The global burden of viral hepatitis remains unacceptably high despite the availability of affordable antiviral treatments and an effective hepatitis B vaccine. The World Health Organization (WHO)’s 2024 Global Hepatitis Report highlights a concerning stagnation in progress toward the 2030 viral hepatitis elimination goals [
1]. Although there has been some progress in diagnosis and treatment of viral hepatitis since 2019, the number of deaths from hepatitis B virus (HBV) and hepatitis C virus (HCV) infection rose to 1.3 million in 2022, exceeding the 2019 estimate of 1.1 million. This places viral hepatitis as the second most common communicable cause of death following COVID-19. Additionally, there were 1.2 million new hepatitis B infections and approximately 1 million new hepatitis C infections in 2022, figures only marginally lower than those from 2019 estimates. Regarding diagnosis and treatment, only 13% of individuals with chronic hepatitis B had been diagnosed, and about 3% had received antiviral therapy by the end of 2022. Similarly, only 36% of patients with hepatitis C had been diagnosed, with 20% having received antiviral therapy. Although these statistics show slight improvements compared to 2019 data, they are still far from the WHO goal to treat 80% of patients with viral hepatitis by 2030.
South Korea is one of the 20 countries that collectively bear more than 75% of the global burden of viral hepatitis [
2]. To assess current status towards the WHO goal of eliminating viral hepatitis in South Korea, Lee et al. [
3] estimated the incidence, linkage-to-care, treatment, and liver-related mortality rates for patients diagnosed with HBV and HCV infection from 2018 to 2020 [
3]. The study found that the incidence of acute HBV infection in South Korea was 0.71 cases per 100,000 population, with a linkage-to-care rate of only 39.4%. The treatment rate for those requiring hepatitis B therapy was 67.3%, falling short of the WHO’s 80% target. Furthermore, the annual liver-related mortality due to HBV was 18.85 cases per 100,000 population, with hepatocellular carcinoma being the predominant cause of death. These statistics contrast sharply with the WHO’s target of four cases per 100,000 population, underscoring the critical need for enhanced interventions. The situation with HCV presents similar challenges. The annual incidence of newly diagnosed HCV infection was 11.9 cases per 100,000 population, more than double the WHO target of five. The linkage-to-care rate for HCV-infected patients was 65.5% and the treatment rate was 56.8%, both significantly lower than the WHO targets of 90% and 80%, respectively. The annual liver-related mortality rate due to HCV infection was 2.02 cases per 100,000 population, indicating a pressing need for improved healthcare policies and practices. These results highlight the shortcomings of the current approach to eliminating HBV and HCV infections in South Korea.
The Korean Association for the Study of the Liver, in collaboration with the Korean Disease Control and Prevention Agency, has established national targets for the elimination of HBV and HCV [
4]. These targets include achieving an HBV antibody prevalence of 1% with a treatment uptake of 95%, and an HCV antibody prevalence of 0.3% with a treatment uptake of 90%. To achieve these goals, a comprehensive national policy is essential. This policy should include robust public health campaigns to enhance general awareness of viral hepatitis, implement cost-effective screening tests as part of national health screening programs, and improve access to diagnostic programs and effective treatments for viral hepatitis [
5,
6]. Continuous monitoring and evaluation of these measures will also be crucial to ensure progress towards the elimination goals. Unfortunately, South Korea has made no progress in policy between 2018 and 2023, as measured by a hepatitis elimination policy index, while 14 of the top 20 most heavily burdened countries have advanced in this area, indicating that there is still a long way to go for South Korea [
5,
7].
In conclusion, the study provides a critical assessment of South Korea’s efforts to eliminate HBV and HCV infections, revealing significant shortfalls in achieving WHO targets. The suboptimal linkage-to-care and treatment rates, coupled with high liver-related mortality, underscore the urgent need for a strategic overhaul. By adopting a more rigorous and comprehensive strategy, South Korea can make meaningful strides towards the elimination of viral hepatitis, improving public health outcomes and reducing the burden of liver disease.
FOOTNOTES
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Conflicts of Interest
The author has no conflicts of interest to declare.
Abbreviations
REFERENCES
- 1. World Health Organization. Global hepatitis report 2024: action for access in low-and middle-income countries. Geneva; World Health Organization, 2024.
- 2. Cooke GS, Andrieux-Meyer I, Applegate TL, Atun R, Burry JR, Cheinquer H, et al. Accelerating the elimination of viral hepatitis: A Lancet Gastroenterology & Hepatology Commission. Lancet Gastroenterol Hepatol 2019;4:135-184.
- 3. Lee CH, Choi GH, Choi HY, Han S, Jang ES, Chon YE, et al. Core indicators related to the elimination of hepatitis B and C virus infection in South Korea: A nationwide study. Clin Mol Hepatol 2023;29:779-793.
- 4. Jee Y. Inclusion of hepatitis C virus testing in National Health Screening to accelerate HCV elimination in South Korea. Glob Health Med 2021;3:288-292.
- 5. Cooke GS, Flower B, Cunningham E, Marshall AD, Lazarus JV, Palayew A, et al. Progress towards elimination of viral hepatitis: A Lancet Gastroenterology & Hepatology Commission update. Lancet Gastroenterol Hepatol 2024;9:346-365.
- 6. Choi GH, Jang ES, Kim JW, Jeong SH. A survey of the knowledge of and testing rate for hepatitis C in the general population in South Korea. Gut Liver 2020;14:808-816.
- 7. Palayew A, Razavi H, Hutchinson SJ, Cooke GS, Lazarus JV. Do the most heavily burdened countries have the right policies to eliminate viral hepatitis B and C? Lancet Gastroenterol Hepatol 2020;5:948-953.
Citations
Citations to this article as recorded by
- Correspondence to letter to the editor on “Contemporary awareness of viral hepatitis between 2012 and 2022 among Korean adults”
Chang Hun Lee, In Hee Kim, Sook-Hyang Jeong
Clinical and Molecular Hepatology.2025; 31(2): e149. CrossRef - Correspondence to editorial on “Core indicators related to the elimination of hepatitis B and C virus infection in South Korea: A nationwide study”
Chang Hun Lee, In Hee Kim, Sook-Hyang Jeong
Clinical and Molecular Hepatology.2024; 30(4): 997. CrossRef
