Chari Cohen, DrPH, MPH: Advances in Hepatitis B Management

Chari Cohen, DrPH, MPH, president of the Hepatitis B Foundation, sat down with HCPLive to discuss emerging treatment opportunities for hepatitis B, barriers and disparities in access to adequate care, and her hopes for the future of hepatitis B management.

Cohen was a speaker during multiple sessions at The Liver Meeting 2023 from the American Association for the Study of Liver Diseases (AASLD), including “White House Hepatitis C Elimination Plan: What it means for you and your community” and “New directions for WHO Hepatitis B Global Guidelines on Diagnosis, Treatment and Service Delivery.”

Chronic hepatitis B virus (HBV) infection remains a heavy public health burden worldwide. Despite the existence of a safe and effective vaccine, no therapeutic regimen has been identified for inducing a functional cure. Many novel therapeutic approaches are in development, with Cohen describing recent advances as “an exciting time” and referencing late-breaking data presented at The Liver Meeting.

Beyond developments in therapies, Cohen also mentioned progress surrounding access to treatment, new treatment guidelines, and biomarkers for hepatitis B, further discussing the importance of incorporating patient voices in these processes.

“One of the things that we as a patient advocacy organization, and a public health research organization, have been doing is looking to help integrate the patient voice and patient values and preferences and community values into things like guideline development and clinical trial development and the management of hepatitis B to make it more patient-centered,” explained Cohen. “We would like to see some of that integrated into the new guidelines. We want to see patients have an opportunity to have a say in how they are treated.”

Clinicians also play a pivotal role in shaping the management of hepatitis B. Cohen described how patients are advocates, but also stressed the importance of clinicians being advocates as well and using their voice and influence to help implement change patients may not be able to achieve on their own.

“Providers have strong voices and medical societies are strong. I think if they took more of an active role in advocating for people living with hepatitis B, we would see more progress. The patient voice is of course very important, but it's also a stigmatized community and not necessarily loud enough, and not everybody listens,” Cohen said.

Pointing to other areas in need of improvement, Cohen also cited the global under-prioritization of hepatitis B manifesting as a lack of access to diagnostic testing, providers not screening and vaccinating, and their subsequent inability to treat and manage hepatitis B with the tools they currently have.

“We have to be thinking about how we address challenges holistically with every stakeholder. So among the community, we have to address stigma and discrimination, we have to address treatment access issues and cost issues, to help promote people to get into the health care system and to get tested and to get treated and vaccinated if they need it,” explained Cohen, describing the need to increase the capacity of healthcare systems around the world so the burden does not fall solely on hepatologists but is rather addressed by government efforts to prioritize hepatitis B elimination.

Looking ahead, Cohen hopes to see simplified and expanded treatment guidelines for hepatitis B. Specifically, she mentioned decentralizing care to improve opportunities for patients and give them a louder voice for influencing decisions surrounding their disease: “I think there’s a lot we can do there,” Cohen said.