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Executive Summary

This Action Plan sets out the strategic plan to reduce the burden of chronic hepatitis B and hepatitis C in Hong Kong through effective prevention, treatment and control of viral hepatitis.

Viral hepatitis poses a significant public health burden worldwide, leading to an estimated 1.34 million deaths in 2015. Most of the deaths were attributed to the sequelae of chronic infection with hepatitis B virus (HBV) or hepatitis C virus (HCV), including liver cancer, cirrhosis and other chronic liver diseases. Globally, an estimated 257 million and 71 million people were living with chronic HBV and HCV infection respectively.

In Hong Kong, epidemiological studies gauged a prevalence of 7.2% and 0.3% for HBV and HCV infection respectively in the general population, amounting to about 540 000 HBV cases and 22 000 HCV cases. Many of them are asymptomatic and unaware of their infection. Without treatment, the chronic infection can span several decades and lead to cirrhosis and liver cancer. Annually, there are around 1 500 - 1 600 registered deaths from liver cancer, which is the third leading cause of cancer deaths in Hong Kong and mostly associated with hepatitis B and C.

HBV infection is a vaccine-preventable disease; universal immunisation programme for babies launched in 1988 has resulted in substantial decline in the incidence of HBV infection in the younger generation. However, mother-to-child transmission (MTCT) of HBV is still of concern, as 90 percent of HBV-infected newborns will develop chronic infection and may suffer from related complications in the subsequent decades of lives. It is therefore important to focus efforts on prevention of MTCT of HBV and treatment of people with chronic HBV infection.

HCV is primarily spread through contact with infected blood. People who were given transfusion of contaminated blood and blood products before the institution of blood donor screening for HCV in 1991, people on renal dialysis, people who inject drugs and HIV-positive people are at substantially higher risk for HCV infection. Curative treatment is now available and elimination of HCV is made possible through targeting these disproportionately affected populations for the diagnosis and treatment of HCV.

As endorsed in World Health Assembly in 2016, the Global health sector strategy on viral hepatitis, 2016 - 2021 outlines a global goal of eliminating viral hepatitis as a major public health threat by 2030. The strategy provides a set of global impact targets, which refers to achieving a reduction of 90% in incidence and 65% in mortality by 2030, as compared with the baseline in 2015. It also includes a number of service coverage targets on key interventions, including (i) hepatitis B vaccination, (ii) prevention of MTCT of HBV, (iii) harm reduction, (iv) blood safety, (v) injection safety, (vi) diagnosis of hepatitis B and C, and (vii) treatment of hepatitis B and C.

In recognition of the public health threat posed by viral hepatitis, the Hong Kong Government announced in the 2017 Policy Address the setting up of a steering committee to formulate strategies to prevent and control viral hepatitis. Since the establishment of the Steering Committee on Prevention and Control of Viral Hepatitis (SCVH) in July 2018, the SCVH have been tasked to advise the Government on the overall policy, targeted strategies and effective resource allocation related to the prevention and control of viral hepatitis, and with a view to formulating an action plan. In 2020, the SCVH formulated this Hong Kong Viral Hepatitis Action Plan 2020 - 2024, providing a comprehensive strategy for reducing the public health burden of viral hepatitis in Hong Kong.

To eliminate viral hepatitis as a public health threat, this Action Plan has its Vision and Goals -

  • Vision – where new viral hepatitis infections have ceased, and where everyone with chronic viral hepatitis has access to effective and affordable care and treatment; and
  • Goals – reducing transmission of viral hepatitis, as well as morbidity and mortality due to viral hepatitis

This Action Plan adopts four strategic axes, as described in the World Health Organization (WHO) framework for global action: awareness, surveillance, prevention and treatment. Priority actions in each axis to be carried out in 2020 – 2024 for progressing towards the 2030 WHO targets of viral hepatitis elimination have been developed as follows.

Strategy 1: Awareness Strategy 2: Surveillance
  • Awareness campaign for the general population
  • Professional training for healthcare workers
  • Education targeting at-risk populations, patients and their service providers
  • Building a supportive environment
  • Ongoing surveillance from notification system for acute viral hepatitis and assessment for chronic viral hepatitis
  • Development of local indicators for monitoring and evaluation of the viral hepatitis elimination strategies
Strategy 3: Prevention Strategy 4: Treatment
  • Universal neonatal hepatitis B vaccination
  • Antivirals to prevent mother-to-child transmission of HBV
  • Post-vaccination serologic testing
  • Prevention of healthcare-related transmission of HBV and HCV
  • Reduction of risk and disease burden in vulnerable populations
  • Enhancement of treatment for HBV infection
  • Expansion of access to direct-acting antivirals for HCV
  • Micro-elimination of HCV in targeted populations
  • Promotion of HCV testing in people who inject drugs

This Action Plan outlines specific actions for Department of Health, Hospital Authority and other stakeholders, as well as the timelines for the implementation of the actions. Targets and indicators have also been developed to facilitate monitoring and evaluation of the implementation of this Action Plan and to drive the progress towards reaching the WHO 2030 goals of eliminating HBV and HCV infection.

We urge everyone to support the Action Plan and join hands to make Hong Kong free of chronic viral hepatitis.