Intended for healthcare professionals


Control of hepatitis B and C worldwide

BMJ 2009; 339 doi: (Published 28 October 2009) Cite this as: BMJ 2009;339:b4431
  1. Rakesh Aggarwal, additional professor,
  2. Amit Goel, senior resident
  1. 1Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India
  1. aggarwal.ra{at}

    Treatment is costly and has limited effectiveness, so preventive measures are essential

    Hepatitis B virus (HBV) and hepatitis C virus (HCV) are hepatotropic viruses that share several characteristics, including transmission through percutaneous routes, such as transfusion of blood products and contaminated injections. The viruses often cause persistent infection with serious long term sequelae such as liver cirrhosis and hepatocellular cancer.

    HBV infection is highly endemic (the prevalence of hepatitis B surface antigen exceeds 8% in the general population) in sub-Saharan Africa, Southeast Asia, and Western Pacific regions, and HCV infection is highly prevalent in Egypt, affecting 15-20% of the population. Globally, nearly 340 million and 170 million people are thought to be chronically infected with HBV and HCV, respectively,1 2 far exceeding the 33 million people infected with HIV.

    Chronic HBV and HCV infection are responsible for nearly 57% of cases of liver cirrhosis (HBV 30%, HCV 27%) and 78% of hepatocellular cancers (HBV 53%, HCV 25%) worldwide and cause nearly one million deaths each year.3 Furthermore, these infections often affect young people, impairing their quality of life and productivity. Safe vaccines with more than 95% protective efficacy against HBV have been available for more than …

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