From targets to real world impact: a review of models of care for chronic HBV and HCV in Europe
Picchio CA., Nicolàs A., Duffell E., Martró E., Vickerman P., Dudareva S., Lens S., Vanderlinden A., Cabezas J., Forns X., Gill US., Razavi-Shearer D., Aghemo A., Halford R., Vanwolleghem T., Matthews PC.
Hepatitis B virus (HBV) and hepatitis C virus (HCV) remain public health threats in the WHO European region, where an estimated 29 million people live with chronic infection and viral hepatitis-related deaths now surpass those from HIV/AIDS and tuberculosis combined. Although effective prevention tools and antiviral treatments reduce the risk of complications, overall mortality has not declined. This Series paper reviews models of care (MoC) implemented between 2015 and 2025, drawing on scientific literature and policy documents to assess regional progress. Simplified testing and treatment, childhood and targeted adult HBV vaccination, harm-reduction programmes, and prison-based interventions have advanced elimination efforts. Pragmatic approaches, including point-of-care testing, decentralised services, and integrated models tailored to key populations demonstrate clear benefits. However, major challenges persist: large undiagnosed populations, regional disparities, inadequate healthcare worker knowledge, and inequities affect at-risk groups. Achieving elimination by 2030 will require accelerated case-finding, broader access to simplified treatment, stronger risk-tailored and vaccination strategies, improved data systems, and renewed commitment.