Hepatitis treatment coverage among infected population

This indicator measures progress of treatment coverage among people living with chronic HBV and viraemic HCV infections, towards the 2030 hepatitis elimination goals.

• Proportion of people with chronic hepatitis B initiated on treatment of those eligible
• Proportion of people with viraemic hepatitis C initiated on treatment

By country and WHO region

Country-reported data: The indicator is compiled from routine national programme, surveillance, laboratory, clinical or health information system records. Data should cover the reporting year and the geographical and population scope reported by the country. Countries should describe whether the data are national or subnational, which sectors and facilities are included, and whether individual-level deduplication or record linkage is used.

HBV: Numerator: Number of people with chronic hepatitis B ever initiated on treatment of those eligible. This may be sourced from specific programme or clinical patient monitoring tools (electronic or paper medical records) Denominator: Estimated number of people living with chronic HBV. This can be derived from nationally representative biomarker survey or modelled estimates

HCV: Numerator: :Number of people with viraemic hepatitis C ever initiated on treatment. This may be sourced from specific programme or clinical patient monitoring tools (electronic or paper medical records) Denominator: Estimated number of people living with viraemic HCV. This can be derived from nationally representative biomarker survey or modelled estimates. For chronic HCV the denominator includes those with resolved infection (cured or naturally cleared) . all total HCV infections (all ages) since 2015. This intended to reflect the historical testing effort and treatment coverage. Those with re-infection are included but counted once.

Modelled estimates: Where complete country-reported data are unavailable, WHO may produce a country-calibrated estimate using available programme data, epidemiological evidence, demographic data and other relevant inputs. The modelled estimate is intended to provide a coherent value for the specified reference year and may not equal a value reported directly by the country.

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)

Estimates are also produced at global level and for WHO regions

Percent

Every two years

Continuous at country level reported every two years to WHO

Comparability and Interpretation: Coverage estimates are suitable for monitoring broad progress toward elimination targets but should not be used for precise ranking of countries. Comparisons should take account of differences in epidemiological context, treatment policies and data quality.

This dataset contains a combination of country-reported data and WHO-supported modelled estimates. Values may differ because they are derived from different data sources, population coverage, reference years and methodologies. Country-reported data are intended primarily for national programme monitoring, whereas modelled estimates are intended to support standardized comparisons across countries and over time. Direct comparisons between country-reported and modelled values, or between countries represented by different observation types, should therefore be made with caution. Differences between WHO estimates and official national figures should not necessarily be interpreted as errors but may reflect methodological and data-source differences.

hepatitisreporting@who.int

Diana Faini

3605

Treatment coverage estimates are influenced by uncertainty in both treatment and prevalence estimates. Differences in treatment eligibility definitions, patient retention, reporting completeness and prevalence estimation methods may affect results.