Why labs hold the key to ending hepatitis B and C
Find out why millions of cases of hepatitis B and C are going undiagnosed and how clinical labs could play an important role in getting more people tested and treated
30 Oct 2025Accessible, affordable and fast diagnosis of hepatitis B and C is a critical step towards the global elimination of the disease. Improved lab workflows, in partnership with public health programs, could play a key role in ensuring more people are tested and treated.
Despite being treatable and preventable, hepatitis B and C continue to kill more than a million people each year. These infectious diseases silently cause liver damage, cancer and death, often without symptoms until it is too late. With nearly 300 million people living with hepatitis B or C globally, the virus remains one of the most underdiagnosed and undertreated public health threats of our time1.
Dr. John Ward, Director of the Coalition for Global Hepatitis Elimination (left) and Dr. Alan Wu, Professor of Laboratory Medicine at UCSF and Chief of Clinical Chemistry and Toxicology at San Francisco General Hospital (right)
The Coalition for Global Hepatitis Elimination, or CGHE, is leading a growing movement of scientists, laboratorians, clinicians and governments pushing toward an ambitious goal: eliminate hepatitis B and C as public health threats by 2030.
At a recent webinar hosted by SelectScience®, CGHE Director Dr. John Ward and Dr. Alan Wu, Professor of Laboratory Medicine at UCSF and Chief of Clinical Chemistry and Toxicology at San Francisco General Hospital, outlined how this goal can become a reality and why laboratories play a central role in that future.
Hepatitis is a global burden
Hepatitis B affects roughly 250 million people worldwide, mostly in Asia and Africa. Hepatitis C affects about 50 million globally, with particularly high prevalence among people who inject drugs, in prison populations, and in some middle-income countries. According to the WHO, hepatitis-related illnesses result in 1.1 million deaths each year, mostly due to liver cancer and cirrhosis. Yet the vast majority of people living with hepatitis, more than 80 percent by some estimates, are unaware they have it2.
The lack of diagnosis is the root of the crisis. Without testing, there is no treatment. Without treatment, people suffer and die from a disease that is often preventable and, in the case of hepatitis C, curable with a short course of antiviral medication.
Dr. Ward discusses targets set out by the WHO, stating it, “called for a 90 percent reduction in new hepatitis infections and a 65 percent reduction in mortality by 2030”. But a key challenge is that many people, especially in developing countries, are not aware they are infected. He notes, “only a very low percentage of people are aware of their infection and are receiving treatment”.
CGHE has taken these goals and translated them into real-world programs, partnerships and policies. The coalition works with ministries of health, civil society, clinicians and public health experts to build national and subnational hepatitis elimination programs that actually work; grounded in data, tailored to local needs and aimed at sustainable impact.
Labs have a clear role in elimination
If hepatitis elimination is the goal, lab testing must be at the forefront. “It’s critical. It’s really the main way we have the high-throughput and large-volume testing needed to screen and detect people,” Dr. Ward says during the webinar.
The challenge is not only awareness or technology, but also efficiency. Testing needs to be accessible, affordable and fast. This is where the lab workflow becomes a critical factor and where Dr. Wu’s perspective comes into play.
“There has been a consistent increase in test demands,” Dr. Wu says of the shifting healthcare landscape. “Because of staffing and resource limitations, labs are becoming bigger and more automated. But that’s not to say that the space has been increased to match the consolidation. Depending on the test, there are demands for rapid turnaround time because time is money”.
Modernizing workflows is key
One solution is smarter technology; manufacturers are working on new platforms that can meet both urgent care needs and routine testing. Dr. Wu shared how his team at San Francisco General Hospital implemented a next-generation platform, the Siemens Healthineers Atellica IM system, that “combines STAT testing with routine testing on the same platform” without compromising turnaround times.
Traditionally, labs have used separate analyzers for urgent STAT tests like cardiac troponin and routine infectious disease tests like hepatitis panels. This required more space, more staff and created inefficiencies. By using a platform that combines both workflows, Dr. Wu shares that his team are able to consolidate “both routine and STAT testing … without compromising the turnaround time for the STAT tests and the overall throughput for all of the tests that are put on it.”
Faster, consolidated testing means more people can be screened for hepatitis without increasing cost or complexity. It also allows for reflex testing, where a single blood sample can be tested for hepatitis antibodies and, if positive, automatically tested for viral RNA.
“We showed this to be very effective in CDC labs in improving the number of persons being tested for the virus,” Dr. Ward notes. “We found that the labs that were conducting reflex testing, those patients were being more frequently treated and treated more quickly after diagnosis, compared to patients who did not have reflex testing. So, there’s a clear role for reflex testing and how changes in lab procedures can improve access to treatment.”
Public health strategies with real-world results
CGHE’s work goes far beyond the lab. The coalition builds hepatitis elimination profiles for countries, gathering data on policies, testing coverage, and progress. These profiles help governments understand where they stand, identify gaps and learn from peer countries.
Take Ghana; CGHE helped assess the hepatitis burden and testing capacity across regions. The data, Dr. Ward says, revealed an “unexpectedly high hepatitis C prevalence” in the north of the country. Using that insight, CGHE brokered a partnership between Ghana and Egypt, whose own hepatitis elimination program has been a global model. Egypt agreed to donate HCV medications, and Ghana launched a national treatment program.
Dr. Ward adds, “we’re helping Thailand evaluate a recent policy change where they are recommending HBV and HCV testing for all persons born before 1992.” In Australia and South Korea, the coalition has highlighted effective policies that empower primary care providers, reduce treatment barriers and expand screening to high-risk populations.
The bottom line is that hepatitis elimination is not theoretical. It is happening in clinics, in labs and at the policy level. But it depends on continued investment in testing, smarter workflows and stronger partnerships.
What laboratorians and clinicians can do next
Dr. Wu closes the webinar with a simple message: labs must be seen, valued and integrated into the broader medical mission. “We are a service provider, and we don’t see patients… I think it’s for that reason we’re sort of taken for granted,” he states. “What we need to do is get out there more and be a part of the medical practice, not just stay in our labs, but be visible.”
Dr. Ward emphasizes that labs can and should partner with public health programs. “Becoming more mindful of the activities already underway in many communities and being a full participant in those… labs can help overcome these challenges,” he says. Dr. Ward shares that labs can also contribute by “improving their processes to increase efficiency and being a source of information for their health system and public health officials.”
Whether it is sharing data for disease surveillance, identifying barriers to testing, or piloting innovations like saliva-based or dried blood spot assays, labs can play a key role in getting more people tested and treated.
There is support available. “A number of tests are available at lower cost,” Dr. Ward notes. “The virologic testing tends to be the most expensive part … but there are international efforts such as the Pan American Health Organization’s strategic investment fund and Global fund agreements to make diagnostics available at lower cost.”
Hepatitis elimination will not be achieved by one tool or one sector. It will take smarter strategies and the active involvement of laboratorians, clinicians and public health professionals worldwide.
References
1. Centers for Disease Control and Prevention. Global viral hepatitis. 2025, July 25. https://www.cdc.gov/hepatitis/global/index.html. Accessed: 12 August 2025.
2. World Health Organization. Hepatitis B. 2025, July 23. https://www.who.int/news-room/fact-sheets/detail/hepatitis-b. Accessed: 12 August 2025.