--- title: "Hibsago (bepirovirsen) in Chronic hepatitis B virus infection in adults without cirrhosis: Prevalence" description: "Formulary evidence on Hibsago (bepirovirsen, GSK3228836) in Chronic hepatitis B virus infection in adults without cirrhosis: Prevalence. Topics: United States, NHANES 2013 to 2018: prevalence of chronic infection and share born outside the United States; United States, NHANES 2017 to March 2020: prevalence, number infected, and awareness; United States, 2018: foreign-born persons with chronic infection by region of origin; United States, 2019 expert panel: estimated number with chronic infection; 9 further topics. 13 evidence topics quoted from 15 sources." canonical: "https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/product-information-and-disease-description/prevalence" published: "2026-10-21T22:39:04-04:00" modified: "2026-10-22T19:07:03-04:00" --- # Hibsago (bepirovirsen) in Chronic hepatitis B virus infection in adults without cirrhosis: Prevalence ## 2.2.1.2.2 Prevalence of Chronic hepatitis B virus infection in adults without cirrhosis ### United States, NHANES 2013 to 2018: prevalence of chronic infection and share born outside the United States > “Non-US-born residents accounted for 69.1% of the population with chronic HBV infection and were 9.1 times more likely to be living with chronic hepatitis B, compared with US-born persons.” > “Despite increasing immune protection among young persons vaccinated after birth, the estimated prevalence of persons living with chronic hepatitis B in the USA has remained unchanged at 0.3% since 1999.” Source: [Roberts et al. (2021)](https://pubmed.ncbi.nlm.nih.gov/34097776/) ### United States, NHANES 2017 to March 2020: prevalence, number infected, and awareness > “During the years 2013–2018, 880,000 persons or 0.3% of the US population aged 6 years and older were estimated to have HBV infection; among these persons, 69.1% were non–US-born, and the prevalence of HBV infection was highest among non-Hispanic (NH) Asian persons.” > “Among persons aged 6 years and older, 4.0% (95% CI: 3.1%–4.9%) had past or present hepatitis B; and 0.2% (95% CI: 0.1%–0.3%) or an estimated 660,000 (95% CI: 410,000–1,000,000) persons had HBV infection, among whom 49.8% (95% CI: 25.1%–74.6%) were aware of their infection.” > “NH-Asian persons accounted for 48.4% (95% CI: 30.6%–66.5%) and non–US-born persons accounted for 73.6% (95% CI: 50.6%–90.0%) of all persons with HBV infection.” > “No persons under the age of 20 years were identified with HBV infection; therefore, estimates for persons aged 20 years or older are included in Table 1.” > “Similarly, the current prevalence estimate is not statistically different from the previous estimate of 880,000.” Source: [Bixler et al. (2023)](https://pmc.ncbi.nlm.nih.gov/articles/PMC10069827/) ### United States, 2018: foreign-born persons with chronic infection by region of origin > “Although prevalence of chronic hepatitis B (CHB) in the USA includes 0.42 million (range, 0.28‐0.67) U.S.‐born persons, foreign‐born (FB) persons contribute a substantially larger number to the burden of CHB in the USA.” > “The weighted average CHB prevalence for all FB in the USA in 2018 was 3.07%. Approximately 59% of FB with CHB in the USA in 2018 emigrated from Asia, 19% from the Americas, and 15% from Africa.” > “Using FB populations from ACS and country‐specific CHB pooled rates from the mid‐range RE meta‐analyses, we estimate that the number of FB with CHB living in the USA in 2018 was 1.47M persons (95% CI, 1.21‐1.73; Table 1).” > “Including FB and U.S.‐born persons, the total prevalence of CHB in the USA may be as high as 2.4 million.” Source: [Wong et al. (2021)](https://pmc.ncbi.nlm.nih.gov/articles/PMC8453838/) ### United States, 2019 expert panel: estimated number with chronic infection > “The panel proposed an overall estimated prevalence for chronic HBV infection in the US of 1.59 million persons (range 1.25-2.49 million).” Source: [Lim et al. (2020)](https://pubmed.ncbi.nlm.nih.gov/32483003/) ### United States, 2020 model: number infected, age distribution, and share among immigrants > “In 2020, it is estimated that there were a total of 1.8 million (95% uncertainty interval: 1.3–2.6 million) HBV-positive individuals in the US, corresponding to a prevalence of 0.55% (UI: 0.41–0.77%) in all ages.” > “The analysis estimated that almost 1.4 million of these infections, or 76% (1.4 million out of 1.8 million total infections) of all estimated infections, were among immigrants.” > “Of all HBV infections, 82% (1.15 million out of 1.4 million) fell within the ages 30–74.” Source: [Razavi-Shearer et al. (2023a)](https://pmc.ncbi.nlm.nih.gov/articles/PMC10239007/) ### United States and Puerto Rico, 2021 model: national and state prevalence > “Utilising this bottom up approach to estimate the prevalence of HBV in the United States, we estimate there are 1.7 million (UI: 795,000–4.1 million) people living with HBV in the United States and Puerto Rico, corresponding to a prevalence of 0.50% (UI: 0.24%–1.23%; Table 1).” > “Of these cases, 76% are estimated to be among the foreign‐born population (1.3 million, UI: 589,000–3.1 million), with 396,000 (UI: 206,000–1,007,000) cases being among the non‐foreign‐born population (Table 1).” > “The highest HBV prevalence was found in Hawai‘i, 1.3% (UI: 0.5%–4.0%); California, 0.9% (UI: 0.5%–1.9%); New York, 0.8% (UI: 0.4%–1.7%); Maryland, 0.8% (UI: 0.4%–1.7%); and New Jersey, 0.8% (UI: 0.4%–1.5%; Figure 1).” Source: [Razavi-Shearer et al. (2026)](https://pmc.ncbi.nlm.nih.gov/articles/PMC12715829/) > “CHB affects approximately 1.7 million people in the US” Source: [GSK press release, Hibsago US approval (2026)](https://www.gsk.com/en-gb/media/press-releases/hibsago-bepirovirsen-approved-in-the-us-for-the-treatment-of-chronic-hepatitis-b-chb/) ### United States: range of published estimates cited in the 2023 CDC screening recommendations > “An estimated 580,000 to 2.4 million persons are living with HBV infection in the United States (5,6), two thirds of whom might be unaware of their infection (5).” > “Chronic HBV infection disproportionately affects persons born outside the United States; non-U.S.–born persons account for 14% of the general population, but account for 69% of the U.S. population living with chronic HBV infection (5–7).” Source: [Conners et al. (2023)](https://pmc.ncbi.nlm.nih.gov/articles/PMC9997714/) ### United States: proportion diagnosed, aware, and treated > “By 2020, we estimate that approximately 334,800 chronic HBV infections were diagnosed in the US, corresponding to a diagnosis coverage of 18% (334,800 diagnosed out of 1.8 million infected) with just under 17% (90,500 treated out of 534,100 eligible) of all eligible individuals on treatment.” Source: [Razavi-Shearer et al. (2023a)](https://pmc.ncbi.nlm.nih.gov/articles/PMC10239007/) > “An estimated 1.3 million (95% CI, 0.9–1.7 million) persons in the United States were HBV-infected. 34% (95% CI, 19%–54%) of HBV-infected persons reported awareness and 28% (95% CI, 10%–57%) of aware persons reported ever having HBV treatment.” Source: [Zhou and Terrault (2020)](https://pmc.ncbi.nlm.nih.gov/articles/PMC8028744/) > “32.4 percent of persons with chronic hepatitis B were aware they have chronic hepatitis B in 2013-16” Source: [ODPHP Healthy People 2030 IID-13](https://odphp.health.gov/healthypeople/objectives-and-data/browse-objectives/infectious-disease/increase-proportion-people-who-know-they-have-chronic-hepatitis-b-iid-13) ### United States, commercially insured adults 2003 to 2019: evaluation, treatment eligibility, and treatment > “We included 12,608 eligible patients in the study analysis (mean age 45.7 years, 52.1% male, 54.6% Asian, 18.1% Caucasian, 10.5% African American).” > “Of those with an adequate evaluation, 11.2% were treatment eligible by AASLD criteria and 13.9% by EASL criteria; 60.4% of AASLD eligible patients and 54.3% of EASL eligible patients received treatment within 12 months from becoming eligible.” Source: [Ye et al. (2022)](https://pubmed.ncbi.nlm.nih.gov/34474097/) ### Quantitative HBsAg distribution relevant to the 3,000 IU/mL eligibility threshold > “In a key secondary endpoint, a functional cure rate of 26% (200 of 768 vs. 0 of 393 in the placebo group) was achieved in participants with ≤1000 IU/ml HBsAg level, a group that represents approximately 45% of diagnosed CHB cases globally.” Source: [GSK press release, Hibsago US approval (2026)](https://www.gsk.com/en-gb/media/press-releases/hibsago-bepirovirsen-approved-in-the-us-for-the-treatment-of-chronic-hepatitis-b-chb/) ### Nucleos(t)ide analogue-treated trial participants: HBsAg distribution before peg-interferon add-on > “Mean age was 43 (±11) years, mean SOT HBsAg was 3.03 (±0.94) log10 IU/mL (HBsAg<100 IU/mL: 69 (12%); 100–1000: 163 (28%); ≥1000: 342 (60%)), mean HBV DNA was 1.58 (±0.78) log10 IU/mL, with 517 (89%) patients having HBV DNA<100 IU/mL” Source: [Dongelmans et al. (2026)](https://pmc.ncbi.nlm.nih.gov/articles/PMC13638273/) ### Global, 2024: prevalence, diagnosis, and treatment coverage > “In 2024, 240 million people (95% UI: 202–296 million) were living with a chronic HBV infection, equivalent to 2.9% (95% UI: 2.5–3.6%) of the global population.” > “Based on the latest WHO guidelines, approximately 50% of people with HBV infection worldwide are eligible for treatment.” > “Globally in 2024, only 27% of the estimated 240 million people with HBV infection had been diagnosed and 4.3% were on treatment.” Source: [WHO Global hepatitis report (2026)](https://iris.who.int/server/api/core/bitstreams/6f6caedc-37a0-49ee-a02a-df9c3b78ff42/content) > “Forty-three million people are infected in the WHO South-East Asia Region, 16 million in the WHO Eastern Mediterranean Region, 9.7 million in the WHO European Region and 5 million in the WHO Region of the Americas.” > “In 2024 only 10 million people were on antiviral treatment, this being equivalent to 4.3% of all people living with chronic hepatitis B.” Source: [WHO hepatitis B fact sheet (2026)](https://www.who.int/news-room/fact-sheets/detail/hepatitis-b) ### Global, 2022 model: prevalence, diagnosis, and treatment of eligible persons > “We developed models for 170 countries which resulted in an estimated global prevalence of HBV infection in 2022 of 3·2% (95% uncertainty interval 2·7-4·0), corresponding to 257·5 million (216·6-316·4) individuals positive for HBsAg. Of these individuals, 36·0 million were diagnosed, and only 6·8 million of the estimated 83·3 million eligible for treatment were on treatment.” Source: [Polaris Observatory Collaborators (2023)](https://pubmed.ncbi.nlm.nih.gov/37517414/) ### Proportion with cirrhosis among adults with chronic infection, United States No evidence found. ## Related pages - [Hibsago (bepirovirsen): Chronic hepatitis B virus infection in adults without cirrhosis](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis) · [Markdown](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis.md) - [Hibsago (bepirovirsen) in Chronic hepatitis B virus infection in adults without cirrhosis: Terms and abbreviations](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/terms-and-abbreviations) · [Markdown](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/terms-and-abbreviations.md) - [Hibsago (bepirovirsen): Chronic hepatitis B virus infection in adults without cirrhosis](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/executive-summary) · [Markdown](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/executive-summary.md) - [Hibsago (bepirovirsen) in Chronic hepatitis B virus infection in adults without cirrhosis: Product information and disease description](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/product-information-and-disease-description) · [Markdown](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/product-information-and-disease-description.md) - [Hibsago (bepirovirsen) in Chronic hepatitis B virus infection in adults without cirrhosis: Clinical evidence](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/clinical-evidence) · [Markdown](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/clinical-evidence.md) - [Hibsago (bepirovirsen) in Chronic hepatitis B virus infection in adults without cirrhosis: Economic information and modeling report](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/economics) · [Markdown](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/economics.md) - [Hibsago (bepirovirsen) in Chronic hepatitis B virus infection in adults without cirrhosis: References](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/references) · [Markdown](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/references.md) - [Hibsago (bepirovirsen) in Chronic hepatitis B virus infection in adults without cirrhosis: new drug review](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/monograph/review) · [Markdown](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/monograph/review.md) - [Hibsago (bepirovirsen) in Chronic hepatitis B virus infection in adults without cirrhosis: cost-effectiveness analyses and utility weights](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/cost-effectiveness-analyses) · [Markdown](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/cost-effectiveness-analyses.md)