1887
Systematic Review Open Access
Like 0

Abstract

Background

The burden of chronic hepatitis B virus (HBV) varies across the European Union (EU) and European Economic Area (EEA).

Aim

We aimed to update the 2017 HBV prevalence estimates in EU/EEA countries and the United Kingdom for 2018 to 2021.

Methods

We undertook a systematic review, adding to HBV prevalence estimates from an existing (2005–2017) database. Databases were searched for original English-language research articles including HBV surface antigen prevalence estimates among the general population, pregnant women, first-time blood donors (FTB), men who have sex with men (MSM), migrants and people in prison. Country experts contributed grey literature data. Risk of bias was assessed using a quality assessment framework.

Findings

The update provided 147 new prevalence estimates across the region (updated total n = 579). Median HBV prevalence in the general population was 0.5% and the highest was 3.8% (Greece). Among FTB, the highest prevalence was 0.8% (Lithuania). Estimates among pregnant women were highest in Romania and Italy (5.1%). Among migrants, the highest estimate was 31.7% (Spain). Relative to 2017 estimates, median prevalence among pregnant women decreased by 0.5% (to 0.3%) and increased by 0.9% (to 5.8%) among migrants. Among MSM, the highest estimate was 3.4% (Croatia). Prevalence among people in prison was highest in Greece (8.3%) and the median prevalence increased by 0.6% (to 2.1%).

Conclusions

The HBV prevalence is low in the general population and confined to risk populations in most European countries with some exceptions. Screening and treatment should be targeted to people in prison and migrants.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2023.28.30.2200738
2023-07-27
2024-06-24
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2023.28.30.2200738
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/28/30/eurosurv-28-30-3.html?itemId=/content/10.2807/1560-7917.ES.2023.28.30.2200738&mimeType=html&fmt=ahah

References

  1. World Health Organization (WHO). Global progress report on HIV, viral hepatitis and sexually transmitted infections, 2021. Geneva: WHO; 2021. Available from: https://www.who.int/publications/i/item/9789240027077
  2. World Health Organization (WHO). Hepatitis B. Geneva: WHO; 2022. Available from: https://www.who.int/news-room/fact-sheets/detail/hepatitis-b
  3. World Health Organization (WHO/Europe). Factsheet - Hepatitis B in the WHO European Region. Copenhagen: WHO/Europe; 2021 [Available from: https://www.who.int/europe/publications/m/item/factsheet---hepatitis-b-in-the-who-european-region
  4. World Health Organization (WHO). Guidelines for the prevention, care and treatment of persons with chronic hepatitis B infection. Geneva: WHO; 2015. Available from: https://www.who.int/publications/i/item/9789241549059
  5. Ott JJ, Stevens GA, Groeger J, Wiersma ST. Global epidemiology of hepatitis B virus infection: new estimates of age-specific HBsAg seroprevalence and endemicity. Vaccine. 2012;30(12):2212-9.  https://doi.org/10.1016/j.vaccine.2011.12.116  PMID: 22273662 
  6. European Centre for Disease Prevention and Control (ECDC). Prevention of hepatitis B and C in the EU/EEA and the UK. Stockholm: ECDC; 2020. Available from: https://www.ecdc.europa.eu/en/publications-data/prevention-hepatitis-b-and-c-eueea-and-uk
  7. European Centre for Disease Prevention and Control (ECDC). Systematic review on hepatitis B and C prevalence in the EU/EEA. Stockholm: ECDC; 2016. Available from: https://www.ecdc.europa.eu/en/publications-data/systematic-review-hepatitis-b-and-c-prevalence-eueea
  8. European Centre for Disease Prevention and Control (ECDC). Monitoring the responses to hepatitis B and C epidemics in EU/EEA Member States, 2019. Stockholm: ECDC; 2020. Available from: https://www.ecdc.europa.eu/en/publications-data/monitoring-responses-hepatitis-b-and-c-epidemics-eueea-member-states-2019
  9. World Health Organization Regional Office for Europe (WHO/Europe). Viral hepatitis: fact sheet on Sustainable Development Goals (‎SDGs)‎: health targets. Copenhagen: WHO/Europe; 2017. Available from: https://apps.who.int/iris/handle/10665/340890
  10. World Health Organization (WHO). Global health sector strategy on viral hepatitis 2016-2021. Towards ending viral hepatitis. Geneva: WHO; 2016. Available from: https://apps.who.int/iris/handle/10665/246177
  11. European Centre for Disease Prevention and Control (ECDC). Hepatitis B - prevalence database. Stockholm: ECDC; 2019. Available from: https://www.ecdc.europa.eu/en/all-topics-z/hepatitis-b/tools/hepatitis-b-prevalence-database
  12. Hofstraat SHI, Falla AM, Duffell EF, Hahné SJM, Amato-Gauci AJ, Veldhuijzen IK, et al. Current prevalence of chronic hepatitis B and C virus infection in the general population, blood donors and pregnant women in the EU/EEA: a systematic review. Epidemiol Infect. 2017;145(14):2873-85.  https://doi.org/10.1017/S0950268817001947  PMID: 28891457 
  13. Falla AM, Hofstraat SHI, Duffell E, Hahné SJM, Tavoschi L, Veldhuijzen IK. Hepatitis B/C in the countries of the EU/EEA: a systematic review of the prevalence among at-risk groups. BMC Infect Dis. 2018;18(1):79.  https://doi.org/10.1186/s12879-018-2988-x  PMID: 29433454 
  14. Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1.  https://doi.org/10.1186/2046-4053-4-1  PMID: 25554246 
  15. Kowdley KV, Wang CC, Welch S, Roberts H, Brosgart CL. Prevalence of chronic hepatitis B among foreign-born persons living in the United States by country of origin. Hepatology. 2012;56(2):422-33.  https://doi.org/10.1002/hep.24804  PMID: 22105832 
  16. R Core Team. R: A language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2013. Available from: http://www.R-project.org
  17. Lahti L, Huovari J, Kainu M, Biecek P. Retrieval and analysis of Eurostat open data with the eurostat package. R J. 2017;9(1):385-92.  https://doi.org/10.32614/RJ-2017-019 
  18. Hansen N, Hay G, Cowan S, Jepsen P, Bygum Krarup H, Obel N, et al. Hepatitis B prevalence in Denmark - an estimate based on nationwide registers and a national screening programme, as on 31 December 2007. Euro Surveill. 2013;18(47):20637.  https://doi.org/10.2807/1560-7917.ES2013.18.47.20637  PMID: 24300884 
  19. Sánchez AL, Olmedo Lucerón C. 2° Estudio de Seroprevalencia en España, 2017-2018. [2nd seroprevalence study of Spain 2017-2018]. 2021. Rev Esp Salud Pública. 2021;95:e202103059. Spanish.
  20. Dhillon R. Nicol E, Lee V. Online home testing - A review of service users and outcomes. BASHH Virtual Annual Conference, 19th to 21st October 2020.
  21. Macejova Z, Kristian P, Janicko M, Halanova M, Drazilova S, Antolova D, et al. The Roma population living in segregated settlements in eastern Slovakia has a higher prevalence of metabolic syndrome, kidney disease, viral hepatitis B and E, and some parasitic diseases compared to the majority population. Int J Environ Res Public Health. 2020;17(9):3112.  https://doi.org/10.3390/ijerph17093112  PMID: 32365672 
  22. Karatapanis S, Dimitroulopoulos D, Papastergiou V, Papakonstantinou F, Chasiou A, Ntetskas G, et al. P2‐167: Sixteen years after the implementation of compulsory hepatitis B vaccination in a hepatitis delta endemic area in Greece: comparison between two population‐based serosurveys. J Viral Hepat. 2018;25(S2).
  23. Touloumi G, Karakosta A, Kaskafetou S, Petraki I, Anagnostou O, Gavana M, et al. Treatment cascade of hepatitis B and C in general, migrant and Roma populations. J Hepatol. 2017;66(1):S71-2.  https://doi.org/10.1016/S0168-8278(17)30404-X 
  24. Popovici O, Radu R, Romaniuc A, Azoicăi D. A seroprevalence study for hepatitis B virus markers of infection in pregnant women in Romania: results and opportunities for prevention. J Gastrointestin Liver Dis. 2018;27(2):133-7.  https://doi.org/10.15403/jgld.2014.1121.272.hpb  PMID: 29922757 
  25. Giachè S, Foroghi L, Taliani G. High hepatitis B virus seroprevalence in pregnant women coming from middle and high-endemicity countries: An unresolved issue. Dig Liver Dis. 2019;51(8):1201-2.  https://doi.org/10.1016/j.dld.2019.05.023  PMID: 31257170 
  26. Visser M, van der Ploeg CPB, Smit C, Hukkelhoven CWPM, Abbink F, van Benthem BHB, et al. Evaluating progress towards triple elimination of mother-to-child transmission of HIV, syphilis and hepatitis B in the Netherlands. BMC Public Health. 2019;19(1):353.  https://doi.org/10.1186/s12889-019-6668-6  PMID: 30922277 
  27. Brouard C, Koenig C, Bonnet C, Blondel B, Sommen C, Lot F. Prévention de la transmission mère-enfant du virus de l’hépatite B en France. Enquête nationale périnatale 2016. [Prevention of mother-to-child transmission of hepatitis B virus in France. 2016 national perinatal survey]. Bull Epidémiol Hebd. 2020;31-32:612-23. French. Available from: http://beh.santepubliquefrance.fr/beh/2020/31-32/2020_31-32_2.html
  28. Kelly C, Pericleous M, Ahmed A, Vandrevala T, Hendy J, Shafi S, et al. Improving uptake of hepatitis B and hepatitis C testing in South Asian migrants in community and faith settings using educational interventions-A prospective descriptive study. Int J Infect Dis. 2020;100:264-72.  https://doi.org/10.1016/j.ijid.2020.08.059  PMID: 32861830 
  29. Salas-Coronas J, Cabezas-Fernández MT, Lozano-Serrano AB, Soriano-Pérez MJ, Vázquez-Villegas J, Cuenca-Gómez . Newly arrived African migrants to Spain: epidemiology and burden of disease. Am J Trop Med Hyg. 2018;98(1):319-25.  https://doi.org/10.4269/ajtmh.17-0604  PMID: 29165212 
  30. Tiittala P, Tuomisto K, Puumalainen T, Lyytikäinen O, Ollgren J, Snellman O, et al. Public health response to large influx of asylum seekers: implementation and timing of infectious disease screening. BMC Public Health. 2018;18(1):1139.  https://doi.org/10.1186/s12889-018-6038-9  PMID: 30249224 
  31. Brennan M, Boyle P, O’Brien A, Murphy K. Health of asylum seekers – are we doing enough. Irishhealthpro; 2013. Available from: https://www.irishhealthpro.com/content/articles/show/name/health-of-asylum-seekers--are-we-doing-enough
  32. Calin R, Massari V, Pialoux G, Reydellet N, Plenel E, Chauvin C, et al. Acceptability of on-site rapid HIV/HBV/HCV testing and HBV vaccination among three at-risk populations in distinct community-healthcare outreach centres: the ANRS-SHS 154 CUBE study. BMC Infect Dis. 2020;20(1):851.  https://doi.org/10.1186/s12879-020-05601-7  PMID: 33198672 
  33. Vilibić-Čavlek T, Kolarić B, Pavlić J, Kosanović-Ličina ML, Nemeth-Blažić T. Seroprevalence and risk factors for HIV, hepatitis B, and syphilis in populations with high-risk behaviors in Croatia. Acta Dermatovenerol Croat. 2018;26(4):3147-320. PMID: 30665481 
  34. Jacomet C, Guyot-Lénat A, Bonny C, Henquell C, Rude M, Dydymski S, et al. Addressing the challenges of chronic viral infections and addiction in prisons: the PRODEPIST study. Eur J Public Health. 2016;26(1):122-8.  https://doi.org/10.1093/eurpub/ckv183  PMID: 26454876 
  35. Busschots D, Bielen R, Koc ÖM, Dercon E, Brixko C, Laukens P, et al. Viral hepatitis in Belgian prisons: a first-time multicenter prevalence study. J Hepatol. 2020;73:S799.  https://doi.org/10.1016/S0168-8278(20)32044-4 
  36. European Centre for Disease Prevention and Control (ECDC). Hepatitis B and C testing in the EU/EEA: Progress in reaching the elimination targets. Stockholm: ECDC; 2021. Available from: https://www.ecdc.europa.eu/en/publications-data/hepatitis-b-and-c-testing-eueea-progress-reaching-elimination-targets
  37. Meireles LC, Marinho RT, Van Damme P. Three decades of hepatitis B control with vaccination. World J Hepatol. 2015;7(18):2127-32.  https://doi.org/10.4254/wjh.v7.i18.2127  PMID: 26328023 
  38. European Centre for Disease Prevention and Control (ECDC). The EMIS network. EMIS-2017 – The European men-who-have-sex-with-men internet survey. Key findings from 50 countries. Stockholm: ECDC; 2019. Available from: https://www.ecdc.europa.eu/en/publications-data/emis-2017-european-men-who-have-sex-men-internet-survey
  39. Schweitzer A, Horn J, Mikolajczyk RT, Krause G, Ott JJ. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet. 2015;386(10003):1546-55.  https://doi.org/10.1016/S0140-6736(15)61412-X  PMID: 26231459 
  40. Ahmad AA, Falla AM, Duffell E, Noori T, Bechini A, Reintjes R, et al. Estimating the scale of chronic hepatitis B virus infection among migrants in EU/EEA countries. BMC Infect Dis. 2018;18(1):34.  https://doi.org/10.1186/s12879-017-2921-8  PMID: 29325525 
  41. Rossi C, Shrier I, Marshall L, Cnossen S, Schwartzman K, Klein MB, et al. Seroprevalence of chronic hepatitis B virus infection and prior immunity in immigrants and refugees: a systematic review and meta-analysis. PLoS One. 2012;7(9):e44611.  https://doi.org/10.1371/journal.pone.0044611  PMID: 22957088 
  42. Mason LM, Duffell E, Veldhuijzen IK, Petriti U, Bunge EM, Tavoschi L. Hepatitis B and C prevalence and incidence in key population groups with multiple risk factors in the EU/EEA: a systematic review. Euro Surveill. 2019;24(30):1800614.  https://doi.org/10.2807/1560-7917.ES.2019.24.30.1800614  PMID: 31362808 
  43. Nakitanda AO, Montanari L, Tavoschi L, Mozalevskis A, Duffell E. Hepatitis B virus infection in EU/EEA and United Kingdom prisons: a descriptive analysis. Epidemiol Infect. 2021;149:e59.  https://doi.org/10.1017/S0950268821000169  PMID: 33487201 
  44. European Centre for Disease Prevention and Control (ECDC). Monitoring of responses to the hepatitis B and C epidemics in EU/EEA countries – 2020 data. Stockholm: ECDC; 2022. Available from:https://www.ecdc.europa.eu/en/publications-data/monitoring-responses-hepatitis-b-and-c-epidemics-eueea-countries-2020-data
  45. European Centre for Disease Prevention and Control (ECDC). Public health guidance on screening and vaccination for infectious diseases in newly arrived migrants within the EU/EEA. Stockholm: ECDC; 2018. Available from: https://www.ecdc.europa.eu/en/publications-data/public-health-guidance-screening-and-vaccination-infectious-diseases-newly
/content/10.2807/1560-7917.ES.2023.28.30.2200738
Loading

Data & Media loading...

Supplementary data

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error