In the majority of developing countries, almost all children are infected and become immune against hepatitis A virus by age six. However, with development this early life exposure changes and the shifting of infection and disease to older age groups is observed.
It is estimated that over two billion people worldwide have been infected with hepatitis B virus. Of these, approximately 360 million individuals are chronically infected and at risk of serious illness and death, mainly from liver cirrhosis and cancer. The global burden of disease due to cirrhosis of the liver and hepatocellular carcinoma is high (around 2% of all deaths) and expected to increase over the next 2 decades.
WHO estimates that around 4.3 million persons are infected with hepatitis B virus and 800 000 persons are infected with hepatitis C virus each year in the Eastern Mediterranean Region. It is estimated that 15 323 deaths due to hepatitis B occurred in 2008.
Most of these infections are acquired in the health-care setting and approximately 10%–20% of infections are acquired at birth due to perinatal hepatitis b virus transmission from mothers with chronic hepatitis B virus infection. It is estimated that approximately 17 million persons in the Region have chronic hepatitis C virus infection.
Studies indicate that more than 75% of cirrhosis and hepatocellular carcinoma in the Region is attributable to chronic hepatitis B virus or hepatitis C virus infection. The cost to treat patients with chronic hepatitis B virus or hepatitis C virus infection far outweighs the cost of implementing prevention programmes.