This indicator measures progress of diagnosis coverage among people living with chronic HBV and viraemic HCV infections, towards the 2030 hepatitis elimination goals.
Definition:
• Number of chronic HBV infected persons diagnosed with a positive HBsAg test
• Number of chronic HCV infected persons currently viraemic, diagnosed with a positive HCV RNA (PCR) or HCV core antigen, any year prior to or in the reporting year as long as they are still alive and viraemic
• Number of chronic HCV infected persons ever diagnosed with a positive HCV RNA (PCR) or HCV core antigen, including those cured
Disaggregation:
By country and WHO region
Method of measurement
Number of persons diagnosed with chronic HBV and HCV is collected as part of routine surveillance .Routine surveillance data from countries is prioritized and used for reporting by countries and complied by WHO.
Where these data are unavailable, WHO leads a consultative process to produce country-calibrated modelled estimates of number of chronic hepatitis HBV and HCV infected persons diagnosed.
For chronic HCV, the adjusted number of people living with chronic HCV includes those with resolved infection (cured or naturally cleared). This is intended to reflect the cumulative burden of the disease. The number is then used to estimated diagnosis and treatment coverage so as to demonstrate the historical testing effort and treatment coverage. Those with re-infection are included but counted once.
Method of estimation:
HBV model structure (PRoGReSs model): the HBV model uses a dynamic mathematical framework that estimates annual HBV prevalence and incidence by stage of liver disease, age and sex using disease progression and mortality (all-cause and liver-related) rates. The model integrates demographic profiles, vaccination coverage (including timely birth dose and three-dose infant
series), prevention measures such as hepatitis B immune globulin (HBIG) and maternal antiviral prophylaxis, HBV diagnosis and treatment schedules, and established HBV epidemiological parameters. Perinatal, early childhood and horizontal transmission are modelled using age-specific hepatitis B surface antigen (HBsAg) prevalence together with available prevention-coverage data. This allows the model to reflect both historical and current programme performance. HCV model structure: the HCV model employs a Markov/semi-dynamic natural history framework that follows people with viraemic infection across stages of liver disease, by age and sex, over time using disease progression and mortality (all-cause and liver-related) rates. It incorporates inputs from demographic profiles, HCV diagnosis and treatment initiation schedules, and subsequent cure (sustained virological response, SVR).
Method of estimation of global and regional aggregates:
Regional estimates are the sum of the country data in each WHO region.
Preferred data sources:
Information may be sourced from specific programme or clinical patient monitoring tools (electronic or paper medical records), hepatitis testing records, laboratory registers, logbooks and reporting forms at the facility and community levels
Unit of Measure:
Cases
Expected frequency of data dissemination:
Every two years
Expected frequency of data collection:
Continuous at country level reported every two years to WHO
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