Published online Nov 14, 2015. doi: 10.3748/wjg.v21.i42.11941
Peer-review started: April 27, 2015
First decision: July 13, 2015
Revised: July 23, 2015
Accepted: September 30, 2015
Article in press: September 30, 2015
Published online: November 14, 2015
Hepatitis B virus (HBV) infection has shown an intermediate or high endemicity level in low-income countries over the last five decades. In recent years, however, the incidence of acute hepatitis B and the prevalence of hepatitis B surface antigen chronic carriers have decreased in several countries because of the HBV universal vaccination programs started in the nineties. Some countries, however, are still unable to implement these programs, particularly in their hyperendemic rural areas. The diffusion of HBV infection is still wide in several low-income countries where the prevention, management and treatment of HBV infection are a heavy burden for the governments and healthcare authorities. Of note, the information on the HBV epidemiology is scanty in numerous eastern European and Latin-American countries. The studies on molecular epidemiology performed in some countries provide an important contribution for a more comprehensive knowledge of HBV epidemiology, and phylogenetic studies provide information on the impact of recent and older migratory flows.
Core tip: Hepatitis B virus (HBV) infection is a heavy burden in most developing countries because of its wide spread, particularly in rural areas, and the high cost of prevention, management, and treatment. Therefore, a greater effort should be made towards implementing universal vaccination programs as they have been demonstrated to be effective in reducing the incidence of acute hepatitis B and the prevalence of hepatitis B surface antigen chronic carriers. In several low-income countries, an improvement in the current knowledge of HBV epidemiology, molecular epidemiology, HBV replication and co-infection with other viruses such as hepatitis C virus and human immunodeficiency virus is strongly desired.