Awareness, Knowledge, and Care Pathways in Viral Hepatitis: A Narrative Synthesis of Global Evidence

Abstract

Across the globe, viral hepatitis continues to drive chronic liver disease, cirrhosis, and liver cancer, even though awareness among both the public and health professionals has not kept pace with available vaccines and antiviral treatments. This review draws together findings from nineteen studies spanning Asia, Africa, the Middle East, Europe, and North America to assess how much is known about hepatitis, and how well existing care pathway’s function. Community-based surveys repeatedly find only low-to-moderate understanding of how hepatitis spreads, how it can be prevented, and whether vaccination is available, with recurring myths — that the virus passes through casual contact, shared cutlery, or mosquito bites — still widespread. Health workers and trainees typically know that hepatitis exists but often lack detail on transmission routes and what to do after an exposure, and this gap is uneven across medical, dental, and nursing groups. More than gaps in knowledge, it is weak linkage between a positive screening result and actual treatment that most consistently undermines the care cascade. Programmes that embed a facilitator or lay health worker produced real gains in engagement and testing in some contexts, yet elsewhere better knowledge did not translate into more testing. China's decades-long investment in vaccination and antenatal antiviral coverage shows what sustained system-level commitment can achieve, while conflict-affected settings illustrate how quickly gains can reverse once water and sanitation infrastructure collapses. Meeting the World Health Organization's 2030 elimination targets will likely require pairing targeted education with stronger screening-to-treatment linkage and investment tailored to local health-system conditions, rather than counting on awareness campaigns alone.