Burden of Chronic Hepatitis B and C Infections in 2015 and Future Trends in Japan

Background: Determining the number of chronic hepatitis B (HBV) and C virus (HCV) infections is essential to assess the progress towards the World Health Organization 2030 viral hepatitis elimination goals. Using data from the Japanese National Database (NDB), we calculated the number of chronic HBV and HCV infections in 2015 and predicted the trend until 2035. Methods: NDB and first-time blood donors data were used to calculate the number of chronic HBV and HCV infections in 2015. A Markov simulation was applied to predict chronic infections until 2035 using transition probabilities calculated from NDB data. Findings: The total number of chronic HBV and HCV infections in 2015 in Japan was 2,001,221–2,487,881 (HCV:890,902–1,302,179, HBV:1,110,319–1,185,702), of which 1,019,695–1,506,355 were undiagnosed or diagnosed but not linked to care (“not engaged in care”), and 981,526 were engaged in care. Chronic HBV and HCV infections are expected to be 991,388–1,302,438 in 2030, and 796,585–1,044,043 in 2035. Compared to 2015, by 2035, the number of persons with HCV not engaged in care will decline by 59·8 – 74·7% and 86·5% for patients in care. For HBV, a 47·3 – 48·2% decrease is expected for persons not engaged in care and a decline of 26·0% for patients engaged in care. Interpretation: Although the burden of HBV and HCV is expected to decrease by 2035, challenges in controlling hepatitis remain. Improvements in screening and linkage to care for HCV and functional HBV cure are needed. Funding Information: This study was funded in part by the Ministry of Health, Labour and Welfare, Japan, grant number 19HC1001. Declaration of Interests: The authors declare no conflict of interest. Ethics Approval Statement: Data from the NDB were obtained in accordance with the Guidelines for the Provision of Information on Receipt and Specified Health Examination established by the MHLW (approval number MHLW-H-0722-13).Before donating blood, all donors signed an informed consent form stating that their laboratory test results could be used for research purposes. The ethics committee for epidemiological research of Hiroshima University waived the requirement for further consent (approval number E-1082).All study procedures were performed following the applicable regulations and guidelines.