The prevalence of hepatitis B infection in adults in England and Wales

Abstract

Cost effectiveness analyses of alternative hepatitis B vaccination programmes in England and Wales require a robust estimate of the lifetime risk of carriage. To this end, we report the prevalence of infection in 3781 anonymized individuals aged 15-44 years whose sera were submitted in 1996 to 16 microbiology laboratories in England and Wales. One hundred and forty-six individuals (3.9%) were confirmed as anti HBc positive, including 14 chronic carriers (0.37%). The prevalence of infection and carriage was higher in samples collected in London and increased with age. No increased risk of infection was seen in sera from genito-urinary (GUM) clinics. Only 15 sera positive for hepatitis B were also positive for hepatitis C. Our results confirm the low prevalence of hepatitis B in England and Wales, are consistent with previous estimates of carriage and suggest that many infections were acquired while resident outside the UK. Future prevalence studies should determine the country of birth and other risk factors for each individual in order to confirm these findings.

Surveillance and epidemiology of hepatitis B and C in Europe – a review

“…In low endemic countries HBV is usually acquired via injecting drug use, sexual contacts, or body piercing activities [1]. There is evidence, at least from Denmark and the Netherlands, that the number of HBV infections transmitted by sexual contact has recently been increasing [32,33] but injecting drug use is a major mode of transmission in many countries [32,34]. In the past, HBV was frequently transmitted via blood transfusion, but due to improved testing of blood donors the estimated residual risk of acquiring HBV infection ranges from 1 to 10 per million transfusions in Europe [35][36][37][38][39].…”

Incidence and routes of transmission of hepatitis B virus in England and Wales, 1995–2000: implications for immunisation policy

“…To assess the validity of our incidence estimate, we compared the resulting cumulative incidence by age with the prevalence of infection (anti-HBc prevalence) found in population surveys (Gay et al, 1999). This prevalence will reflect incidence from both during and before the period of surveillance analysed here.…”

Ten years of serological surveillance in England and Wales: methods, results, implications and action

“…The hepatitis B surveys are an example of seroprevalence studies that complement disease incidence data and improve the understanding of disease epidemiology. These confirmed the low prevalence of hepatitis B infection in the UK 16,17 and informed the decision not to implement a universal hepatitis B vaccination programme at present.…”