Global Chronic Hepatitis B Infection in Children Under 5 Drops to Under 1%

Worldwide efforts to combat Hepatitis B have led to a significant reduction in chronic infections among children under five, with prevalence dropping to just under 1% in 2019 from approximately 5% in the pre-vaccine era. This progress comes as public health advocates continue to highlight the severe consequences of the viral infection, particularly its link to liver cancer and its broad transmissibility. Ruxandra Teslo, a public health commentator, recently underscored these concerns, stating, "I don't think kids should get liver cancer bcuz of their mother's behaviour."

Hepatitis B is a viral infection that attacks the liver, potentially leading to acute or chronic disease, cirrhosis, and hepatocellular carcinoma (primary liver cancer). The virus is most commonly transmitted from mother to child during birth, or horizontally among young children, routes responsible for the majority of chronic infections. Globally, an estimated 254 million people were living with chronic Hepatitis B in 2022, with the disease causing approximately 1.1 million deaths annually, primarily from cirrhosis and liver cancer.

Prevention strategies, particularly universal infant vaccination, have been instrumental in curbing the spread of the virus. The World Health Organization (WHO) recommends that all infants receive their first dose of the Hepatitis B vaccine as soon as possible after birth, ideally within 24 hours, followed by additional doses. This vaccination protocol offers nearly 100% protection against the virus and has been a cornerstone of global elimination efforts.

Despite vaccination successes, challenges remain, especially concerning mother-to-child transmission from mothers with high viral loads. To address this, WHO now recommends antiviral prophylaxis, such as tenofovir, for pregnant women with high viral loads from the 28th week of pregnancy until birth. This measure supplements infant vaccination to further reduce transmission risk.

Teslo further emphasized the broader public health implications of the virus, noting, "even if you don't care abt that, Hep B is ~ easily transmissible, including without sexual contact, so it's bad for everyone if this disease becomes common enough." The virus can spread through contact with infected body fluids, including blood, saliva, and semen, and through unsafe injections or shared sharp instruments. Global health strategies aim to eliminate viral hepatitis as a public health threat by 2030, targeting a 90% reduction in new infections and a 65% reduction in mortality.