Hepatitis C declines, but vigilance still needed

In Belgium, the number of hepatitis C cases has been decreasing since the introduction of direct-acting antiviral treatments. The number of hepatitis B cases, however, remains relatively stable. This is according to new figures from Sciensano, released in connection with World Hepatitis Day (July 28). At the same time, Sciensano continues to call for stronger prevention, screening, and treatment efforts, especially for vulnerable population groups.

Hepatitis B and C are viral liver infections that can lead to chronic disease, cirrhosis, or liver cancer. They are often asymptomatic but can be easily detected. Hepatitis C is treatable, and there is a highly effective vaccine for hepatitis B, which has been part of Belgium’s infant vaccination program since 1999.

In 2015, the World Health Organization (WHO) launched a global strategy aiming to eliminate viral hepatitis as a public health threat by 2030.

Hepatitis C: Decline in cases, but continued efforts required

In 2022, an estimated 700 new hepatitis C cases were recorded in Belgium — about 6 per 100,000 people, in line with WHO targets. The number has declined steadily since 2019, when treatment reimbursement was extended to all infected individuals. Men are more affected than women (60%), and the average age at diagnosis is 50.

People who inject drugs remain the most affected group in Europe. Other high-risk groups include men who have sex with men, people in prison, migrants from high-prevalence countries, and the homeless.

Nearly 800,000 screening tests were reimbursed in 2023, a 5% increase from the previous year. Nonetheless, more action is needed to reach the most vulnerable and to reduce hepatitis C stigma.

Hepatitis B: Case numbers remain too high despite effective vaccine

The number of hepatitis B cases in Belgium has not declined and still exceeds WHO targets. In 2022, 1,915 new cases were estimated, or 16.5 per 100,000 people. The average age at diagnosis is 46, and men are slightly more affected (56%).

Transmission occurs mainly through sexual contact. Those with multiple partners or risky sexual behavior are at higher risk. Unvaccinated migrants from high-prevalence countries are also particularly vulnerable.

In 2023, almost 763,000 screening tests were reimbursed — 65 per 1,000 residents — with an increase in testing across all three regions.

World Hepatitis Day: A Call to Action

To help eliminate hepatitis by 2030, Sciensano is calling for intensified prevention, vaccination, screening, and treatment. Key actions include:

• Increasing hepatitis B vaccination rates, especially among high-risk groups

• Ensuring early childhood vaccination for lifelong protection

• Guaranteeing access to screening and care for people with limited healthcare access

• Raising awareness among at-risk groups and healthcare providers

Sciensano also stresses the importance of prevention efforts such as:

• Promoting condom use to reduce sexually transmitted infections

• Strengthening harm-reduction programs for drug use

• Combating stigma and discrimination to improve the quality of life for people with hepatitis