Abstract
Hepatitis viruses are a global public health concern. In Thailand, they are a significant
issue, causing acute and chronic hepatitis, cirrhosis, and liver cancer, with liver cancer being
the most common cancer among Thai males. Historically, hepatitis B infection rates were as
high as 6-8% in the 1980s, while hepatitis C was around 2% in the 1990s. Hepatitis B was
predominantly transmitted from mother to child, whereas hepatitis C transmission was
associated with shared sharp instruments and blood transfusions.
Today, hepatitis B infection can be effectively prevented through neonatal
vaccination, supported by a robust healthcare system, public awareness, and universal
blood screening. The World Health Organization (WHO) has set a goal to eliminate hepatitis
by 2030, with targets including zero mother-to-child transmission of hepatitis B, an infection
rate of less than 0.1% in children under five, screening coverage of at least 90%, prevention
of over 90% of new infections, and treatment access for more than 80% of infected
individuals. Mortality related to hepatitis should also decline by at least 65%.
This study aims to monitor hepatitis virus infections in Thailand, utilizing data from
the Chulalongkorn Hepatitis Center, which has conducted surveys every decade since 2004.
The 2024 survey focuses on the prevalence of hepatitis A, B, and C infections, using data
from four representative provinces: Uttaradit, Phra Nakhon Si Ayutthaya, Buriram, and Trang,
with 1,500 participants from each province. Participants were selected from urban and rural
areas, covering ages from six months to 80 years, based on statistical sampling reflecting
vaccination programs initiated in 1992.
Blood samples were tested for hepatitis markers using commercial chemiluminescent
kits. These included HBsAg, anti-HBs, and anti-HBc for hepatitis B; anti-HCV and HCV core
antigen for hepatitis C; and anti-HAV IgG for hepatitis A. The findings were analyzed for agespecific prevalence and compared with national data to determine infection rates across
Thailand. Hepatitis A: Most of the population lacks immunity (anti-HAV IgG). The median age for
acquiring immunity is 47 years. This positions Thailand as a very low endemicity country for
hepatitis A.
Hepatitis B: Since introducing effective vaccines in 1992, the prevalence of HBsAg has
significantly decreased, particularly in individuals under 30. The national infection rate is now
1.16%, a substantial decline from previous surveys in 2004 (4.0% and (3.48%). Anti-HBc
prevalence among younger populations is minimal, and most individuals have protective
anti-HBs antibodies. The successful elimination of mother-to-child transmission is evident,
with HBsAg rates in children under five below 0.1%, meeting WHO targets. This achievement
predicts a decline in hepatitis B-related liver cancer.
Hepatitis C: Infection rates have declined markedly, with anti-HCV prevalence
dropping from previous rates to 0.94% in 2014 and further to 0.56% in 2024, representing
approximately 363,475 individuals. This reduction is attributed to enhanced healthcare
systems, public education, and blood screening. Current treatments offer high cure rates,
suggesting that hepatitis C may be nearly eliminated by 2030.
The findings provide critical national data for planning hepatitis elimination strategies
and highlight Thailand’s success in combating hepatitis over the past 30 years. These results
have been disseminated in three international high impact journal publications addressing
hepatitis A, B, and C.
