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Progress towards elimination goals for viral hepatitis

Nature Reviews Gastroenterology & Hepatology volume 17, pages 533–542 (2020)Cite this article

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Abstract

The global burden of viral hepatitis is substantial; in terms of mortality, hepatitis B virus and hepatitis C virus infections are on a par with HIV, malaria and tuberculosis, among the top four global infectious diseases. In 2016, the 194 Member States of the World Health Organization committed to eliminating viral hepatitis as a public health threat by 2030, with a particular focus on hepatitis B virus and hepatitis C virus infection. With only 10 years to go until the 2030 deadline is reached, and although much progress has been made towards elimination, there are still some important gaps in terms of policy and progress. In this Viewpoint, we asked a selection of scientists and clinicians working in the viral hepatitis field for their opinions on whether elimination of viral hepatitis by 2030 is feasible, what the key areas of progress are and what the focus for the next 10 years and beyond should be for viral hepatitis elimination.

The contributors

Andrea L. Cox is currently a Professor of Medicine, Oncology, and Immunology at The Johns Hopkins University School of Medicine, USA. Her research and clinical interests focus on hepatitis C virus, hepatitis B virus and HIV, including mechanisms through which these chronic viral infections stimulate and evade immune responses.

Manal H. El-Sayed is Professor of Paediatrics and director of the Clinical Research Centre at the Faculty of Medicine, Ain Shams University. She is a founding member of the Egyptian National Committee for Control of Viral Hepatitis since 2006. She is the secretary general of the Egyptian Liver Care Society (NGO) and board member of the EASL International Liver Foundation.

Jia-Horng Kao is the Chair Professor of the Graduate Institute of Clinical Medicine at the National Taiwan University, Taipei, Taiwan. He has published more than 550 articles on the prevention, natural history, molecular virology, pathogenesis and treatment of chronic viral hepatitis and liver cancer. He is currently the Steering Council member of The Asian Pacific Association for the Study of the Liver (APASL).

Jeffrey V. Lazarus is head of the Health Systems and Infectious Diseases team at the Barcelona Institute for Global Health (ISGlobal) and an Associate Professor at the Faculty of Medicine, University of Barcelona, Spain. He is Vice-Chairman of the board of the EASL International Liver Foundation, where he leads the work on the microelimination of hepatitis C.

Maud Lemoine is Professor and Honorary Consultant in Hepatology at Imperial College London, UK. Her research interests are mainly related to viral hepatitis in resource-limited countries, where she developed expertise on screening and management of patients with viral hepatitis. She is the head of the PROLIFICA (Prevention of Liver Fibrosis and Cancer in Africa) programme and the chief investigator and co-investigator of several studies and interventions on the prevention and management of viral hepatitis B and C in West and East Africa.

Anna S. Lok is a Professor of Internal Medicine, Director of Clinical Hepatology, and Assistant Dean for Clinical Research at the University of Michigan, USA. She has published more than 550 articles on viral hepatitis and liver diseases including five editions of the American Association for the Study of Liver Diseases guidelines on hepatitis B and the first edition of the World Health Organization guidelines on hepatitis B.

Fabien Zoulim is Professor of Medicine at Lyon University, Head of the Hepatology Department at the Hospices Civils de Lyon, and Head of the Viral Hepatitis Research Laboratory at INSERM U1052, France. He is currently coordinating the ANRS “HBV cure” programme in France and the “IP-cure-B” project funded by the EU H2020 work programme. He co-founded the International Coalition to Eliminate HBV (ICE-HBV).

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Acknowledgements

J.-H.K. thanks D.-S. Chen for his instructions and M. H. Lee, C. J. Liu, R. F. Pwu and H. I. Yang for providing their expert opinions. M.L. thanks the investigators, partners, funders and patients and their families of the PROLIFICA programme, and is also grateful to the European Commission, MRC UK, Gilead Sciences, Abbott, Echosens and Cepheid companies for their financial and technical support. J.V.L. is supported by a Spanish Ministry of Science, Innovation and Universities Miguel Servet grant (Instituto de Salud Carlos III/ESF, European Union [CP18/00074]) and further acknowledges support from the Spanish Ministry of Science, Innovation and Universities through the “Centro de Excelencia Severo Ochoa 2019-2023” Programme (CEX2018-000806-S), and from the Government of Catalonia through the CERCA Programme. F.Z. acknowledges J. French for critically reading the manuscript, and the International Coalition to eliminate HBV and ANRS for supporting research efforts to cure viral hepatitis. M.H.E.-S. acknowledges the Faculty of Medicine Ain Shams University Research Institute (MASRI) and the Egyptian National Committee for Control of Viral Hepatitis.

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Authors and Affiliations

  1. Department of Medicine, Johns Hopkins University, Baltimore, MD, USA

    Andrea L. Cox

  2. Department of Paediatrics, Ain Shams University, Cairo, Egypt

    Manal H. El-Sayed

  3. Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan

    Jia-Horng Kao

  4. Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan

    Jia-Horng Kao

  5. Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain

    Jeffrey V. Lazarus

  6. Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Hepatology section, Imperial College London, St Mary’s Hospital, London, UK

    Maud Lemoine

  7. Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA

    Anna S. Lok

  8. Medical School, Lyon University, Lyon, France

    Fabien Zoulim

  9. Hepatology Department, Hospices Civils de Lyon, Lyon, France

    Fabien Zoulim

  10. Viral Hepatitis Research Laboratory, CRCL – INSERM U1052, Lyon, France

    Fabien Zoulim

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  1. Andrea L. Cox
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  2. Manal H. El-Sayed
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  3. Jia-Horng Kao
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  4. Jeffrey V. Lazarus
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  5. Maud Lemoine
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  6. Anna S. Lok
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  7. Fabien Zoulim
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Corresponding authors

Correspondence to Andrea L. Cox, Manal H. El-Sayed, Jia-Horng Kao, Jeffrey V. Lazarus, Maud Lemoine, Anna S. Lok or Fabien Zoulim.

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Competing interests

M.H.E.-S. has received an educational grant from Gilead. J.-H.K. declares that he has acted as a consultant for Arbutus, Gilead Sciences and Roche, and appeared on speaker’s bureau for Bristol-Myers Squibb, Gilead Sciences, Fujirebio, Merck Sharp & Dohme and Roche. J.V.L. reports grants and personal fees from AbbVie, Gilead Sciences and MSD, and personal fees from CEPHEID, GlaxoSmithKline, Intercept and Janssen, outside of the submitted work. M.L. has received funding and fees from Gilead and Viiv Health care. A.S.L. acknowledges research grants (to the University) from Assembly, Bristol-Myers Squibb, Gilead, and TARGET, and has served on advisory boards or as a consultant for Gilead, GlaxoSmithKline, Huahui, Spring Bank and TARGET. F.Z. has research contracts through INSERM with Evotec and Roche. He has also acted as an advisor or consultant for Assembly, Aligos, Evotec, Galapagos, Gilead, GlaxoSmithKline, Myr Pharma, Roche Molecular Systems, Transgene and Vir Bio. A.L.C. declares no competing interests.

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Related links

AASLD HCV Guidelines: https://www.hcvguidelines.org

ANRS: http://www.anrs.fr/fr

Coalition for Global Viral Hepatitis Elimination: https://www.globalhep.org

International Coalition to Eliminate HBV: https://www.ice-hbv.org

PROLIFICA: http://www.prolifica.africa

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Cox, A.L., El-Sayed, M.H., Kao, JH. et al. Progress towards elimination goals for viral hepatitis. Nat Rev Gastroenterol Hepatol 17, 533–542 (2020). https://doi.org/10.1038/s41575-020-0332-6

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