Each May, during Hepatitis Awareness Month, attention turns to the millions of people worldwide living with viral hepatitis, many of whom are undiagnosed or untreated. Chronic hepatitis B (CHB) poses a major public health challenge despite the availability of effective vaccines and treatments. According to GlobalData’s epidemiology forecast for the seven major markets (7MM: the US, France, Germany, Italy, Spain, the UK, and Japan), the burden of CHB is expected to remain substantial over the next ten years, at approximately 3.9 million and 2.1 million total and diagnosed prevalent cases per year, respectively. While progress in prevention has reduced new infections in many countries, ongoing gaps in screening and access to care and chronic disease complications, such as cirrhosis, continue to place pressure on healthcare systems.
In the 7MM, the diagnosed prevalence of CHB increases with age, with more than 56% of diagnosed prevalent cases occurring in individuals aged 45 years and older. This pattern highlights remaining gaps in diagnosis and linkage to care, since chronic infections remain silent for decades before serious complications emerge. Across these markets, one of the largest contributors to the healthcare burden of CHB is progression to liver cancer, in particular hepatocellular carcinoma (HCC). Additionally, ageing populations across the 7MM mean that more CHB patients present with co-occurring illnesses that make managing care and treatment more costly and complicated. Comorbidities, even those that are non-liver related, also reduce the patient’s quality of life. Another major contributor to the economic challenges of CHB management is its chronic nature. Many patients require lifelong antiviral therapy and surveillance for liver complications. The epidemiology of hepatitis B in the 7MM is increasingly defined by chronic disease management rather than acute infection control. This is in part due to successful infant vaccination campaigns and targeted outreach in communities with a high risk of hepatitis B infection, such as migrants from regions where hepatitis B is endemic, resulting in fewer new infections.
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Continued focus on early childhood vaccination and improved case finding will be critical in managing CHB. CHB is expected to remain a significant public health challenge over the next decade due to the growing concentration of cases among older adults living with CHB and comorbid conditions. Population ageing may shift the future impact of CHB in these markets from reducing transmission to managing the cumulative clinical and economic demands associated with multimorbidity, underscoring the importance of epidemiological surveillance, screening, diagnosis, and treatment.
