Acute hepatitis B notification rates in Flanders, Belgium, 2009 to 2017

Abstract

Background Belgium is a low-endemic country for hepatitis B. Universal hepatitis B vaccination in infants with catch-up in the age cohort of 10–13 year-olds began in 1999. Aims Our objective was to evaluate the effect of prevention and control strategies on acute hepatitis B notification rates in Flanders (Belgium) from 2009 to 2017. Methods This observational study collected demographic data and risk factors for acute hepatitis B from mandatory notifications to the Agency for Care and Health. Results In Flanders, acute hepatitis B notification rates per 100,000 population decreased from 1.6 in 2009 to 0.7 in 2017. These rates declined in all age groups: 0–4-year-olds: 0.6 to 0.0, 5–14-year-olds: 0.2 to 0.0, 15–24-year-olds: 0.8 to 0.7, 25–34-year-olds: 3.4 to 1.1 and ≥ 35-year-olds: 1.59 to 0.7. There was also a downward trend in acute hepatitis B notification rates in native Belgians and first-generation migrants. Among 15–24-year-olds and 25–34-year-olds, a possible reversal of the decreasing trend was observed in 2016 and 2015, respectively. Among 548 acute hepatitis B cases, the main route of transmission was sexual activity (30.7%), and the pattern of transmission routes over time showed an increasing proportion of sexual transmission in men who have sex with men (MSM) after 2014. During the period from 2009 to 2017, five mother-to-child transmissions were reported. Conclusions Prevention and control strategies were effective in reducing the acute hepatitis B notification rate. However, stronger prevention and control measures are needed in adult risk groups, particularly MSM.

Hepatitis B virus prevalence in first‐time blood donors in Flanders, Belgium: Impact of universal vaccination and migration

“…Moreover, the self-reported coverage of vaccination against HBV between 1999 and 2017 in Flanders, Belgium, exceeded 90% of the infants from 2005 onwards while it was below 90% for adolescents up to 2017. 35 In line with these results, the majority of the HBsAg positive donors born ≥1987 in our analysis were expected to be vaccinated at ages between 10 and 13 years. Lastly, we cannot confirm whether correct measures were taken to prevent perinatal HBV transmission (e.g., HBsAg screening of pregnant women).…”

Early detection of chronic hepatitis B and risk factor assessment in Turkish migrants, Middle Limburg, Belgium

“…To assess the impact of universal HBV vaccination in Belgium among Turkish SGM, we stratified HBsAg, anti-HBc and/or anti-HBs prevalence into two birth cohorts (1930-1986 and 1987-2001). This cutoff was chosen as the free-of-charge HBV vaccination program in infants since September 1999 with catch-up vaccination for 10-13 year-olds covered children born after 1987 in Belgium [18].…”

The effect of universal infant vaccination on the prevalence of hepatitis B immunity in adult solid organ transplant candidates

“…The cut-off was chosen since children born in 1986 or after were covered by the universal infant HBV vaccination programme in Belgium. 28,29 Age was grouped as 18-to 24-yearolds, 25-to 40-year-olds, 40-to 64-year-olds and ≥65-year-olds as defined by the Medical Subject Headings (MeSH). Selected analysis was performed comparing <40-year-olds and ≥40-year-olds in line with prior hepatitis B vaccine efficacy studies.…”

“…This increase could be explained by the effect of universal vaccination at a young age and in the absence of underlying disease. 6,10,27,28 Considering the rigorous immunization programme in dialysis patients, the highest HBV immunity rate was observed in renal transplant candidates. Nevertheless, the response rate was still suboptimal in this condition.…”

“…In Belgium, universal infant HBV vaccination began in 1999 with catch-up vaccination for 10-to 13-year-olds (birth cohort born in 1986 or after). 28,29 2 | PATIENTS AND ME THODS…”