Viral hepatitis remains a major global public health challenge, causing significant morbidity and mortality worldwide.

This group of infectious diseases primarily affecting the liver includes hepatitis A, B, C, D, and E viruses, each with distinct transmission routes, clinical severity, and prevention strategies.

Despite advances in diagnostic tools, vaccines, and antiviral treatments, viral hepatitis continues to pose complex challenges related to underdiagnosis, limited treatment access, and persistent new infections.

Global Epidemiology and Disease Burden

According to recent global reports, viral hepatitis causes approximately 1.3 million deaths annually, paralleling the mortality burden of tuberculosis. The global prevalence is heavily influenced by chronic infections with hepatitis B (HBV) and hepatitis C (HCV) viruses, which together afflict over 300 million individuals worldwide—254 million harbor chronic HBV and nearly 50 million chronic HCV infections.

While incidence rates for new infections have shown modest declines—from 3 million new cases in 2019 to 2.2 million in 2022—millions continue to contract these infections each year.

The burden is unequally distributed, with low- and middle-income countries experiencing over 85% of viral hepatitis-related deaths. The African Region accounts for 63% of new HBV infections yet faces low vaccination coverage; only 18% of newborns in this region receive the critical HBV birth-dose vaccine. Despite having intermediate treatment coverage, some areas still experience a disproportionately high number of deaths from hepatitis B.

Diagnostic and Treatment Challenges

Diagnosing viral hepatitis remains problematic due to the asymptomatic nature of chronic infections, leading to late-stage liver disease presentations. Globally, only 13% of HBV-infected individuals are diagnosed, with around 3% receiving antiviral treatment. For HCV, diagnosis is somewhat better at 36%, with 20% receiving curative therapies.

Current global diagnosis and treatment rates are not on track to meet the 2030 goal of providing care to 80% of affected individuals.

Barriers include limited access to affordable testing and treatment, lack of awareness, health infrastructure deficits, and sociocultural stigma. Despite the availability of effective vaccines for hepatitis A and B, and direct-acting antivirals (DAAs) curative for hepatitis C, coverage gaps persist. International travel, unsafe medical practices, and intravenous drug use contribute to ongoing transmission.

Prevention and Control Measures

Vaccination forms the cornerstone of viral hepatitis prevention. Universal infant HBV vaccination starting at birth has demonstrated substantial impact but requires expansion, especially the timely birth dose in high-burden areas. Hepatitis A vaccines prevent outbreaks but are variably adopted worldwide.

Harm reduction strategies target transmission among high-risk groups, including needle exchange programs and safe blood transfusion practices. Antiviral treatment for chronically infected persons not only improves health outcomes but reduces transmission risk, strengthening elimination efforts.

Global advocacy has culminated in World Hepatitis Day, observed annually on July 28 to raise awareness and galvanize action. The 2025 theme "Hepatitis: Let's Break It Down" emphasizes dismantling economic, societal, and structural barriers to hepatitis elimination.

Future Perspectives and Recommendations

Accelerated efforts are imperative to close the testing and treatment gaps through decentralized, affordable diagnostics and therapy scale-up. Innovations like point-of-care molecular testing and pan-genotypic DAAs facilitate broader reach.

Integration of hepatitis services into general healthcare, leveraging digital health technologies for monitoring and education, and strengthening health systems are vital strategies. Tailored interventions addressing regional epidemiological profiles will enhance efficacy.

Dr. Anna S. Lok, a preeminent hepatologist, declared in a 2025 expert panel discussion, "The fight against viral hepatitis is at a critical juncture where scientific advancements provide powerful tools; however, real-world impact hinges on equitable access and overcoming persistent barriers in diagnosis and care delivery."

While significant strides have been made in understanding and combating viral hepatitis, persistent challenges threaten global elimination goals. High prevalence, underdiagnosis, and treatment inequities demand coordinated, multifaceted strategies encompassing vaccination, harm reduction, improved diagnostics, and access to curative therapies.