HBV Infections Among Children Under 5 Drop in the 21st Century 

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SEATTLE, Washington — The proportion of children under the age of 5 years old chronically infected with the hepatitis B virus (HBV) dropped to under 1% in 2019 from 5% in the late 20th Century. This achievement checks off one of the Sustainable Development Goals’ boxes under global health.
Doctors reached this goal by focusing on preventing HBV’s mother-to-child transmission by making the hepatitis B vaccine, which provides 95% protection, more convenient. On World Hepatitis Day 2020, the World Health Organization called for pregnant women to be tested and supplied with the vaccine. Additionally, they also called for making antiviral drugs and preventive antiviral therapy for pregnant women who test positive and hepatitis B immunization and birth dose vaccine for children more accessible.

Understanding the HBV Infection Among Children

HBV is a long-term liver infection that inflames the organ. HBV has chronically infected over 250 million people and is the cause of death for 900,000 people a year. Those who are infected at a young age and survive will likely battle liver damage and liver cancer in the future.
The most common transmission of the hepatitis B virus is via birth and delivery, from mother to child. Pregnant women at risk of acquiring HBV are tested in their first trimester and again at 28 weeks.
An estimated 80 to 90% of children infected before one year of age develop chronic infections. The birth dose vaccine, which is delivered within 24 hours of birth and is the first of three necessary doses, significantly protects infants.

The Good News

Gavi, The Vaccine Alliance, has contributed to driving down the number of HBV infections among children. Gavi support is on track to avert 0.3 to 1.2 million infection-related deaths from 2021 to 2035 as it establishes mandatory and extensive delivery of the immunization and birth dose. Coverage of the three doses of the HBV vaccine extended to 85% of children in 2019. China, for example, reduced the statistic of children under 5 who had the hepatitis B surface antigen to 0.32% well before 2020.

Future Progress and The Road Ahead

In 2019, 43% of infants worldwide attained the HBV birth dose within 24 hours of birth. However, although global coverage is at an all-time high, critical birth doses merely reached 34% of children in the WHO-designated Eastern Mediterranean Region, and 6% of infants in the WHO-designated African Region. Moreover, multiple countries in the region of sub-Saharan Africa have not yet received the birth dose.
Amid the COVID-19 pandemic, The WHO projects a surplus of 5.3 million HBV infections among children and 1 million deaths between 2020 and 2030 due to pandemic-related disruptions in expanding the vaccination program. In the worst-case scenario, the pandemic may delay 60% of recipients’ access to the birth dose and 20% of childhood HBV immunizations.

Conclusions

The rate of HBV infections among children under the age of 5 decreased to 1%, fulfilling the 2020 Sustainable Development Goal. However, the Western Pacific, South Asia and sub-Saharan Africa have still not gained adequate access to the HBV birth dose; thus, full elimination of the transmission of the virus and the attainment of the birth dose is underway.

Isabella Thorpe
Photo: Flickr
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