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Changing patient safety in India: Mandatory hepatitis B immunity

1 Hepatitis B is a dreaded infectious disease and one of the major global public health problems and is the tenth leading cause of death. The global disease burden is staggering with about two billion people acutely infected and nearly 350 million chronically infected with hepatitis B virus (HBV). Worldwide, it has been estimated that more than 2 billion of the population has evidence of the past or recent HBV infection, and there are more than 350 million chronic carriers of the mentioned infection. In India, the prevalence of hepatitis B surface antigen (HBsAg) among the general population ranges from 2% to 8%, placing India in an intermediate HBV endemicity zone. Our country has over 50 million cases making it the second largest global pool of chronic HBV infections. HBV is also the second most common cause for acute hepatitis in India (after hepatitis E), being responsible for nearly one‐third of acute viral hepatitis patients. The seroprevalence is two to four times higher among healthcare workers. This, in the context of an outsized population of the country and absence of a national hepatitis B immunization program, could spell a projected escalating burden of the disease in the years to come.