Viral hepatitis: a silent threat, screening remains our best weapon
On the occasion of World Hepatitis Day, this year's theme being "Hepatitis: Let's Break Down the Barriers", the Department of Gastroenterology and Hepatology at Erasme Hospital (H.U.B) is raising awareness of a major yet often overlooked public health issue and highlighting the crucial importance of early screening.
Viral hepatitis B, C and D remain among the leading causes of liver cirrhosis and liver cancer worldwide. According to the World Health Organization (WHO), they claimed 1.34 million lives in 2024, representing nearly 3,500 deaths every day, most of them resulting from preventable complications. In Belgium, screening rates continue to improve: more than 760,000 hepatitis B tests and nearly 800,000 hepatitis C tests were reimbursed in 2023 (Sciensano). However, further efforts are needed to achieve the WHO's goal of eliminating viral hepatitis as a public health threat by 2030.
These infections usually progress silently, without symptoms for many years. Up to two-thirds of people living with chronic hepatitis B and nearly half of those infected with hepatitis C remain unaware of their condition until cirrhosis or liver cancer develops. A simple blood test is therefore the key to early diagnosis. Effective treatments are now available for hepatitis B and C, capable of controlling the disease and, in the case of hepatitis C, achieving a cure.
Our department is currently placing particular emphasis on hepatitis D (Delta hepatitis), the most severe form of viral hepatitis. It affects only people already infected with hepatitis B and dramatically accelerates progression to cirrhosis and liver cancer. In 2025, the WHO classified hepatitis D as carcinogenic to humans. After actively contributing about a decade ago to the clinical studies that made hepatitis C curable, our team is now involved in several clinical trials evaluating new treatments for hepatitis D, including bulevirtide, the first therapy specifically approved for this virus. However, it is still not reimbursed in Belgium.
« At a time when the WHO is calling for barriers to access to care to be removed, we hope reimbursement criteria in Belgium will soon evolve, both for chronic hepatitis B and, even more urgently, for hepatitis D » said Christophe Moreno, Head of the Department of Gastroenterology and Hepatopancreatology. « Erasme Hospital brings together several hepatologists specialising in viral hepatitis, an in-house molecular biology laboratory providing rapid PCR diagnosis, and FibroScan® technology to assess liver damage without the need for a biopsy. This comprehensive pathway—from screening and diagnosis to treatment and clinical research—makes our department a referral centre for liver diseases and viral hepatitis in Brussels ».
Too many patients are still diagnosed with hepatitis only once cirrhosis has already developed, even though early detection can completely change their prognosis. Our message on World Hepatitis Day is simple: don't wait for symptoms before getting tested.