Estimates of hepatitis B virus prevalence among general population and key risk groups in EU/EEA/UK countries: a systematic review

Sandra Bivegete*, Adam J W Trickey, Zak Thornton, Becky L Scanlan, Anna L McNaughton, Aaron G Lim, Lina Nerlander, Hannah Fraser, Josephine G Walker, Matt Hickman, Peter T Vickerman, Helen Johnson, Erika Duffell, Ellen Brooks Pollock, Hannah Christensen

*Corresponding author for this work

Research output: Contribution to journalReview article (Academic Journal)peer-review

2 Citations (Scopus)
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Background: The burden of chronic hepatitis B virus (HBV) varies across the European Union (EU) and European Economic Area (EEA). We aimed to provide updated estimates of HBV prevalence in EU/EEA/UK countries for 2018-2021.

Methods: We undertook a systematic review to update estimates of HBV prevalence in an existing database (spanning 2005-2017). Databases were searched for original English-language research articles including HBV surface antigen (HBsAg) 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. Grey literature data were obtained from country experts. 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). The median HBV prevalence in general population was 0.5% and the highest prevalence 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: HBV prevalence is low in the general population and confined to key risk populations in most European countries with some exceptions. HBV screening and treatment should be targeted to people in prison and migrants.
Original languageEnglish
Pages (from-to)1-14
Issue number30
Publication statusPublished - 27 Jul 2023

Bibliographical note

Funding Information:
JGW & PV have received unrestricted research grants from Gilead Sciences, unrelated to this work.

Funding Information:
HC, EBP, PV, MH, AGL, HF, SB are supported by the NIHR Health Protection Research Unit in Behavioural Science and Evaluation at the University of Bristol in partnership with UK Health Security Agency (UK HSA). HC is also funded by a NIHR Career Development Fellowship (CDF-2018-11-ST2-015). The views expressed are those of the authors and not necessarily those of the NIHR, the Department of Health and Social Care or UK HSA. The University of Bristol received funding from ECDC. The funders had no role in the design of the study, collection, analysis and interpretation of the data, or in writing the manuscript.

Publisher Copyright:
© 2023 European Centre for Disease Prevention and Control (ECDC). All rights reserved.


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