Hepatitis B Re-Engagement Efforts Underreported in Lower-Resource Settings: Helen Nde, MPH

In part 2 of an interview with The American Journal of Managed Care^®, Helen Nde, MPH, of the Center for Disease Analysis Foundation, further discussed her scoping review on hepatitis B, which was presented at the European Association for the Study of the Liver in May 2026.

Re-Engagement Research Concentrated in High-Income Countries

She began by pointing out a notable pattern in the literature on re-engagement in care for people living with hepatitis B: virtually all peer-reviewed, formally published, and indexable research on re-engagement efforts comes from high-income countries. This creates a misleading impression that little or nothing is being done to re-engage patients in lower-resource settings.

Nde detailed a conversation she had with a patient advocate from the African region, who told her that re-engagement work is happening but is not being written up and published in the formal literature. She stressed that the absence of published data does not mean an absence of activity; rather, it means the activity is not being documented in the channels researchers typically search.

Gaps Remain for Chronically Infected Populations

Nde broadened the point by noting that in many low- and middle-income countries, hepatitis B programming tends to concentrate on vaccination and managing pregnant women, since that is where a large share of transmission risk lies. Within this context, she highlighted catch-up vaccination programs and follow-up efforts for people who missed vaccination, along with substantial follow-up for pregnant women, as examples of re-engagement occurring within narrower populations.

However, her own search focused on the general population of people chronically infected with hepatitis B, not just pregnant women or unvaccinated individuals. For that broader group, she found no formal peer-reviewed evidence of re-engagement efforts. Nde said she sees this as a genuine, meaningful gap rather than just a publication or documentation problem.

More Action Needed in High-Burden Regions

She closed by connecting this to the bigger picture: since tenofovir, the standard hepatitis B treatment, is inexpensive, well-established, and accessible, there is a strong case that more could and should be done, both in terms of actual re-engagement work and documenting and publishing those efforts, especially in the regions of the world most heavily affected by chronic hepatitis B infection.

“The ultimate message is for the parts of the world that are most affected by this virus; more can definitely be done,” Nde concluded.