Hepatitis B and C testing in the EU/EEA: progress in reaching the elimination targets

Technical report
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European Centre for Disease Prevention and Control. Hepatitis B and C testing in the EU/EEA: progress in reaching the elimination targets – March 2021. Stockholm: ECDC; 2021.

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This brief will present a snapshot of hepatitis B and C testing in the European Union/European Economic Area (EU/EEA), discussing progress made towards the European action plan 2020 testing target, focussing on key populations and settings for testing, barriers to testing, and testing policies.

Executive summary

Key messages

  • Many people living with chronic hepatitis B and C infections in the European Union/European Economic Area (EU/EEA) are not aware of their infection. Testing and diagnosis of hepatitis B and C is the key step in the continuum of care to link people living with these infections to necessary care and treatment.
  • The World Health Organization (WHO) European Region hepatitis action plan testing target for 2020 is for 50% of people living with chronic hepatitis B (HBV) and hepatitis C (HCV) to be diagnosed and aware of their condition. Reported data from 2017 show that the region is far from meeting this target, with around one fifth of people with HBV and one quarter of people with HCV diagnosed.
  • Of the 31 countries in the EU/EEA, 19 did not report data on the proportion of HBV diagnosed and 16 did not report data on the proportion of HCV diagnosed for 2017, showing large gaps in the available data and an urgent need to improve monitoring and reporting of HBV and HCV diagnosis rates.
  • HBV and HCV testing efforts must be improved in key populations disproportionately affected by chronic viral hepatitis, including people in prisons, people who inject drugs (PWIDs), migrants to the European region, pregnant women (because of the risk to their child), and people living with HIV. There are several barriers to testing, including at the individual, policy, and wider structural levels, which must be addressed in order to improve access to hepatitis testing.