SHANGHAI — Hepatitis is no longer the pervasive problem in China it once was, but the country must continue to invest in immunization programs and improve public awareness if it hopes to eliminate the disease completely, Shanghai health officials said Saturday at the third annual China International Import Expo.

Last month, China announced that it was no longer a global hot spot for hepatitis B, which now affects less than 1% of children under 5 in the country, down from over 9% two decades ago.

One of the most common causes of cirrhosis, hepatic cancer, and other liver diseases, hepatitis B has long been a serious public health concern for China. In a 1992 survey, the country reported that over 9% of the national population was living with chronic hepatitis B infections, making China a “highly endemic zone” for the disease under World Health Organization guidelines.

To combat the disease, the country has invested heavily in immunization, launching a childhood vaccination program in 1992. This was later expanded to universal free coverage to reduce mother-to-child transmission, one of the most common ways the hepatitis B virus is spread. The three-dose vaccine administered within 24 hours of birth has since averted an estimated 120 million hepatitis B infections, according to one study.

Today, China is home to some 86 million people living with chronic hepatitis B infections, accounting for around one-third of all hepatitis B carriers worldwide. People with hepatitis frequently encounter discrimination in Chinese society — in school, at work, and in their personal lives. In 2010, authorities prohibited employers from requiring job applicants to submit to a hepatitis B test, previously a common practice.

Globally, viral hepatitis is among the top 10 leading causes of death. To eliminate the disease, the World Health Organization has set goals of reducing new infections by 90%, diagnosing over 90% of people with the disease, and treating 80% of them by 2030.

“The infection rate has been greatly reduced, but there is still a large gap in terms of our diagnosis and treatment rate of hepatitis B and achieving the 2030 goals,” Liu Jingyi, a senior disease control official in Shanghai’s Xuhui District, told reporters during a group interview. She called for improved public awareness of hepatitis B prevention and expanded adult vaccination, especially for at-risk individuals such as those who are in close contact with carriers of the virus.

Despite a steep reduction in new hepatitis infections, less than 20% of all those affected have been diagnosed and are receiving treatment, Yang Xizhong, secretary general of the Chinese Foundation for Hepatitis Prevention and Control, told domestic media earlier this year.

For many who have been diagnosed, receiving effective treatment remains a major challenge. There’s no cure for hepatitis B, so patients rely on a limited number of medications including antiviral drugs and interferon therapy. In search of affordable treatments, China’s hepatitis carriers used to buy imported generic drugs from countries like India.

Now, however, thanks to successful negotiations with foreign pharmaceutical companies, essential drugs have become cheaper and more accessible for average Chinese families. Drugmakers like Gilead Sciences and GlaxoSmithKline are also working to develop new medicines that could become a “functional cure” for viral hepatitis.

Editor: David Paulk.

(Header image: A medical worker handles blood samples for hepatitis B tests in Yuncheng, Shanxi province, Aug. 21, 2020. Jiang Hua/IC)