Review finds uneven hepatitis testing and treatment access in eight European countries
A survey found broad use of international guidance but continuing gaps in testing, affordability and care delivery.
Low evidenceReviewSome caution advised
Medical disclaimer: This article summarizes research findings and is for informational purposes only. It is not medical advice.
Editorial illustration — not from the study.
Researchers surveyed nine high-burden countries and received responses from eight: Armenia, Azerbaijan, Belarus, Kazakhstan, Kyrgyzstan, the Republic of Moldova, Turkmenistan and Uzbekistan. The survey covered testing, treatment regimens, service delivery and barriers to implementation.
Most responding countries reported national guidelines broadly aligned with international standards. However, availability and payment coverage for testing and medicines varied, reflex PCR testing was limited, elastography coverage was restricted, and hepatitis C treatment in harm-reduction settings was uncommon.
The question examined
The WHO Regional Office for Europe surveyed national health authorities in nine high-burden countries; eight responded. The survey examined policies and reported practices for chronic hepatitis B and C, including testing availability, viral-load testing, treatment regimens, liver-disease staging, service delivery and implementation barriers. This was a country-level policy and health-system survey, not a randomized clinical trial or a study measuring outcomes in a defined group of patients.
What the analysis found
The abstract reports that most countries had national hepatitis B and C guidelines aligned with international standards, although updates were not consistent. Point-of-care PCR viral-load testing was available in five countries, and reflex PCR testing had been implemented in four. All eight countries reported using non-invasive tests for liver-disease staging, but access to elastography remained limited.
Treatment regimens generally followed international guidance, while medicine prices and national coverage differed substantially. Several countries still required some out-of-pocket payment. Testing and care had increasingly been decentralized and integrated into primary care and HIV clinics in most countries, but hepatitis C treatment in harm-reduction settings remained rare. The survey therefore identified reported gaps in access and delivery, rather than demonstrating that any specific policy caused better or worse health outcomes.
Who this is relevant to
The findings may be relevant to national and regional health-system planning in the eight responding countries and may offer context for other countries with similar hepatitis burdens and health systems. They do not directly describe every country in the WHO European Region, individual patients, or the effectiveness of a particular medicine or testing strategy. The abstract also does not provide enough information to determine how closely reported national policies matched services available in specific communities.
Why it matters
Chronic hepatitis B and C affect millions of people in the WHO European Region, according to the estimates cited in the abstract. Understanding where testing and treatment systems are available can help describe progress toward regional public-health goals. However, this work does not establish the effectiveness of individual treatment policies, and it does not show how many patients received care or experienced improved health.
Limitations & evidence assessment
The survey received responses from only eight of the nine countries approached, so the findings may not represent all high-burden countries in the WHO European Region. The abstract does not describe the respondents, response methods in detail, or whether reported policies were independently verified. Country-level reports may not reflect actual access for patients within each country, and the survey did not provide patient outcomes, direct measures of treatment uptake, or comparisons over time. As a cross-sectional policy survey, it can describe reported conditions at the time of data collection but cannot establish causes or determine which approaches are most effective.
Why this evidence level: The article reports a survey of national policies and practices in eight countries, rather than a clinical study of patients. The results describe reported health-system coverage and gaps, but they do not show whether particular policies improve outcomes.
Evidence levels are editorial estimates derived from study metadata — they are not clinical appraisals.
// Source
Discover Public Health · 2026 · DOI: 10.1186/s12982-026-02748-7
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