GLOBAL TRENDS AND TRANSMISSION PATTERNS OF HEPATITIS B AND C: A SYSTEMATIC REVIEW OF DISEASE BURDEN AND RISK FACTORS

Abstract

Background: Hepatitis B (HBV) and Hepatitis C (HCV) continue to pose significant global public health challenges, particularly in low- and middle-income countries. Understanding global trends, transmission patterns, and associated risk factors is essential for effective disease control and prevention strategies. Methods: A systematic review was conducted to assess the burden, transmission routes, and risk factors of HBV and HCV worldwide. Databases including PubMed, Scopus, and Web of Science were searched for observational studies published from 2015 to 2025. Eligible studies were screened, and data were extracted according to PRISMA guidelines. The Newcastle-Ottawa Scale (NOS) was used to assess the risk of bias in included studies. Results: This systematic review of six global studies identified marked regional variation in HBV and HCV prevalence. HBV predominated in Eastern Asia (61%) and the Western Pacific (59%) with HBV/HCV ratios >4, while HCV dominated in the Eastern Mediterranean and Northern Africa (70–83%; ratios 0.1–0.2). Mixed endemicity was seen in South-East Asia and Sub-Saharan Africa, and higher HCV prevalence with lower HBV rates occurred in Europe and the Americas. Globally, viral hepatitis burden was 63% (HBV: 42%, HCV: 21%). Transmission patterns differed by virus and region, with HBV spread mainly perinatally or in early childhood, and HCV linked to unsafe medical practices and injecting drug use. Conclusion: Distinct global patterns of HBV and HCV highlight the need for region-specific prevention, including targeted vaccination, harm reduction, safe healthcare practices, and enhanced screening to reduce the global hepatitis burden.