Author information

¹KEMRI Wellcome Trust Research Programme, Kilifi, Kenya.

²Nuffield Department of Medicine, University of Oxford, Oxford, UK.

³Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.

⁴The National Organization for People Living with Hepatitis B (NOPLHB), Kampala, Uganda.

⁵British Liver Trust, Winchester, UK.

⁶The Francis Crick Institute, London, UK.

⁷Uganda Virus Research Institute, Entebbe, Uganda.

⁸Department of Health Sciences, University of York, York, UK.

⁹Mortimer Market Centre, Central North West London NHS Foundation Trust, London, UK.

¹⁰London School of Hygiene and Tropical Medicine, London, UK.

¹¹Department of Infectious Diseases, University College London Hospitals, London, UK.

¹²The Institute for Infection and Immunity, St George's University of London, London, UK.

¹³Find and Treat, University College London Hospitals, London, UK.

¹⁴Institute for Global Health, University College London, London, UK.

¹⁵Department of Hepatology, Royal Free Hospital NHS Foundation Trust, London, UK.

¹⁶Storr Liver Centre, The Westmead Institute for Medical Research, The University of Sydney at Westmead Hospital, Westmead, New South Wales, Australia.

¹⁷Centre for Infectious Diseases and Microbiology, Sydney Infectious Diseases Institute, The University of Sydney at Westmead Hospital, Westmead, New South Wales, Australia.

¹⁸HepBCommunity.org, Sydney, New South Wales, Australia.

¹⁹Hepatitis B Voices Australia, Melbourne, Victoria, Australia.

²⁰Africa Health Research Institute, KwaZulu-Natal, South Africa.

²¹Department of Hepatology, King's College Hospital NHS Foundation Trust, London, UK.

²²Division of Medical Virology, Faculty of Medicine and Health Sciences, Stellenbosch University and National Health Laboratory Service, Cape Town, South Africa.

²³Radcliffe Department of Medicine, University of Oxford, Oxford, UK.

²⁴Division of Hepatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.

²⁵Hepatitis B Foundation, Doylestown, Pennsylvania, USA.

²⁶Cooperman Barnabas Medical Center, Florham Park, New Jersey, USA.

²⁷World Hepatitis Alliance, London, UK.

²⁸CFID/CCT Taraba, Tarabba, Nigeria.

²⁹The Hepatitis C Trust, London, UK.

³⁰Hepatology Department, Nottingham University Hospitals NHS Trust, Nottingham, UK.

³¹Liver Unit and National Institute for Health Research Biomedical Research Centre at the University Hospitals Birmingham, University of Birmingham, Birmingham, UK.

Abstract

Chronic hepatitis B infection (CHB) affects 300 million people worldwide and is being targeted by the United Nations 2030 Sustainable Development Goals (SDGs) and the World Health Organisation (WHO), working towards elimination of hepatitis B virus (HBV) as a public health threat. In this piece, we explore the evidence and potential impact of peer support to enhance and promote interventions for people living with CHB. Peer support workers (PSWs) are those with lived experience of an infection, condition or situation who work to provide support for others, aiming to improve education, prevention, treatment and other clinical interventions and to reduce the physical, psychological and social impacts of disease. Peer support has been shown to be a valuable tool for improving health outcomes for people living with human immunodeficiency virus (HIV) and hepatitis C virus (HCV), but to date has not been widely available for communities affected by HBV. HBV disproportionately affects vulnerable and marginalised populations, who could benefit from PSWs to help them navigate complicated systems and provide advocacy, tackle stigma, improve education and representation, and optimise access to treatment and continuity of care. The scale up of peer support must provide structured and supportive career pathways for PSWs, account for social and cultural needs of different communities, adapt to differing healthcare systems and provide flexibility in approaches to care. Investment in peer support for people living with CHB could increase diagnosis, improve retention in care, and support design and roll out of interventions that can contribute to global elimination goals.