Prevention, Diagnosis, and Treatment Strategies for Viral Hepatitis: A Comprehensive Review

Abstract

Viral hepatitis, caused principally by hepatitis A, B, C, D, and E viruses, remains one of the leading infectious causes
of morbidity and mortality worldwide, responsible for approximately 1.3 million deaths annually, a burden
comparable to tuberculosis and HIV/AIDS. Hepatitis B and C together account for more than 95% of hepatitis-related
deaths, driven largely by the long, often silent natural history of chronic infection that progresses to cirrhosis, hepatic
decompensation, and hepatocellular carcinoma. This review synthesizes current evidence and international guidance
on the prevention, diagnosis, and treatment of the five major hepatitis viruses. Preventive strategies discussed include
universal hepatitis B birth-dose and infant vaccination, hepatitis A and E vaccination in endemic and outbreak settings,
safe injection and blood-transfusion practices, harm-reduction programmes for people who inject drugs, and antenatal
screening with tenofovir-based prophylaxis to interrupt mother-to-child transmission. Diagnostic advances reviewed

include serological and molecular assays, point-of-care and reflex RNA testing algorithms for hepatitis C, non-
invasive fibrosis assessment, and the expanding role of simplified testing in decentralized and primary-care settings.

Treatment strategies encompass nucleos(t)ide analogue therapy and emerging finite regimens aiming at functional
cure for hepatitis B, and pangenotypic direct-acting antiviral regimens that now cure more than 95% of hepatitis C
infections. The review also addresses persistent gaps in diagnosis and treatment coverage, particularly in low- and
middle-income countries and the WHO African and Western Pacific regions, and outlines priority actions required to
meet the World Health Organization's 2030 hepatitis elimination targets. Continued investment in vaccination,
decentralized testing, affordable antivirals, and integrated service delivery is essential to close the gap between
available tools and their equitable global deployment.