Geneva, March 12, 2015 – WHO today released its first-ever guidance on the treatment of chronic hepatitis B. Chronic hepatitis B is a viral infection transmitted through blood and body fluids that damages the liver and causes an estimated 650,000 deaths each year, most of which are in low- and middle-income countries. Globally, approximately 240 million people carry the chronic hepatitis B virus, with the highest rates of infection in Africa and Asia. People with chronic hepatitis B infection are at higher risk of dying from cirrhosis and liver cancer. Effective drugs are available to prevent these diseases and thus prolong their lives, but the majority of people with such drug needs do not yet have access to them or have access only to non-regulated treatment. One reason for this situation is the lack of clear evidence-based guidance for countries, especially low- and middle-income countries, on who should receive treatment and what drugs should be used. “Determining who needs access to hepatitis B treatment depends on a number of factors,” said Dr. Stefan Wiktor, head of WHO’s Global Hepatitis Programme. “These new guidelines provide treatment recommendations backed by easy, inexpensive tests that will help clinicians make the right determination.” The WHO Guidelines for the Prevention, Care and Treatment of People with Chronic Hepatitis B Infection present a simplified approach to be used to treat people with chronic hepatitis B infection, particularly as it relates to resource-constrained settings. This guidance document covers all elements of treatment, from determining who needs to be treated to which drugs to use and how to monitor infected individuals over time. The main recommendations are: use of several simple, non-invasive tests to assess the stage of liver disease to help determine who needs to be treated; prioritizing the treatment of patients with cirrhosis – the most advanced stage of liver disease; using tenofovir or entecavir, two safe and highly effective drugs for the treatment of chronic hepatitis B Regular monitoring using a simple test for early detection of liver cancer to assess whether the treatment is working and whether it needs to be stopped. The specialized needs of specific populations, such as people co-infected with HIV, children and adolescents, and pregnant women, have also been taken into account. Many countries now have access to two recommended generic drugs that are relatively inexpensive, requiring as little as$5 per person per month. “Since for many people there is a need to get lifelong treatment, it is important that patients have access to these drugs at the lowest possible price.” Dr. Wiktor said. Several countries have already begun to develop hepatitis B treatment plans, and this newly released document also brings guidance on how to organize hepatitis care and treatment services. “For example, countries need to consider the modalities used to improve access to medicines and how to best provide quality care based on existing health services and personnel,” said Dr. Philippa Easterbrook, WHO Global Hepatitis Programme. For people already infected with hepatitis B, treatment can prolong their lives, but it is equally important to focus on preventing new infections. WHO recommends that all children be vaccinated against hepatitis B, receiving their first dose of the vaccine at birth. Some countries, particularly in Asia, have already reduced the rate of hepatitis B infection in childhood through universal childhood immunization. The challenge now is to keep increasing efforts to ensure that all children worldwide are protected from this virus. Another route of infection is the reuse of medical devices, especially syringes. WHO has recently launched a new policy on injection safety that will also help prevent new hepatitis B infections. This policy calls for the worldwide use of “smart” syringes to prevent the reuse of syringes or needles. The new guidelines for the treatment of hepatitis B were developed in succession to the WHO’s first guidelines for the treatment of hepatitis C, which were issued last year. Notes to editors The preferred drugs recommended in the guidelines are tenofovir and entecavir. These drugs have a low risk of resistance, are easy to take, are taken as little as one tablet per day, and have minimal side effects. Both drugs are available generically, and tenofovir can also be used to treat HIV. WHO recommends two non-invasive tests to assess the stage of liver disease to help determine who needs to be treated. One is based on a blood test (APRIC aspartate aminotransferase [AST] to platelet ratio index) and the other is a scan-based assay (transient elastography, such as FibroScan).