Publication

Summary

In 2022, we published an updated global analysis of HBV that also described the uncertainty in national estimates. We are able to estimate the 2023 burden, cascade of care, and the number of countries expected to meet the 2030 elimination targets based on the current levels of treatment and diagnosis, the uncertainties described in our paper will carry to the 2023 estimates as well. Building upon that analysis, we can estimate the 2023 burden, cascade of care, and the number of countries expected to meet the 2030 elimination targets based on the current levels of treatment and diagnosis. This was achieved through a modified Delphi process that built expert consensus on the inputs necessary for the fully dynamic disease burden and transmission PRoGReSs model.

In 2023, we estimate that there were 253 million people living with HBV globally, representing a prevalence of 3.2%. Of these, 5.4 million were aged 5 years old or younger corresponding to an early childhood prevalence of 0.7%.

The prevalence of HBV is heavily concentrated, with over 95% of all infections and 99% of infections among children aged 5 years and younger occurring in lowincome and middle-income countries.

The overall and the under 5-year-old shares of global infection can be compared to the strength and impact of prevention of mother-to-child transmission measures. High and upper middle-income countries have historically had strong prevention of mother-to-child transmission programs, and they have been able to greatly reduce their share of infections in early childhood when compared to their overall share of infections. However, lower middle-income and low-income countries have seen increases in their share largely due to the lack of availability of timely birth doses.

These trends can also be observed at the World Health Organization regional level. The majority of people living with HBV, 62.7%, live in Southeast Asia and the Western Pacific Region (SEARO and WPRO), but the majority of early childhood infections are in the African region (AFRO). While progress has been made in prevention efforts, HBV-related morbidity and mortality continue to increase globally.