Abstract
Background
Hepatitis B virus (HBV) epidemiology in Europe differs by region and population risk group, and data are often incomplete. We estimated chronic HBV prevalence as measured by surface antigen (HBsAg) among general and key population groups for each country in the European Union, European Economic Area and the United Kingdom (EU/EEA/UK), including where data are currently unavailable.
Methods
We combined data from a 2018 systematic review (updated in 2021), data gathered directly by the European Centre for Disease Control (ECDC) from EU/EEA countries and the UK and further country-level data. We included data on adults from the general population, pregnant women, first time blood donors (FTBD), men who have sex with men (MSM), prisoners, people who inject drugs (PWID), and migrants from 2001-2021, with three exceptions made for pre-2001 estimates. Finite Mixture Models (FMM) and Beta regression were used to predict country and population group HBsAg prevalence. A separate multiplier method was used to estimate HBsAg prevalence among the migrant populations within each country, due to biases in the data available.
Results
There were 595 included studies from 31 countries (N=41,955,969 people): 66 were among the general population (mean prevalence (p ̅) 1.3% [range: 0.0-7.6%]), 52 among pregnant women (p ̅=1.1% [0.1-5.3%]), 315 among FTBD (p ̅=0.3% [0.0-6.2%]), 20 among MSM (p ̅=1.7% [0.0-11.2%]), 34 among PWID (p ̅=3.9% [0.0-16.9%]), 24 among prisoners (p ̅=2.9% [0.0-10.7%]), and 84 among migrants (p ̅=7.0% [0.2-37.3%]). The FMM grouped countries into 3 classes. We estimated HBsAg prevalence among the general population to be <1% in 24/31 countries, although it was higher in 7 Eastern/Southern European countries. HBsAg prevalence among each population group was higher in most Eastern/Southern European than Western/Northern European countries, whilst prevalence among PWID and prisoners was estimated at >1% for most countries. Portugal had the highest estimated prevalence of HBsAg among migrants (5.0%), with the other highest prevalences mostly seen in Southern Europe.
Conclusions
We estimated HBV prevalence for each population group within each EU/EAA country and the UK, with general population HBV prevalence to be <1% in most countries. Further evidence is required on the HBsAg prevalence of high-risk populations for future evidence synthesis.
Hepatitis B virus (HBV) epidemiology in Europe differs by region and population risk group, and data are often incomplete. We estimated chronic HBV prevalence as measured by surface antigen (HBsAg) among general and key population groups for each country in the European Union, European Economic Area and the United Kingdom (EU/EEA/UK), including where data are currently unavailable.
Methods
We combined data from a 2018 systematic review (updated in 2021), data gathered directly by the European Centre for Disease Control (ECDC) from EU/EEA countries and the UK and further country-level data. We included data on adults from the general population, pregnant women, first time blood donors (FTBD), men who have sex with men (MSM), prisoners, people who inject drugs (PWID), and migrants from 2001-2021, with three exceptions made for pre-2001 estimates. Finite Mixture Models (FMM) and Beta regression were used to predict country and population group HBsAg prevalence. A separate multiplier method was used to estimate HBsAg prevalence among the migrant populations within each country, due to biases in the data available.
Results
There were 595 included studies from 31 countries (N=41,955,969 people): 66 were among the general population (mean prevalence (p ̅) 1.3% [range: 0.0-7.6%]), 52 among pregnant women (p ̅=1.1% [0.1-5.3%]), 315 among FTBD (p ̅=0.3% [0.0-6.2%]), 20 among MSM (p ̅=1.7% [0.0-11.2%]), 34 among PWID (p ̅=3.9% [0.0-16.9%]), 24 among prisoners (p ̅=2.9% [0.0-10.7%]), and 84 among migrants (p ̅=7.0% [0.2-37.3%]). The FMM grouped countries into 3 classes. We estimated HBsAg prevalence among the general population to be <1% in 24/31 countries, although it was higher in 7 Eastern/Southern European countries. HBsAg prevalence among each population group was higher in most Eastern/Southern European than Western/Northern European countries, whilst prevalence among PWID and prisoners was estimated at >1% for most countries. Portugal had the highest estimated prevalence of HBsAg among migrants (5.0%), with the other highest prevalences mostly seen in Southern Europe.
Conclusions
We estimated HBV prevalence for each population group within each EU/EAA country and the UK, with general population HBV prevalence to be <1% in most countries. Further evidence is required on the HBsAg prevalence of high-risk populations for future evidence synthesis.
| Original language | English |
|---|---|
| Article number | 457 |
| Journal | BMC Infectious Diseases |
| Volume | 23 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 10 Jul 2023 |
Bibliographical note
Funding Information:PV and JGW reports research grants from Gilead unrelated to this work. All other authors do not have competing interests.
Funding Information:
We would like to acknowledge the contributions of in-country experts from the EU/EEA regions and UK who provided additional data for the study. AT acknowledges funding from Wellcome Trust (222770/Z/21/Z). PV acknowledges funding from NIAID and NIDA (R01AI147490) and NIDA (R01DA033679 and R21DA047902). Multiple authors acknowledge support from the NIHR Health Protection Research Unit in Behavioural Science and Evaluation at University of Bristol.
Funding Information:
We would like to acknowledge the contributions of in-country experts from the EU/EEA regions and UK who provided additional data for the study. AT acknowledges funding from Wellcome Trust (222770/Z/21/Z). PV acknowledges funding from NIAID and NIDA (R01AI147490) and NIDA (R01DA033679 and R21DA047902). Multiple authors acknowledge support from the NIHR Health Protection Research Unit in Behavioural Science and Evaluation at University of Bristol.
Publisher Copyright:
© 2023, The Author(s).
