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

[Guest guest]

Journal of Clinical Virology

Incidence and routes of transmission of hepatitis B virus in England and

Wales, 1995–2000: implications for immunisation policy [Review]

Hahné, Ramsay, Koye Balogun, W. Edmunds and Philip Mortimer

Background: The incidence of hepatitis B virus (HBV) infection in the UK is

low. Since the infection can have serious sequelae, there is a continuing

need to examine its epidemiology...

Journal of Clinical Virology, 2004, 29:4:211-220

(Owing to the limitations of HTML, mathematical notation in this article may

not be rendered entirely accurately. Please consult the PDF version for

confirmation.)

Manuscript received 18 September 2003 Accepted 23 September 2003;

Abstract

Background: The incidence of hepatitis B virus (HBV) infection in the UK is

low. Since the infection can have serious sequelae, there is a continuing

need to examine its epidemiology so as to inform control measures.

Objectives: We aimed to describe the current HBV incidence and patterns of

transmission in the UK, to estimate the rate of new carrier infections, and

to discuss implications for the control of HBV through immunisation. Study

design: We analysed routine England and Wales laboratory surveillance data

of acute HBV infection (1995–2000) and data on migration and global HBsAg

prevalence. Results: The estimated annual incidence of HBV infection in

England and Wales was 7.4 per 100,000. Injecting drug use was the most

frequently reported route of transmission. The number of cases attributed to

heterosexual contact was fairly stable, whereas the number of cases in men

having sex with men decreased. These observations continue trends reported

for the early 1990s. Transmission during childhood was rarely reported, but

was more frequent among South Asians. The incidence in South Asians is

relatively high, and their main risk factors are medical treatment overseas

and heterosexual contact. For about a third of cases of acute HBV infection

no route of transmission is reported, but analysis of secular trends and age

distribution suggest that many of these may be related to injecting drug

use. Endemic transmission gives rise to only a small proportion of all new

chronic infections, with the vast majority arising from immigration of

established HBV carriers. Conclusions: The incidence of acute HBV infection

in England and Wales has remained low, with a similar pattern of reported

routes of transmission compared to the early 1990s. The UK prevalence of HBV

infection is dependant on global rather than national immunisation policy.

Endemic transmission may be reduced by improving immunisation coverage among

injecting drug users, which is expected to also reduce the number of cases

without a risk factor reported. In addition, immunisation options that

better suit the needs of ethnic minorities need to be explored.

[Guest guest]

Journal of Clinical Virology

Incidence and routes of transmission of hepatitis B virus in England and

Wales, 1995–2000: implications for immunisation policy [Review]

Hahné, Ramsay, Koye Balogun, W. Edmunds and Philip Mortimer

Background: The incidence of hepatitis B virus (HBV) infection in the UK is

low. Since the infection can have serious sequelae, there is a continuing

need to examine its epidemiology...

Journal of Clinical Virology, 2004, 29:4:211-220

(Owing to the limitations of HTML, mathematical notation in this article may

not be rendered entirely accurately. Please consult the PDF version for

confirmation.)

Manuscript received 18 September 2003 Accepted 23 September 2003;

Abstract

Background: The incidence of hepatitis B virus (HBV) infection in the UK is

low. Since the infection can have serious sequelae, there is a continuing

need to examine its epidemiology so as to inform control measures.

Objectives: We aimed to describe the current HBV incidence and patterns of

transmission in the UK, to estimate the rate of new carrier infections, and

to discuss implications for the control of HBV through immunisation. Study

design: We analysed routine England and Wales laboratory surveillance data

of acute HBV infection (1995–2000) and data on migration and global HBsAg

prevalence. Results: The estimated annual incidence of HBV infection in

England and Wales was 7.4 per 100,000. Injecting drug use was the most

frequently reported route of transmission. The number of cases attributed to

heterosexual contact was fairly stable, whereas the number of cases in men

having sex with men decreased. These observations continue trends reported

for the early 1990s. Transmission during childhood was rarely reported, but

was more frequent among South Asians. The incidence in South Asians is

relatively high, and their main risk factors are medical treatment overseas

and heterosexual contact. For about a third of cases of acute HBV infection

no route of transmission is reported, but analysis of secular trends and age

distribution suggest that many of these may be related to injecting drug

use. Endemic transmission gives rise to only a small proportion of all new

chronic infections, with the vast majority arising from immigration of

established HBV carriers. Conclusions: The incidence of acute HBV infection

in England and Wales has remained low, with a similar pattern of reported

routes of transmission compared to the early 1990s. The UK prevalence of HBV

infection is dependant on global rather than national immunisation policy.

Endemic transmission may be reduced by improving immunisation coverage among

injecting drug users, which is expected to also reduce the number of cases

without a risk factor reported. In addition, immunisation options that

better suit the needs of ethnic minorities need to be explored.

[Guest guest]

Journal of Clinical Virology

Incidence and routes of transmission of hepatitis B virus in England and

Wales, 1995–2000: implications for immunisation policy [Review]

Hahné, Ramsay, Koye Balogun, W. Edmunds and Philip Mortimer

Background: The incidence of hepatitis B virus (HBV) infection in the UK is

low. Since the infection can have serious sequelae, there is a continuing

need to examine its epidemiology...

Journal of Clinical Virology, 2004, 29:4:211-220

(Owing to the limitations of HTML, mathematical notation in this article may

not be rendered entirely accurately. Please consult the PDF version for

confirmation.)

Manuscript received 18 September 2003 Accepted 23 September 2003;

Abstract

Background: The incidence of hepatitis B virus (HBV) infection in the UK is

low. Since the infection can have serious sequelae, there is a continuing

need to examine its epidemiology so as to inform control measures.

Objectives: We aimed to describe the current HBV incidence and patterns of

transmission in the UK, to estimate the rate of new carrier infections, and

to discuss implications for the control of HBV through immunisation. Study

design: We analysed routine England and Wales laboratory surveillance data

of acute HBV infection (1995–2000) and data on migration and global HBsAg

prevalence. Results: The estimated annual incidence of HBV infection in

England and Wales was 7.4 per 100,000. Injecting drug use was the most

frequently reported route of transmission. The number of cases attributed to

heterosexual contact was fairly stable, whereas the number of cases in men

having sex with men decreased. These observations continue trends reported

for the early 1990s. Transmission during childhood was rarely reported, but

was more frequent among South Asians. The incidence in South Asians is

relatively high, and their main risk factors are medical treatment overseas

and heterosexual contact. For about a third of cases of acute HBV infection

no route of transmission is reported, but analysis of secular trends and age

distribution suggest that many of these may be related to injecting drug

use. Endemic transmission gives rise to only a small proportion of all new

chronic infections, with the vast majority arising from immigration of

established HBV carriers. Conclusions: The incidence of acute HBV infection

in England and Wales has remained low, with a similar pattern of reported

routes of transmission compared to the early 1990s. The UK prevalence of HBV

infection is dependant on global rather than national immunisation policy.

Endemic transmission may be reduced by improving immunisation coverage among

injecting drug users, which is expected to also reduce the number of cases

without a risk factor reported. In addition, immunisation options that

better suit the needs of ethnic minorities need to be explored.

[Guest guest]

Journal of Clinical Virology

Incidence and routes of transmission of hepatitis B virus in England and

Wales, 1995–2000: implications for immunisation policy [Review]

Hahné, Ramsay, Koye Balogun, W. Edmunds and Philip Mortimer

Background: The incidence of hepatitis B virus (HBV) infection in the UK is

low. Since the infection can have serious sequelae, there is a continuing

need to examine its epidemiology...

Journal of Clinical Virology, 2004, 29:4:211-220

(Owing to the limitations of HTML, mathematical notation in this article may

not be rendered entirely accurately. Please consult the PDF version for

confirmation.)

Manuscript received 18 September 2003 Accepted 23 September 2003;

Abstract

Background: The incidence of hepatitis B virus (HBV) infection in the UK is

low. Since the infection can have serious sequelae, there is a continuing

need to examine its epidemiology so as to inform control measures.

Objectives: We aimed to describe the current HBV incidence and patterns of

transmission in the UK, to estimate the rate of new carrier infections, and

to discuss implications for the control of HBV through immunisation. Study

design: We analysed routine England and Wales laboratory surveillance data

of acute HBV infection (1995–2000) and data on migration and global HBsAg

prevalence. Results: The estimated annual incidence of HBV infection in

England and Wales was 7.4 per 100,000. Injecting drug use was the most

frequently reported route of transmission. The number of cases attributed to

heterosexual contact was fairly stable, whereas the number of cases in men

having sex with men decreased. These observations continue trends reported

for the early 1990s. Transmission during childhood was rarely reported, but

was more frequent among South Asians. The incidence in South Asians is

relatively high, and their main risk factors are medical treatment overseas

and heterosexual contact. For about a third of cases of acute HBV infection

no route of transmission is reported, but analysis of secular trends and age

distribution suggest that many of these may be related to injecting drug

use. Endemic transmission gives rise to only a small proportion of all new

chronic infections, with the vast majority arising from immigration of

established HBV carriers. Conclusions: The incidence of acute HBV infection

in England and Wales has remained low, with a similar pattern of reported

routes of transmission compared to the early 1990s. The UK prevalence of HBV

infection is dependant on global rather than national immunisation policy.

Endemic transmission may be reduced by improving immunisation coverage among

injecting drug users, which is expected to also reduce the number of cases

without a risk factor reported. In addition, immunisation options that

better suit the needs of ethnic minorities need to be explored.