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Fast tracking elimination of Hepatitis B among mothers and children

On World Hepatitis Day 2020, WHO is seeking to unite and step up to prevent mother-to-child transmission of hepatitis B (HBV), a preventable viral infection that attacks the liver and around 900 every year Claims the lives of millions of people. .

Globally, more than 250 million people are living with chronic HBV infection. Infants are particularly vulnerable: approximately 90% of children infected with HBV become chronic HBV carriers in the first year of life.

"Nobody should die due to hepatitis B in 2020," said Dr. Tedrus, Director-General of WHO, Tedros Adenom Ghebayeus – This is a classic example of a disease and should be prevented. "" Preventing transmission from hepatitis B
Mother-to-child and childhood are the most important strategies to control illness and save lives. Even in the midst of the COVID-19 pandemic, we must ensure that mothers and their babies have access to life-saving services
Hepatitis B Vaccination. "

Prevent hepatitis b

Infants can be protected from HBV through a safe and effective vaccine that provides over 95% protection against infection. WHO recommends that all infants receive their first dose of hepatitis B vaccine as soon as possible
After birth – preferably within 24 hours – after at least 2 additional doses.

According to WHO's latest prevalence estimates, the proportion of children under the age of five suffering from HBV decreased from 1% in 2019 to about 5% in the early 1980s in the pre-vaccine era.

This is the achievement of a global health sector strategy for the goal of viral hepatitis to reach under 1% prevalence of HBV infection in children aged five years by 2020.

The past two decades have been a great public health success story on the scale of the hepatitis B vaccine worldwide and have contributed to the reduction of HBV infection in children. In 2018, coverage of 3 doses of hepatitis B vaccine during childhood
Reaching 84% worldwide, up from around 30% in 2000. However, access to the first critical dose within 24 hours of birth remains uneven. The global coverage of this birth dose is 42%, but it falls to WHO Eastern Mediterranean and only 33%
4% in the WHO African region.

"Expanding access to timely birth dose of hepatitis B vaccine is the cornerstone of efforts to prevent maternal-to-child transmission of HBV. With reduced vaccine penetration to regions such as Sub-Saharan Africa, coverage is increasing
Dr. Meg Doherty, director of Global HIV, Hepatitis and STI programs, Drs. Meg Doherty stated that timely birth dose is a priority.

An additional method to protect children is to provide antiviral treatment to pregnant women to reduce maternal-to-child transmission of HBV. WHO already recommends regular testing of all pregnant women for HBV, as well as HIV and syphilis at the earliest
In her pregnancy. In view of new evidence on the safety and efficacy of antiviral prophylaxis in pregnant women and their children, WHO is today issuing 2 new recommendations:

  • Pregnant women who test positive for hepatitis B infection and have high levels of HBV in the blood (known as HBV viral load) should receive preventive antiviral therapy with tenofovir from 28.Th Week of pregnancy until birth. Antiviral
    The drug Tenofovir is available in many countries of the world at a price of less than US $ 3 per month.
  • In settings where HBV viral load testing is not available, WHO recommends the use of alternative low cost testing (HBeAg) to determine if a woman is eligible for preventive antiviral therapy.

Countries that have already achieved high coverage of hepatitis B vaccination include timely birth doses, routine testing for HBV infection in pregnant women, and antiviral prophylaxis for the needy, an additional opportunity to prevent is.
Further transmission from mother to child.

"Preventing vertical transmission of HBV is a key pillar of the global global triple elimination 'initiative, which seeks to end maternal-to-child transmission of three infections prevalent in low and middle income countries: HIV,
Syphilis and Hepatitis B Virus, ”Dr. Doherty said.

Eliminating maternal-to-child transmission of HBV is also an important step to reach the goal of WHO's global hepatitis strategy, which aims to reduce new hepatitis infections by 90% and deaths by 65% ​​compared to 2015 levels To do.

COVID-19 epidemic threatens future progress

COVID-19 threatens to impede progress. According to a new modeling study conducted by Imperial College London in collaboration with WHO, the epidemic may have a serious impact on efforts to block the hepatitis B vaccination program.
Reaching the goal of global strategy.

In the worst case scenario, with high levels of birth dose and childhood HBV vaccination (60% and 20% for one year, respectively), along with delay in the expansion of the vaccination program and slow recovery
With the 2030 WHO-targets planned in the COVID-19 period, there will be an estimated 5.3 million additional chronic HBV infections among children born between 2020 and 2030, and 1 million additional HBV-related deaths among those children later.
Thus, the opportunities now missed to prevent new HBV infection will have a long-lasting and life-threatening impact.

Attention Editors

World Hepatitis Day is observed every year on 28 July to raise awareness about viral hepatitis, an inflammation of the liver that causes many health problems including liver cancer. This year's theme is "Hepatitis-Free Future".
With a strong focus on preventing hepatitis B in mothers and newborns.

There are five main strains of hepatitis virus: A, B, C, D and E. Together, hepatitis is the most common cause of B and C deaths, killing 1.3 million people each year. COVID-19 amidst epidemic, viral hepatitis claims thousands
Lives every day.

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