Hepatitis B: A Concise Review

Abstract

Since the introduction of the hepatitis B vaccine and other preventive measures, the worldwide prevalence of hepatitis B virus (HBV) infection has fallen. However, chronic infection remains a major global health problem, with more than 350 million people chronically infected and at risk of hepatic decompensation, cirrhosis, and hepatocellular carcinoma. In developed countries like Canada, the burden of disease is greatest among marginalized populations and immigrants from regions where HBV is endemic, making chronic hepatitis B an important but clinically silent public health issue. The approval of the first potent oral antiviral agent in 1998 has revolutionized hepatitis B treatment, and current treatments such as conventional and pegylated interferon alfa and nucleoside and nucleotide analogues are widely used to suppress virus replication, reduces hepatitis activity, and halt disease progression. However, access to the most effective medicines in Canada remains difficult due to lack of coverage from provincial health plans unless evidence of liver cirrhosis is present. As the immigrant population increases in Canada, opportunities for education, screening, prevention and treatment of hepatitis B should be identified to increase awareness and help limit the spread of HBV. This will improve the outcome of HBV infection and reduce the burden on Canada’s health care system.