WHO’s Dr Philippa Easterbrook gives a situation update on the recent hepatitis outbreak affecting children including possible causes and steps parents, caregivers and countries should take.
An overview of validation structures and responsibilities at national, regional and global levels.
This governance document supplements the global guidance document. Validation of elimination requires rigorous assessment at the national, regional and global levels of the impact and process indicato...rs and the fulfilment of the four foundational requirements for (1) data quality, (2) strong programmes, (3) laboratory quality and (4) human rights, gender equality and community engagement.
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WHO estimates that in 2015, 257 million people were living with chronic hepatitis B virus (HBV) infection worldwide, and that 900 000 died from HBV infection, mostly through the development of cirrhosis and hepatocellular carcinoma. Worldwide, the majority of persons with chronic hepatitis B infecti...on and associated deaths in adulthood acquired their infection at birth through mother-to-child perinatal transmission or in early childhood.
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Testing and diagnosis of hepatitis B (HBV) and C (HCV) infection is the gateway for access to both prevention and treatment services, and is a crucial component of an effective response to the hepatitis epidemic. Early identification of persons with chronic HBV or HCV infection enables them to recei...ve the necessary care and treatment to prevent or delay progression of liver disease. Testing also provides an opportunity to link people to interventions to reduce transmission, through counselling on risk behaviours and provision of prevention commodities (such as sterile needles and syringes) and hepatitis B vaccination.
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J Hepatol (2017), http://dx.doi.org/10.1016/j.jhep.2017.03.021
The recommendations in these guidelines promote the use of simple, non-invasive diagnostic tests to assess the stage of liver disease and eligibility for treatment; prioritize treatment for those with most advanced liver disease and at greatest risk of mortality; and recommend the preferred use of n...ucleos(t)ide analogues with a high barrier to drug resistance (tenofovir and entecavir, and entecavir in children aged 2–11 years) for first- and second-line treatment. Recommendations for the treatment of HBV/HIV-coinfected persons are based on the WHO 2013 Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection, which will be updated in 2015.
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Este documento ofrece una orientación provisional a los países sobre las consideraciones y estrategias de análisis para los casos sospechosos de hepatitis aguda grave de etiología desconocida en niños. Está dirigido principalmente a las partes interesadas en el ámbito clínico, programático,... de laboratorio y de diagnóstico de los Estados miembros y a las autoridades nacionales de salud pública que participan en la identificación e investigación de casos de hepatitis aguda grave en niños.
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Drugs, Diagnostics, Vaccines, Preventive Technologies, Research toward a cure, and immune-based and gene therapies in development
Policy Brief. 24 June 2022. This policy brief, one of two on the updated hepatitis C (HCV) guidelines, focuses on the new recommendations on simplified service delivery for a public health approach to HCV testing, care and treatment. These recommendations include decentralization, integration and ta...sk-sharing, in addition to the use of point-of-care (POC) HCV viral load assays and reflex viral load testing.
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Clinical guideline, Methods, Evidence and Recommendations
In this guideline the following is covered: information needs of people with chronic hep
titis B and their carers; where children, young people and adults with chronic hepatitis B a-
should be assessed; assessment of liver disease, includi...ng the use of non-invasive tests and genotype testing; criteria for offering antiviral treatment; the efficacy, safety and cost effectiveness of currently available treatments; selection of first-line therapy; management of treatment failure or drug resistance; prophylactic treatment during im-
munosuppressive therapy; and monitoring for treatment response
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Viral hepatitis is defined as inflammation of the liver cells due to viral infection. The burden of liver disease in South Africa is mostly underestimated as viral hepatitis, in particular chronic infection, is a silent and neglected cause of morbidity and mortality. However, the burden of disease i...s likely substantial given the prevalence of chronic viral hepatitis. This burden is further compounded by the lack of screening and access to care and treatment as well as inadequate disease surveillance, human and financial resources.
The National Guidelines for the Management of Viral Hepatitis were developed, with the purpose to:
inform healthcare workers in the public and private sectors about the disease, its epidemiology in South Africa and current methods of diagnosis and therapy
strengthen the healthcare response to viral hepatitis
empower communicable diseases workers and stakeholders to make informed decisions regarding appropriate and cost effective interventions
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Direct acting antivirals (DAAs) have revolutionized treatment for hepatitis C. Combi-
nations of DAAs can cure infection with HCV in 12 weeks, are highly effective and
have limited side-effects. Affordability of DAAs has improved significantly, but access remains lim-
i...ted. Initially, due to their high prices, affordability of DAAs was limited in high-, middle- and low-
income countries alike. Now there is a divide between those countries where, because of intellectual
property barriers, prices have remained (very) high and other countries where generics are, or can be,
available at much lower prices. The result is a dual market
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This document provides interim guidance to countries on testing considerations and strategies for suspect cases of severe acute hepatitis of unknown aetiology in children. It is primarily intended for clinical, programmatic, laboratory and diagnostic stakeholders across Member States and national pu...blic health authorities involved in the identification and investigation of cases of severe acute hepatitis in children.
This document is part of a package of guidance for this event, which includes suggested minimum reporting variables and a clinical Case Report Form support Member States with case investigation and reporting.
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Hepatitis B (HBV) infection is a major public health problem and cause of chronic liver disease.
The 2024 HBV guidelines provide updated evidence-informed recommendations on key priority topics. These include expanded and simplified treatment criteria for adults but now also for adolescents; expa...nded eligibility for antiviral prophylaxis for pregnant women to prevent mother-to-child transmission of HBV; improving HBV diagnostics through use of point-of-care HBV DNA viral load and reflex approaches to HBV DNA testing; who to test and how to test for HDV infection; and approaches to promote delivery of high-quality HBV services, including strategies to promote adherence to long-term antiviral therapy and retention in care.
The 2024 guidelines include 11 updated chapters with new recommendations and also update existing chapters without new recommendations, such as those on treatment monitoring and surveillance for liver cancer.
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The Consolidated guidelines on HIV, viral hepatitis and STI prevention, diagnosis, treatment and care for key populations outline a public health response for 5 key populations (men who have sex with men, trans and gender diverse people, sex workers, people who inject drugs and people in prisons and... other closed settings). They present and discuss new recommendations and consolidate a range of recommendations and guidance from current WHO guidelines.
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Validation of elimination of mother-to-child transmission, or vertical transmission, of HIV, syphilis and hepatitis B virus (HBV), is an attestation that a country has successfully met standard criteria for elimination, or for being at 1 of the 3 levels of achievement on the ‘Path to Elimination... while delivering quality services for women, girls and their children, through the life-course, respecting human rights and ensuring gender equality and community engagement.
This document, the third version, adds on EMTCT of hepatitis B virus (HBV), bringing together a package of interventions and metrics to support integrated management and monitoring of vertical transmission across a wide range of epidemiological and programmatic contexts.
This document, the third version, adds on EMTCT of hepatitis B virus (HBV), bringing together a package of interventions and metrics to support integrated management and monitoring of vertical transmission across a wide range of epidemiological and programmatic contexts.
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L’objectif des lignes directrices 2024 est de fournir des recommandations actualisées et fondées sur
des données probantes sur les principaux sujets prioritaires. Ceux-ci concernent notamment les critères élargis et simplifiés de mise sous traitement pour les adultes, mais aussi désormais ...pour les adolescents, l’élargissement des critères d’éligibilité au traitement
antiviral prophylactique pour les femmes enceintes
afin de prévenir la transmission mère-enfant du VHB,
l’amélioration des tests de diagnostic de l’infection par le
VHB grâce à l’utilisation de tests de mesure de la charge
virale du VHB (ADN) sur le lieu de soins (“point-of-care
tests”) et d’approches réflexes pour la recherche de
l’ADN du VHB, et les critères pour déterminer à qui et
comment faire le test pour rechercher une infection par
le VHD.
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With the goal of ending viral hepatitis as a public health threat by 2030, the Regional Action Plan will provide an actionable framework for implementing evidence-based interventions at scale. It will be informed through strategic monitoring of the response, that must be equitable and sustainable an...d allow for innovations for acceleration and reaching out to all in need with health services. A major reduction in prices of newer drugs to potentially cure hepatitis C offers an added opportunity to work towards its elimination.
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