Sofosbuvir/velpatasvir/voxilaprevir is recommended for hepatitis C virus (HCV) retreatment in those who fail initial treatment but is unavailable in resource-limited settings. We describe a government sofosbuvir/velpatasvir + ribavirin (SOF/VEL + RBV) × 24 weeks retreatment program in Rwanda (November 2021–October 2022). Of 231 participants, 174 were cured (75.3% intention-to-treat analysis). SOF/VEL + RBV may be considered for HCV retreatment in resource-limited settings.

Background: Timely treatment of chronic hepatitis B virus (HBV) infection reduces complications such as cirrhosis and hepatocellular carcinoma and improves overall survival. In Sub-Saharan Africa, data on HBV treatment success are limited, especially among people living with HBV mono-infection. We assessed the success of HBV treatment and associated factors among people diagnosed with HBV mono-infection and HIV co-infection. Methods: We used data from the District Health Information System 2 in Rwanda, covering 4.6 million screened individuals (January 2016–June 2023). Patients receiving HBV therapy for ≥12 months were included. Treatment success was defined as undetectable HBV DNA or normal ALT at 12 months. We used multilevel logistic regression to assess risk factors, accounting for clustering by hospital. Results: Among 4733 treated individuals (median age: 39 y, 58.4% male), 4518 (95.5%) achieved treatment success, increasing over time (90.3% for <2 y vs. 95.8% for ≥2 y of follow-up). Treatment success was mostly assessed by ALT normalization (87.5%). HBV mono-infected and HBV/HIV co-infected individuals had similar overall treatment success rates [3730 (95.5%) vs. 788 (95.2%)]. However, among those treated for <2 years, success was lower in HBV/HIV individuals [7 (43.8%) vs. 283 (92.7%)]. In multivariable analysis, HCV co-infection (aOR: 0.33; 95% CI: 0.12, 0.85), follow-up at provincial/referral hospitals (aOR: 0.26; 95% CI: 0.08, 0.86), and cirrhosis (aOR: 0.36; 95% CI: 0.20, 0.63) were associated with a lower likelihood of HBV treatment success. Conclusions: HBV treatment success in Rwanda was high but lower in those with HBV/HCV co-infection or cirrhosis, underscoring the need for early detection and monitoring.

Background/Objectives: In 2016, the World Health Organization (WHO) set targets to eliminate viral hepatitis as a public health threat by 2030, seeking a 90% reduction in new chronic infections and a 65% reduction in mortality relative to a 2015 baseline. Despite effective vaccines and potent antivirals, viral hepatitis mortality is rising. This review assessed the global and regional status of, and impediments to, the 2030 HBV elimination goal and compared hepatitis B virus (HBV) with hepatitis C virus (HCV) elimination trajectories. Methods: A scoping review was conducted following the JBI methodology and reported in accordance with PRISMA-ScR. Peer-reviewed literature, global and regional surveillance reports, and grey literature published between 2015 and 2025 were searched across five databases and multiple institutional repositories. Data were charted against WHO impact and service-coverage indicators and mapped across the six WHO regions. Results: Ten core records that met the search criteria were synthesized. Overall, HBV-specific progress is uneven across the care continuum and differs sharply between regions. Routine infant three-dose vaccination (HepB3) reached 84% coverage globally in 2022, with 190/194 (98%) Member States having introduced HepB3, driving HBsAg prevalence below 1% in children under five. However, the timely birth dose (HepB-BD) stagnated at 46% globally and just 14–18% in the African Region, where only a minority of countries offer a universal birth dose. Only 13% of the 254 million people with chronic HBV were diagnosed, and 2.6% were treated. The total viral hepatitis toll increased from 1.1 million (2019) to 1.3 million (2022), with 83% attributed to HBV. Conclusions: HBV elimination is technically feasible but operationally off-track, and progress is regionally inequitable. Effective vaccines make prevention feasible, but current antiviral therapy remains suppressive rather than curative; the principal impediments are the birth-dose gap (most acute in Africa), a collapsed diagnosis–treatment cascade, centralized care, and inadequate domestic financing. Realigning with the 2030 targets requires integrating HBV services into antenatal and primary care, decentralizing testing and treatment through task-sharing, sustained domestic investment, and continued development of curative therapies.