Ensuring pragmatic and equitable paths forward for hepatitis B virus infection elimination in Latin America.

INTRODUCTION

Latin America is a paradox in hepatitis B virus (HBV) elimination: aggregate prevalence is low, yet the region is far from WHO and PAHO 2030 targets because the burden is structurally concealed within underserved populations and fragmented health systems.

AREAS COVERED: This review examines regional epidemiology, structural and programmatic barriers to elimination, and a pragmatic framework for populations of concentrated unmet need (indigenous communities, incarcerated and displaced persons, and people living with HIV), alongside perinatal prevention; hepatitis D, a defective satellite virus that requires hepatitis B surface antigen to replicate, endemic in the Amazon basin and the most rapidly progressive chronic viral hepatitis; simplified versus precise diagnosis in low-prevalence settings; and locally validated, equity-aware computational tools for case-finding, risk stratification, and investment prioritization. Evidence came from PubMed/MEDLINE (January 2010 to 30 April 2026) plus WHO, PAHO, and ALEH sources.

EXPERT OPINION: Only 23% of people with chronic HBV in the WHO Region of the Americas are diagnosed and 4.5% treated. Closing that gap requires a shift from coverage-centered to precision-centered delivery: reaching the right individuals and coupling decentralization to active linkage to care. HBV elimination in Latin America is a systems delivery challenge under low apparent prevalence.