Background

As 2030 approaches, Belgium must assess its progress toward eliminating hepatitis B and C, a commitment made in 2015. While hepatitis-related deaths are rising globally, Belgium lacks data documenting hepatitis-attributable mortality. Since 2021, the World Health Organization (WHO) recommends using absolute rather than relative mortality targets. Our objective was to estimate age-standardised hepatitis B and C mortality rates in Belgium and assess progress towards elimination.

Methods

Mortality and population data were obtained from Statistics Belgium. We analysed the Belgian national cause-of-death registry data from 2008 to 2022. Hepatitis B and C deaths were identified using ICD-10 codes: B16.2, B16.9, B16.0, B16.1, B18.1, B18.0 (hepatitis B) and B17.1, B18.2 (hepatitis C). Deaths were included if any of these codes were listed in any causes of death. National and regional crude and age-standardised mortality rates were calculated using the Belgian mid-year 2015 population as reference.

Results

During these 15 years, hepatitis B and C were reported in 2231 and 655 deaths, respectively. In 2022, Belgium’s age-adjusted hepatitis C mortality rate was 0.76 per 100,000, compared to 2.78 in 2008. This rate showed a decreasing trend and met the WHO 2030 target (≤2/100,000) since 2010, except in Brussels. Hepatitis B mortality was 0.35 in 2022, compared to 0.72 in 2008. From 2009 to 2022, the trend fluctuated but remained below the 2030 target (≤4/100,000) across all regions. For both infections, mortality was highest in Brussels, followed by Wallonia and Flanders.

Conclusion

Hepatitis B and C related mortality are low in Belgium, and below the 2030 WHO targets. Despite these positive findings, efforts are still needed to reduce the burden of hepatitis in Belgium. Alternative methods to estimate hepatitis attributable deaths should be implemented to validate these results.