Hepatitis B And C: Advances in Epidemiology, Diagnosis, Treatment and Prevention, And the Emerging Prospect of Functional Cure — A Narrative Review
DOI registered with Crossref
https://doi.org/10.37547/ijmsphr/Volume07Issue11-03
Keywords
Hepatitis B
Antiviral Agents
Hepatitis B Vaccines
Abstract
Background: Chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections remain leading causes of cirrhosis and hepatocellular carcinoma. WHO estimated that, in 2024, about 240 million people lived with chronic HBV and 47 million with HCV infection, and that these infections caused about 1.3 million deaths.
Objective: To synthesise current evidence on the epidemiology, natural history, diagnosis, treatment and prevention of HBV and HCV, and to distinguish established practice from emerging and investigational approaches.
Methods: Narrative review of WHO reports, current guidance from WHO, EASL, AASLD–IDSA and CDC, systematic reviews, modelling studies, pivotal trials and regulatory announcements. Searches were run on 9 November 2026 using web search, PubMed records and official websites, with priority given to publications from 2021 to 2026. No patient data were collected.
Main findings: The cascade of care remains the central failure. In 2024, 27% of people with chronic HBV knew their status and fewer than 5% were treated, although about half would be eligible under WHO’s 2024 criteria. New HCV infections had fallen by only 8% since 2015. Guidelines now diverge on HBV treatment eligibility. WHO favours simplified criteria for low-resource settings, EASL bases priority mainly on HBV DNA, ALT and fibrosis, and AASLD/IDSA retains phase-based categories. Pangenotypic direct-acting antivirals cure more than 95% of treated HCV infections, but cure confers no immunity and does not remove the cancer risk in established cirrhosis. In 2026, the FDA approved bulevirtide for chronic hepatitis D and bepirovirsen, which produced functional cure in 19%–20% of selected virologically suppressed HBV patients in phase 3 trials. No HCV vaccine exists.
Conclusion: Effective prevention and treatment exist for both infections, but elimination remains off track. Progress depends mainly on simplified testing, affordable treatment, timely birth-dose vaccination and harm reduction, with new curative approaches for HBV still limited to selected patients.
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