Today, on World Hepatitis Day, we’re taking a closer look at a disease that remains one of the world’s most urgent – yet overlooked – public health challenges. Despite being preventable and, in many cases, treatable, viral hepatitis continues to claim around 1.3 million lives every year ¹, making it one of the leading causes of death from infectious diseases worldwide. 

Viral hepatitis includes several forms of infection, with hepatitis A, B and C being the most common. While hepatitis A is typically acute and preventable through vaccination, hepatitis B and C can become chronic infections. More than 300 million people are estimated to be living with chronic hepatitis B or C globally ¹. Without timely diagnosis and care, these infections can progress unnoticed for years before leading to serious complications like cirrhosis or liver cancer. Around the world, efforts to control the disease face a major challenge: only a small proportion of those infected know their status, highlighting a significant diagnosis gap that continues to limit access to care and treatment.  

Although the World Health Organisation (WHO) has set ambitious goals to eliminate hepatitis as a public health threat by 2030, current progress remains insufficient to achieve this goal, despite major scientific advances and available treatments ¹. 

In this interview, Dr Iván Mojica, Chief Medical Officer at SYNLAB Colombia, shares his perspective on the global burden of hepatitis and the realities of elimination efforts in Colombia, a country identified by the WHO as a priority for hepatitis elimination. 

From your perspective, why does hepatitis remain such a major global health issue despite being preventable and, in many cases, treatable? 

There are multiple factors explaining why viral hepatitis requires a comprehensive approach to prevention, timely diagnosis and reduction of complications associated with chronic infection. Although we have vaccines, diagnostic tests and effective treatments, we have still not been able to contain these diseases sufficiently. According to the WHO, in 2024, more than 70% of people infected with the hepatitis B virus were unaware of their diagnosis ². 

The multiple routes of transmission – mother-to-child, contact with bodily fluids and wounds, high-risk sexual contact with infected individuals, blood transfusions and exposure to contaminated needles – explain how easily the disease burden continues to increase without effective prevention and detection strategies. 

From a clinical perspective, hepatitis B and C are often asymptomatic in more than 80% of cases during the acute phase, which makes it difficult for patients to suspect a possible infection ^2,3. Additionally, between 5% and 10% of patients may progress to chronic infection, with an increased risk of developing severe liver complications associated with high mortality. In a transmission from mother-to-child, the clinical course is different: the likelihood of progression to chronicity is considerably higher, especially when vaccination is not administered at birth – a situation more frequently observed in countries with a high prevalence of maternal infection and low coverage of vaccination programmes ^2,4. 

In addition, HIV coinfection, particularly in the case of hepatitis B, represents a relevant clinical factor, as up to 7.5% of HIV positive population may present coinfection ². 

For all these reasons, viral hepatitis has received special attention from the World Health Organisation, positioning these infections as a public health priority and promoting coordinated actions with countries to reduce the disease burden by 2030.

We know that millions of people are living with hepatitis without knowing it. What are the biggest challenges behind this diagnosis gap, both globally and in Colombia?  

The WHO has promoted the development of regional plans to move towards the elimination of viral hepatitis. In Colombia, a ten-year public health strategy ⁵ aims at increasing diagnosis through the screening of two million people for hepatitis B and at least 25% of the population aged 50 to 70 years for hepatitis C. This strategy has supported active case finding and identification: the incidence rate of hepatitis B rose from 1.8 cases per 100,000 inhabitants in 2019 to 3.0 per 100,000 inhabitants in 2025; similarly, the incidence rate of hepatitis C increased from 0.9 cases in 2019 to 1.7 cases per 100,000 inhabitants in 2025 ⁶. 

The results have been promising; however, significant diagnostic gaps remain. Challenges such as variation in testing pathways, barriers to accessing diagnostic services and delays in reporting can all affect timely follow-up and treatment ⁶.

With new advances in diagnostics and earlier detection methods, how do you see the future of hepatitis evolving in the next decade? 

New technologies, clear diagnostic pathways and supportive public policies will continue to play a fundamental role in reducing the burden of viral hepatitis. 

The development of methods for detecting antibodies against different viral components has enabled the consolidation of diagnostic algorithms with a high capacity to identify patients infected with viral hepatitis. Thanks to these advances, screening strategies have been defined that today allow us to keep the goal of eliminating these infections in the coming years within reach. 

In addition, molecular methods for the detection and monitoring of viral loads have achieved relevant analytical and clinical sensitivity, allowing diagnosis to be confirmed and appropriate follow-up to be performed during treatment. 

Laboratories such as SYNLAB in Colombia already have access to these methodologies and participate in the implementation of screening and diagnostic strategies for hepatitis B and C. However, we must continue working with insurers and healthcare professionals to ensure their full application, so that patients are identified in a timely manner and can access appropriate treatment. 

If you could prioritise one action, either globally or in Colombia, to accelerate progress toward eliminating hepatitis by 2030, what would it be? 

Success will depend on a combination of vaccination, screening, diagnosis, treatment and public awareness. Vaccination has proven to be a key tool for preventing infection in early childhood. Therefore, it is essential to continue strengthening coverage of the full vaccination schedule, including the birth dose within the first 24 hours, particularly to reduce the risk of chronic infection in newborns. 

Screening and diagnostic confirmation are fundamental to identifying patients with chronic infections in a timely manner and initiating the indicated treatment. This makes it possible to reduce progression to cirrhosis, liver cancer and death from associated complications. 

In addition, prevention campaigns to increase public awareness, especially among the most vulnerable groups, are essential to reduce the risk of transmission. The use of condoms, avoiding needle sharing, promoting proper hand hygiene and disseminating clear and consistent messages to the public will remain fundamental actions to ensure that all other strategies are effective. 

From the perspective of laboratory medicine, we will continue to make our best contribution to expanding patient access to high-quality diagnostic technologies and supporting the achievement of the strategy that Colombia has set for eliminating viral hepatitis.