within the first 24 hours of life, followed by doses at one and six months, more than 95% of infants can develop lifelong protection against the virus.

The timing of vaccination is particularly important because infections acquired at birth or during early childhood are much more likely to become chronic. Around 95% of infected infants may develop chronic hepatitis B, compared with fewer than 5% of adults who acquire the infection.

Chronic infection can remain silent for years before causing significant liver damage. Over two to three decades, persistent inflammation may progress to cirrhosis and hepatocellular carcinoma. Importantly, liver cancer can develop even before cirrhosis appears.

Apart from mother-to-child transmission, HBV can spread through infected blood entering open wounds, needle-stick injuries, contaminated equipment used for tattoos and piercings, and sharing infected needles. Vaccination and appropriate infection-control practices can help prevent these infections.

According to World Health Organization estimates for 2024, around 240 million people globally were living with chronic hepatitis B, while approximately 900,000 new infections occurred during the year. Hepatitis B was associated with around 1.1 million deaths, primarily from cirrhosis and primary liver cancer.

Despite progress, significant gaps remain in diagnosis and treatment. The WHO aims for 90% of people living with chronic HBV to be diagnosed by 2030, but only around 27% are currently diagnosed. Among those eligible for treatment, just 4.3% are receiving therapy. Similarly, only about 45% of newborns currently receive the hepatitis B vaccine within 24 hours of birth, against the WHO target of 90%.

The number of new HBV infections has declined, falling by 32% between 2015 and 2024. Prevalence among children under five also dropped from 0.8% to 0.6% during the same period. However, the WHO target of reducing prevalence in this age group to 0.1% by 2030 remains a major challenge.

Dr Varma said several factors can contribute to greater liver damage among people with chronic HBV infection. Alcohol consumption, tobacco use, obesity and increasing age can contribute to continued liver inflammation and immune dysregulation. Vaccine non-response is uncommon but may be more frequently observed among older adults, people with obesity and smokers.

She stressed that timely birth-dose vaccination, completion of the vaccination schedule, prevention of mother-to-child transmission, screening, early diagnosis and appropriate antiviral treatment remain essential to reducing hepatitis B-related deaths and moving towards the WHO goal of eliminating hepatitis B as a public health threat by 2030.