Over 13 million people in the WHO European Region are living with chronic hepatitis B infection and over 15 million with chronic hepatitis C infection. Between them, these two diseases lead to 400 deaths in the Region every day. Many cases of viral hepatitis remain asymptomatic until decades after infection, slowly destroying the liver and eventually presenting as grave and deadly complications such as liver cirrhosis, liver cancer and liver failure.

In most countries in the Region, the majority (in some countries, more than 75%) of people living with viral hepatitis do not know about their infection. Many became infected through blood transfusion or other medical procedures years ago when no tests were available and more than 20% will develop liver cirrhosis or cancer if the diseases are not diagnosed in time.

Several vulnerable population groups, particularly people who inject drugs, are at greatest risk of becoming infected. However, everyone is potentially at risk, because unsafe injections and other invasive procedures that can expose individuals to hepatitis C and hepatitis B viruses within and outside the health care sector still occur.

Even though blood safety and safe injecting practices in health care settings have improved in recent years, the hepatitis viruses continue to spread. In the past, viral hepatitis received little attention from policy-makers. Most countries have been reluctant to address viral hepatitis, such as ensuring access to treatment and prevention to all who need them and reducing the costs of drugs and diagnostics. Sexual transmission of viral hepatitis B is an ongoing issue, although universal vaccination to prevent this disease has been in place for over 20 years in most countries. Vaccination of newborns is the most effective, safest way to prevent mother-to-child transmission of viral hepatitis B, and the vaccine provides protection from the infection throughout life.

As transmission of hepatitis C and B viruses through blood and unsafe injection practices continues in the Region, there should be scaled-up prevention programmes for vulnerable groups based on evidence-based interventions, such as harm reduction for people who inject drugs and equal access to services and treatment. Recent revolutionary treatments for chronic hepatitis C have made it possible to cure more than 90% of infected people in just 3 months, without the severe adverse effects often seen with previous treatment regimens. Unfortunately new treatments are still unacceptably expensive and political will from both government and civil society organizations is needed to improve access to treatment and to ensure affordable prices.

WHO is working on a global strategy to combat viral hepatitis, which will include a comprehensive package of prevention measures and call for better access to treatment and better global awareness about viral hepatitis, the so-called “silent killer”.

To download a factsheet on Hepatitis B, click here    on www.euro.who.int

To download a factsheet on Hepatitis C, click here on www.euro.who.int