Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 14, 2021; 27(26): 4004-4017
Published online Jul 14, 2021. doi: 10.3748/wjg.v27.i26.4004
Progress and challenges in the comprehensive management of chronic viral hepatitis: Key ways to achieve the elimination
Fátima Higuera-de la Tijera, Alfredo Servín-Caamaño, Luis Servín-Abad
Fátima Higuera-de la Tijera, Department of Gastroenterology and Hepatology, Hospital General de México, Mexico City 06726, Mexico
Alfredo Servín-Caamaño, Department of Internal Medicine, Hospital General de México, Mexico City 06726, Mexico
Luis Servín-Abad, Department of Gastroenterology, Saint Cloud Hospital, Saint Cloud, MN 56303, United States
Author contributions: Higuera-de la Tijera F designed the overall concept of the manuscript; Higuera-de la Tijera F and Servín-Caamaño A performed the literature review and wrote the manuscript; Servín-Abad L translated and edited the manuscript to its English version.
Conflict-of-interest statement: Fátima Higuera-de-la-Tijera is speaker for Gilead Sciences Inc. Alfredo Servín-Caamaño and Luis Servín-Abad have not conflict of interests.
Open-Access: This article is an open-access article selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed by the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, and the use is non-commercial. See:
Corresponding author: Fátima Higuera-de la Tijera, MD, MSc, PhD, Academic Research, Professor, Department of Gastroenterology and Hepatology, Hospital General de México, Dr. Balmis 148 Col. Doctores, Del. Cuauhtémoc, Departamento de Gastroenterología 310-D., Mexico City 06726, Mexico.
Received: January 22, 2021
Peer-review started: January 22, 2021
First decision: February 28, 2021
Revised: March 4, 2021
Accepted: June 17, 2021
Article in press: June 17, 2021
Published online: July 14, 2021

Chronic viral hepatitis is a significant health problem throughout the world, which already represents high annual mortality. By 2040, chronic viral hepatitis due to virus B and virus C and their complications cirrhosis and hepatocellular carcinoma will be more deadly than malaria, vitellogenesis-inhibiting hormone, and tuberculosis altogether. In this review, we analyze the global impact of chronic viral hepatitis with a focus on the most vulnerable groups, the goals set by the World Health Organization for the year 2030, and the key points to achieve them, such as timely access to antiviral treatment of direct-acting antiviral, which represents the key to achieving hepatitis C virus elimination. Likewise, we review the strategies to prevent transmission and achieve control of hepatitis B virus. Finally, we address the impact that the coronavirus disease 2019 pandemic has had on implementing elimination strategies and the advantages of implementing telemedicine programs.

Keywords: Hepatitis C, Hepatitis B, Vaccination, Elimination program, Telemedicine, Direct antiviral agents

Core Tip: The World Health Organization proposes eliminating hepatitis infection as a threat to public health by 2030. Despite notable advances reached to achieve those goals, many challenges persist, such as guarantee access to complete vaccination schemes for hepatitis B virus and universal screening for all adults at least once in life to screen for hepatitis C virus. Those non-vaccinated against hepatitis B virus guarantee access to effective therapies programs to all patients who need it, emphasizing risk groups like prison inmates, sex workers, injecting drug users, and men who have sex with men, trying to reduce the high incidence of viral hepatitis in these groups. Telemedicine and telementoring approaches are valuable strategies to facilitate more patients access to healthcare systems and should be encouraged. Coronavirus disease 2019 pandemic affects all strategies significantly to eliminate viral hepatitis, particularly in low-income and middle-income countries. With available effective vaccines for anti-severe acute respiratory syndrome-coronavirus-2, strategies to immunize most people are crucial to restarting the viral hepatitis elimination programs throughout the world as soon as possible.