This indicator measures progress of diagnosis coverage among people living with chronic HBV and viraemic HCV infections, towards the 2030 hepatitis elimination goals.
Definition:
• Proportion of people with chronic hepatitis B (HBsAg positive) who have been diagnosed
• Proportion of people with viraemic hepatitis C who have been diagnosed (HCV RNA positive or HCV core antigen positive) including those cured
Disaggregation:
By country and WHO region
Method of measurement
Measured by counting persons reported with chronic infection and dividing this number by the estimated size of the population infected. In that case, the numerator is the number of persons reported with chronic HBV or viraemic HCV infection from health-care facilities (case reporting) and/or laboratories, while the denominator is the estimated size of the population infected (modelled or estimated from a biomarker survey).
This indicator is measured as part of routine surveillance from countries.
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 numerator includes those with resolved infection (cured or naturally cleared) . This is intended to reflect the historical testing effort and coverage. Those with re-infection are included but counted once. Whereas, the denominator includes all total HCV infections (all ages) since 2015.
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:
Estimates are also produced at global level and for WHO regions
Preferred data sources:
Surveillance systems
Health facility data
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:
Percent
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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