This indicator measures progress towards reducing new chronic HBV and HCV infections and the hepatitis B and C elimination impact targets by 2030.
Evidence-based prevention strategies and highly effective curative treatments are available for HCV infection. This indicator therefore reflects both the outcome and impact of hepatitis C prevention and treatment on new HCV infections. It monitors trends, detects possible shifts in pattern and projects the future direction of the epidemic.
Definition:
Estimated number of new cases due to chronic hepatitis B and during the reporting period
Estimated number of new and relapse cases due to chronic hepatitis C during the reporting period
Disaggregation:
By country and WHO region
Method of measurement
Routine surveillance data from countries is prioritized and used for reporting .Where absent, estimates of incidence of chronic HBV and HCV are produced through a consultative and analytical process led by WHO and are published every two years
M&E Framework:
Impact
Method of estimation:
Incidence cases for chronic HBV infection are estimated using the PRoGReSs model to quantify the annual HBV-infected population by disease stage, sex, and age in a country. The disease stages considered in the PRoGReSs model are chronic hepatitis B, compensated cirrhosis, decompensated cirrhosis, hepatocellular carcinoma, and liver transplant. HBV-infected population in each disease stage is further divided into high-viral load (HBsAg-positive with HBV DNA of 20,000 IU/mL or more), low-viral load (HBsAg-positive with HBV DNA of less than 20,000 IU/mL), and treatment responder subpopulations. The population susceptible to HBV is also tracked by age and sex, consisting of uninfected individuals who had never been exposed to HBV and had not been successfully immunized. Those developing a chronic hepatitis B infection are split into low- and high-viral load cases using reported data on respective proportions of high-viral load cases among HBeAg-negative and HBeAg-positive populations. Since the risk for chronic hepatitis B infection largely depends on the age of acquisition of infection, the model begins in 1900 to allow for full flexibility.
Incidence cases for chronic HCV are estimated using the Markov (disease progression) model . The model is used to quantify the size of the HCV infected population and by the liver disease stages. The model starts with the annual number of acute infections that progressed to chronic HCV (viremic) infection after accounting for spontaneous clearance of the virus. The progression of these new cases was followed along with all chronic infections from prior years. Unless specified, the scope of the model is limited to viremic, HCV ribonucleic acid (RNA) positive cases. Non-viremic cases (those exposed to the virus but spontaneously cleared the virus or were treated and cured) are not considered. The number of new cases at each stage of disease (incidence) is calculated annually by multiplying the annual progression rates times the prevalent population (by age and gender) in the previous stage. After one year, new cases were considered prevalent cases (after accounting for mortality and cured).
Method of estimation of global and regional aggregates:
Regional estimates are the sum of the country data in each WHO region.
Preferred data sources:
Surveillance systems and specific population survey
Unit of Measure:
cases
Expected frequency of data dissemination:
Every two years
Expected frequency of data collection:
Continuous at country level
Comments:
Routine surveillance data provide a good basis for the estimate of incidence of chronic HBV and HCV in countries where the majority of incident cases are treated.
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