The Lurking Danger: Understanding the Prevalence of Hepatitis B in Asia

Mother sick in bed Hepatitis B

Why does Asia have the highest cases of Hepatitis B?

Hepatitis B is a viral infection that attacks the liver and can cause acute and chronic diseases. While it is a global health issue, it is a particularly serious concern in Asia, where the prevalence is the highest in the world. According to the World Health Organization (WHO), approximately 292 million people worldwide are living with hepatitis B, and over two-thirds of them reside in the Asia-Pacific region.


The high incidence of hepatitis B in Asia is a complex issue, with multiple factors contributing to its prevalence. Some of the key factors include cultural practices, lack of awareness, and inadequate access to prevention and treatment services.

One of the significant reasons for the high incidence of hepatitis B in Asia is cultural practices. These include traditional medicine, acupuncture, and tattooing. These practices are often carried out without proper sterilization of equipment and procedures. This can transmit the virus from one person to another. This is particularly concerning in areas where people cannot afford or do not have access to modern healthcare facilities.

Lack of awareness and knowledge about hepatitis B is another significant reason behind its high incidence in Asia. In many countries in the region, there is still a lack of understanding of the disease’s transmission and prevention. Unfortunately, this can lead to a failure to take the necessary precautions. Many people are not aware that they carry the virus and can unknowingly pass it on to others. This lack of awareness can result in delayed diagnosis. Without early detection, the risk of developing severe liver diseases, including liver cancer, increases significantly.

Inadequate access to prevention and treatment services is another factor contributing to the high incidence of hepatitis B in Asia. While there has been progress in increasing access to vaccination, there is still a long way to go. In many countries, the cost of the vaccine is prohibitively high, making it difficult for people to afford it. Furthermore, many people living with the disease do not have access to affordable and quality healthcare services. Consequently, this results in a lack of adequate treatment. These include increasing awareness of the disease and its transmission, promoting vaccination, and ensuring access to affordable and quality healthcare services. 

According to recent statistics, several Asian countries including Vietnam, Mongolia, Laos, China, the Philippines, South Korea, Singapore, and Cambodia have a high or high-intermediate HBsAg prevalence. This makes chronic hepatitis B virus (HBV) infection a huge economic and social burden for the region.

Most of the chronic HBV carriers in Asia acquire their infection during early childhood or through mother-to-child transmission (MTCT). 


Despite the high prevalence of the virus in the region, Asia has been successful in controlling HBV in the last two decades. China, for example, has been particularly successful in controlling the spread of HBV, through a comprehensive strategy aimed at controlling the virus, including universal HBV vaccination for infants since 1992.The prevalence of HBsAg in China’s general population has decreased from 9.75% in 1992 to 7.18% in 2006. This is due to increasing coverage and a timely birth dose of the HBV vaccine

Furthermore, the prevalence of HBsAg in the population under 30 years of age reduced from 10.1% in 1992 to 2.6% in 2014. Passive and active immunization has also been increased, successfully interrupting MTCT in recent years.

Studies in China showed that maternal antiviral therapy in the late trimesters of pregnancy could further reduce MTCT in mothers with a high viral load. First-line treatments such as entecavir and tenofovir are recommended in Chinese guidelines and the Basic Medical Insurance reimbursement list.

Increased awareness, access to, and affordability of antiviral therapy will reduce HBV-related morbidity and mortality. The combined efforts of the government, the medical community, industry, civil society, and the public should eliminate hepatitis B as a public threat by 2030. 


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