New hepatitis B in England report sets the stage for action on elimination

Posted on: 17th February 2023

The UK Health Security Agency (UKHSA) has released a new report on hepatitis B in England. The report is the first of its kind. It sets out the data on hepatitis B and how near England is to meeting the WHO targets to eliminate hepatitis B (along with hepatitis C) as a global health challenge by 2030.

While it highlights how much data we are currently missing, the report itself is a major step forward. It will be produced annually from now on, bringing hepatitis B monitoring and reporting in line with similar viruses such as hepatitis C and HIV. The report also sets out how UKHSA will fill data gaps and when we can expect to have a fuller picture. As well as UKHSA’s plans to tackle hepatitis B in England.

Hepatitis B is a blood-borne virus that damages the liver. The UK has low levels of hepatitis B compared to other countries. Places with higher levels include countries in south and east Europe, west Africa, and south and east Asia. Most people living with hepatitis B in the UK were born in a country where the virus is more common and picked it up there either at birth or as a child.

Stopping hepatitis B being passed on from mothers to their babies is a key tactic in reducing levels and impact of hepatitis B. And the headline finding from the report is that in 2022 WHO Europe confirmed that the UK are meeting the target for elimination of mother to child transmission.

This is through a combination of adding hepatitis B to the 6-in-1 vaccination schedule for babies, which happened in 2017. And screening pregnant women for hepatitis B so their baby can have additional treatments when they are born. These measures are in place across all 4 nations and the UK as a whole is meeting the target.

Other findings from the report, relating to England only, include:

  • UKHSA estimates there are 206,000 people living with hepatitis B in England. Many of these people are undiagnosed, but there is currently no reliable estimate.
  • Fewer than 4 in every 100,000 deaths are caused by hepatitis B, meeting the WHO target, this is largely down to having relatively low levels of the virus.
  • Importantly we haven’t seen any drops in deaths, cancers or liver failure linked to hepatitis B. Or in the need for liver transplants for people who have developed serious liver disease due to the virus.
  • COVID-19 understandably had a big impact on many targeted testing and vaccination programmes, for example for people who inject drugs. Worryingly, the data shows things haven’t bounced back to pre-pandemic levels and work must be done to fill the gaps.

This month the Welsh Government have also published a short update on progress on hepatitis B and C elimination in Wales. This includes data on uptake of the 6-in-1 vaccine for babies, confirming it has been over 95% for the last few years compared to a WHO target of 90%. The Minister for Health and Social Services, Eluned Morgan, also sets out work in progress and plans for the future.

Hepatitis B is long overdue for action and the British Liver Trust are encouraged by the publication of this report. As UKHSA make clear, meeting the UK’s 2030 elimination commitments will take concerted and coordinated action. The British Liver Trust are proud to play our part through collaborative working with policy makers, clinicians and researchers – making sure the voices of people living with hepatitis B are heard.