Exploring the Public Health and Social Implications of Future Curative Hepatitis B Interventions

Jack Wallace; Jacqueline Richmond; Jessica Howell; Behzad Hajarizadeh; Jennifer Power; Carla Treloar; Peter A Revill; Benjamin Cowie; Su Wang; Mark Stoové; Alisa Pedrana; Margaret Hellard

doi:10.3390/v14112542

Exploring the Public Health and Social Implications of Future Curative Hepatitis B Interventions

Viruses. 2022 Nov 17;14(11):2542. doi: 10.3390/v14112542.

Authors

Jack Wallace^{1

2

3}, Jacqueline Richmond¹, Jessica Howell^{1

4

5}, Behzad Hajarizadeh⁶, Jennifer Power², Carla Treloar³, Peter A Revill^{7

8}, Benjamin Cowie⁹, Su Wang¹⁰, Mark Stoové¹, Alisa Pedrana¹, Margaret Hellard^{1

11}

Affiliations

¹ Burnet Institute, Melbourne, VIC 3004, Australia.
² Australian Research Centre in Sex, Health and Society, Latrobe University, Bundoora, VIC 3083, Australia.
³ Centre for Social Research in Health, UNSW, Sydney, NSW 2052, Australia.
⁴ Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia.
⁵ Department of Medicine, University of Melbourne, Parkville, VIC 3010, Australia.
⁶ The Kirby Institute, UNSW, Sydney, NSW 3052, Australia.
⁷ Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Parkville, VIC 3010, Australia.
⁸ Department of Microbiology and Immunology, University of Melbourne, Parkville, VIC 3010, Australia.
⁹ WHO Collaborating Centre for Viral Hepatitis, Peter Doherty Institute for Infection and Immunity, Parkville, VIC 3010, Australia.
¹⁰ Center for Asian Health, Saint Barnabas Medical Center, RWJBarnabas-Rutgers Medical Group, Florham Park, NJ 07039, USA.
¹¹ Department of Infectious Diseases, Alfred Health & Monash University, Melbourne, VIC 3004, Australia.

Abstract

Hepatitis B is a significant global health issue where the 296 million people estimated to live with the infection risk liver disease or cancer without clinical intervention. The World Health Organization has committed to eliminating viral hepatitis as a public health threat by 2030, with future curative hepatitis B interventions potentially revolutionizing public health responses to hepatitis B, and being essential for viral hepatitis elimination. Understanding the social and public health implications of any cure is imperative for its successful implementation. This exploratory research, using semi-structured qualitative interviews with a broad range of professional stakeholders identifies the public health elements needed to ensure that a hepatitis B cure can be accessed by all people with hepatitis B. Issues highlighted by the experience of hepatitis C cure access include preparatory work to reorientate policy settings, develop resourcing options, and the appropriateness of health service delivery models. While the form and complexity of curative hepatitis B interventions are to be determined, addressing current disparities in cascade of care figures is imperative with implementation models needing to respond to the cultural contexts, social implications, and health needs of people with hepatitis B, with cure endpoints and discourse being contested.

Keywords: elimination; hepatitis B cure; hepatitis B virus; implementation; public health; social impact; stigma; treatment.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Hepacivirus
Hepatitis B* / epidemiology
Hepatitis B* / prevention & control
Hepatitis C*
Hepatitis, Viral, Human*
Humans
Public Health

Grants and funding

J.W., J.H. and M.H. receive fellowship support from the Australian National Health and Medical Research Council. J.H. is supported by a University of Melbourne Faculty Trust Fellowship. C.T. has received speaker fees from Gilead and Abbvie, and research funding (for an unrelated project) from Merck. P.A.R. received research funding from Gilead Sciences. M.S. receives investigator-initiated funding from Gilead Sciences, AbbVie, and Bristol Myers Squibb for research unrelated to this work. A.P. has received speaker fees from Gilead Sciences and receives funding from Gilead Sciences, AbbVie, and Merck for investigator-initiated research. M.H. has received funding from Gilead Sciences and AbbVie for investigator-initiated research. The authors gratefully acknowledge the contribution to this work of the Victorian Operational Infrastructure Support Program received by the Burnet Institute.