Table 1.
Goal to 2030
|
Existing resources
|
Barriers
|
Strategies that should be improved
|
Hepatitis C | |||
90% reduction of new viral hepatitis infections | Harm reduction programs: Safe-sex, safe-needles, and safe-syringes | If well, programs exist in the real-life world are not always sufficiently implemented | Target high-risk population such as MSM, prison inmates, sexual workers, patients with HIV, IDU, immigrants, children born from an HCV+ mother |
To reach 90% of patients with viral hepatitis infections being diagnosed | Tests with high sensitivity | If well, detection campaigns exist, it is not enough to reach all people in a real-life setting | Once in life, universal screening for all adults. Also target high-risk population such as immigrants, MSM, prison inmates, sexual workers, patients with HIV, IDU, children born from an HCV+ mother |
65% reduction in liver-related deaths | DAAs. Telemedicine and telementoring programs | Still, there is limited access to therapy. More restrained access in LMICs. Vulnerable groups with high prevalence and incidence of viral hepatitis have restricted access to therapy | Flexible policies that guarantee timely access to treatment to all who need it, including vulnerable groups such as immigrants, prison inmates, sexual workers, patients with HIV, IDU, children born from an HCV+ mother when appropriate. Consider including those without healthcare insurance to cover their medication. Encourage telemedicine programs to access communities of difficult access |
Hepatitis B | |||
Prevention of new HBV infections through vaccination and blood safety | Effective and safe vaccine | In the real-life world they are not always available or schemes are applied incompletely | Programs that effectively ensure universal and complete schemes of vaccination at birth for infants and later for those who did not receive the vaccination in childhood. Coverage should be extended and also prioritized for vulnerable groups |
Identification, linkage to care, and treatment of persons with chronic HBV | Serologic HBV panels. Nucleos(t)ide analogs with a highly effective and high barrier to resistance Telemedicine and telementoring programs | Serologic HBV panels for diagnosis sometimes are restricted to specialists. Still, there is limited access to therapy, more restrained in LMICs. Vulnerable groups with high prevalence and incidence of viral hepatitis have restricted access to therapy | Basic diagnostic tests (HBsAg and anti-HBc) should be available at primary healthcare. More flexible policies that guarantee timely access to treatment to all who need it, including vulnerable groups such as immigrants, prison inmates, sexual workers, IDU, children born from an HCV+ mother when appropriate. Consider including those without healthcare insurance to cover their medication. Encourage telemedicine programs to access communities of difficult access |
anti-HBc: Antibody against hepatitis B core antigen; DAAs: Direct antiviral agents; HBsAg: Hepatitis B surface antigen; HBV: Hepatitis B virus; HCV+: Positive to hepatitis C virus; HIV: Human immunodeficiency virus; IDU: Injecting drug users; LMICs: Low and middle-income countries; MSM: Men who have sex with men.