Wirusowe zapalenie wątroby typu b

Wirusowe zapalenie wątroby typu b
Epidemiologia

Wirusowe zapalenie wątroby typu B (WZW B) pozostaje globalnym problemem zdrowia publicznego, z szacowaną liczbą 254-257 milionów osób przewlekle zakażonych HBV na świecie (3,2-3,3% populacji) w 2022 roku. Rocznie notuje się około 1,2-1,5 miliona nowych zakażeń i około 1,1 miliona zgonów, głównie z powodu marskości wątroby i raka wątrobowokomórkowego (HCC). Epidemiologia WZW B wykazuje znaczne zróżnicowanie geograficzne: najwyższe rozpowszechnienie obserwuje się w regionie Zachodniego Pacyfiku (97-116 mln zakażeń) oraz Afryki (65-81 mln), podczas gdy w USA wskaźnik przewlekłego zakażenia wynosi około 0,26-0,7% populacji (640 000-2,2 mln osób). Transmisja HBV odbywa się głównie drogą wertykalną (perinatalną) w regionach o wysokiej endemiczności oraz horyzontalną (kontakt seksualny, dożylne przyjmowanie narkotyków, kontakty domowe, procedury medyczne) w krajach o niskim rozpowszechnieniu. Nadzór epidemiologiczny, obejmujący systematyczne gromadzenie i analizę danych, jest kluczowy dla monitorowania trendów, identyfikacji grup ryzyka oraz oceny skuteczności programów profilaktycznych i leczniczych.

Epidemiologia wirusowego zapalenia wątroby typu B

Rozpowszechnienie geograficzne zakażeń HBV
Grupy wysokiego ryzyka zakażenia HBV

Drogi transmisji wirusa zapalenia wątroby typu B

Transmisja wertykalna (matka-dziecko)
Transmisja horyzontalna

Nadzór epidemiologiczny nad WZW B

Cele nadzoru epidemiologicznego nad WZW B
Systemy nadzoru nad WZW B
Wyzwania w nadzorze nad WZW B

Trendy epidemiologiczne WZW B

Globalne trendy epidemiologiczne
Trendy epidemiologiczne w USA
Trendy epidemiologiczne w innych krajach

Wpływ programów szczepień na epidemiologię WZW B

Strategie szczepień przeciwko WZW B
Efekty programów szczepień
Wyzwania w programach szczepień

Nadzór nad powikłaniami WZW B

Nadzór nad rakiem wątrobowokomórkowym
Nadzór nad leczeniem WZW B

Perspektywy eliminacji WZW B

Wskaźniki eliminacji WZW B
Wyzwania w eliminacji WZW B

Znaczenie danych epidemiologicznych w kontroli WZW B

Wykorzystanie danych epidemiologicznych w praktyce
Poprawa nadzoru epidemiologicznego nad WZW B
Kolejne rozdziały

Epidemiologia wirusowego zapalenia wątroby typu B

Wirusowe zapalenie wątroby typu B (WZW B) stanowi istotny problem zdrowia publicznego na całym świecie. Według Światowej Organizacji Zdrowia (WHO), w 2022 roku na świecie żyło około 254-257 milionów osób przewlekle zakażonych wirusem zapalenia wątroby typu B (HBV), co stanowi około 3,2-3,3% światowej populacji. Każdego roku odnotowuje się około 1,2-1,5 miliona nowych zakażeń, a choroba prowadzi do około 1,1 miliona zgonów rocznie, głównie w wyniku marskości wątroby i raka wątrobowokomórkowego (HCC)¹²³.

W Stanach Zjednoczonych w 2022 roku zgłoszono 2126 nowych przypadków ostrego WZW B, jednakże szacunkowa liczba ostrych zakażeń HBV wyniosła około 13 800. Ponadto zarejestrowano 16 729 nowo zgłoszonych przypadków przewlekłego WZW B oraz 1797 zgonów związanych z zakażeniem HBV⁴. Szacuje się, że w USA żyje od 640 000 do 2,2 miliona osób przewlekle zakażonych HBV⁵⁶.

Rozpowszechnienie geograficzne zakażeń HBV

Rozpowszechnienie zakażeń HBV znacząco różni się w zależności od regionu geograficznego. Obszary o najwyższej częstości występowania zakażeń przewlekłych to Region Zachodniego Pacyfiku WHO (97-116 milionów zakażeń) oraz Region Afryki (65-81 milionów zakażeń). Kolejne miejsca zajmują: Region Południowo-Wschodniej Azji (61,4 miliona zakażeń), Region Wschodniego Śródziemnomorza (15,1 miliona zakażeń), Region Europejski (10,6-14 milionów zakażeń) oraz obie Ameryki (5 milionów zakażeń)⁷⁸.

Regiony świata można podzielić na trzy kategorie pod względem rozpowszechnienia przewlekłego zakażenia HBV:

Wysokie rozpowszechnienie (≥8%): występuje głównie w Afryce Subsaharyjskiej, Chinach, Azji Południowo-Wschodniej i na wyspach Pacyfiku⁹.
Umiarkowane rozpowszechnienie (2-7%): obejmuje części Europy Wschodniej i Południowej, Bliski Wschód, Japonię i części Ameryki Południowej¹⁰.
Niskie rozpowszechnienie (<2%): dotyczy Ameryki Północnej, Europy Północnej i Zachodniej oraz Australii¹¹.

W przypadku Chin, które znajdują się w górnej granicy umiarkowanego rozpowszechnienia, wskaźnik zakażeń HBV wynosił około 6,89% w 2019 roku. W Stanach Zjednoczonych wskaźnik ten szacuje się na około 0,26% populacji (2018 rok), natomiast w Australii na około 0,9%¹²¹³.

Grupy wysokiego ryzyka zakażenia HBV

Pewne grupy populacji są szczególnie narażone na zakażenie HBV. W Stanach Zjednoczonych najwyższe wskaźniki występowania przewlekłego WZW B obserwuje się wśród osób urodzonych poza USA, zwłaszcza pochodzących z Azji, wysp Pacyfiku i Afryki. Około 70% przypadków w USA dotyczy osób urodzonych poza granicami kraju¹⁴.

Do głównych grup ryzyka na całym świecie należą:

Dzieci urodzone przez matki zakażone HBV¹⁵
Osoby przyjmujące narkotyki drogą dożylną¹⁶
Osoby mające wielu partnerów seksualnych¹⁷
Mężczyźni utrzymujący kontakty seksualne z mężczyznami¹⁸
Pracownicy ochrony zdrowia¹⁹
Pacjenci poddawani hemodializie²⁰
Osadzeni w zakładach karnych²¹
Osoby z grup etnicznych o wysokim wskaźniku zakażeń HBV²²

W USA, w 2022 roku, wskaźnik nowo zgłoszonych przypadków przewlekłego WZW B wśród osób pochodzenia azjatyckiego/z wysp Pacyfiku (20,1 przypadków na 100 000 populacji) był 11,2 razy wyższy niż wśród osób rasy białej nie-latynoskiej (1,8 przypadków na 100 000 populacji). Podobnie, wskaźnik zgonów związanych z WZW B w tej grupie był 9 razy wyższy niż wśród osób rasy białej²³²⁴.

Drogi transmisji wirusa zapalenia wątroby typu B

HBV przenosi się poprzez kontakt z krwią lub innymi płynami ustrojowymi osoby zakażonej. Główne drogi transmisji wirusa różnią się w zależności od regionu geograficznego i wiążą się z różnym rozpowszechnieniem zakażeń²⁵²⁶.

Transmisja wertykalna (matka-dziecko)

Zakażenie perinatalne (wertykalne) jest dominującą drogą transmisji w regionach o wysokiej endemiczności, takich jak Azja Południowo-Wschodnia i Oceania²⁷. Bez odpowiedniej profilaktyki, przewlekłe zakażenie rozwija się u około 90% niemowląt zakażonych HBV w okresie okołoporodowym, podczas gdy u dzieci zakażonych w wieku 1-5 lat odsetek ten wynosi 25-30%, a u osób zakażonych po 5. roku życia około 10%²⁸²⁹.

Ten wysoki wskaźnik przejścia do przewlekłego zakażenia u niemowląt jest głównym powodem, dla którego WHO zaleca podawanie szczepionki przeciwko WZW B wszystkim noworodkom, najlepiej w ciągu 24 godzin po urodzeniu³⁰.

Transmisja horyzontalna

Transmisja horyzontalna obejmuje zakażenia w wyniku:

Kontaktów seksualnych – WZW B jest uznawane za chorobę przenoszoną drogą płciową. W USA prowadzenie aktywnego życia seksualnego z wieloma partnerami jest drugim najczęstszym czynnikiem ryzyka ostrego WZW B³¹³².
Dożylnego przyjmowania narkotyków – dzielenie się igłami, strzykawkami lub innym sprzętem do iniekcji jest głównym czynnikiem ryzyka w USA i innych krajach rozwiniętych. W USA jest to obecnie najczęstsza droga zakażenia ostrym WZW B³³³⁴.
Kontaktów domowych – transmisja może zachodzić między członkami gospodarstwa domowego poprzez dzielenie się przedmiotami osobistymi, takimi jak szczoteczki do zębów, maszynki do golenia czy nożyczki³⁵.
Zabiegów medycznych i paramedycznych – obejmuje to zakażenia w placówkach ochrony zdrowia, poprzez transfuzję krwi, zabiegi endoskopowe, stosowanie niesterylnych narzędzi, akupunkturę, tatuaże i przekłuwanie ciała³⁶³⁷.

Nadzór epidemiologiczny nad WZW B

Nadzór nad WZW B jest kluczowym elementem monitorowania sytuacji epidemiologicznej oraz oceny skuteczności programów profilaktycznych i leczniczych. Według definicji, nadzór epidemiologiczny to ciągłe i systematyczne gromadzenie, analiza i interpretacja danych dotyczących zdrowia w celu planowania, wdrażania i oceny programów zdrowia publicznego³⁸.

Cele nadzoru epidemiologicznego nad WZW B

Główne cele nadzoru nad WZW B obejmują:

Pomiar obciążenia chorobą w populacji³⁹
Określenie czynników ryzyka zakażenia⁴⁰
Identyfikację ognisk epidemicznych⁴¹
Monitorowanie trendów epidemiologicznych⁴²
Ocenę środków kontroli, interwencji i programów profilaktycznych⁴³
Identyfikację osób zakażonych w celu skierowania ich do opieki medycznej, edukacji i poradnictwa⁴⁴
Monitorowanie postępu w kierunku eliminacji WZW B jako problemu zdrowia publicznego⁴⁵

Systemy nadzoru nad WZW B

Większość krajów wprowadziła systemy nadzoru nad WZW B, które różnią się zakresem i metodologią. W Stanach Zjednoczonych Centers for Disease Control and Prevention (CDC) stosuje definicję przypadku ostrego WZW B z 2012 roku do określenia rocznej zapadalności na zakażenia HBV⁴⁶. CDC ustaliło również jednolite definicje przypadków ostrego WZW B, przewlekłego WZW B i okołoporodowego zakażenia HBV w celu wsparcia raportowania w zakresie zdrowia publicznego⁴⁷.

W Chinach do nadzoru nad WZW B wykorzystuje się National Notifiable Disease Reporting System (NNDRS), chociaż badania wykazały problemy z dokładnością diagnoz i zgłaszania przypadków⁴⁸⁴⁹. Podobnie w Korei Południowej Korea Disease Control and Prevention Agency (KDCA) sklasyfikowała WZW B jako chorobę zakaźną klasy 3 podlegającą obowiązkowi zgłaszania, koncentrując nadzór wyłącznie na przypadkach ostrych⁵⁰.

W Unii Europejskiej/Europejskim Obszarze Gospodarczym (UE/EOG) szacuje się, że około 3,6 miliona osób żyje z przewlekłym WZW B, a 64 000 zgonów rocznie przypisuje się przewlekłemu wirusowemu zapaleniu wątroby⁵¹.

Wyzwania w nadzorze nad WZW B

Nadzór nad WZW B napotyka na szereg wyzwań, które mogą wpływać na dokładność danych epidemiologicznych:

Bezobjawowy przebieg zakażeń – około 50-70% osób z ostrym WZW B nie ma objawów, co prowadzi do wielu niezdiagnozowanych i niezgłoszonych zakażeń⁵².
Niska świadomość zakażenia – szacuje się, że tylko około 13% osób przewlekle zakażonych HBV na świecie i tylko około 32% w USA jest świadomych swojego statusu zakażenia⁵³⁵⁴.
Problemy z klasyfikacją przypadków – badania przeprowadzone w Chinach wykazały, że tylko 60% przewlekłych przypadków WZW B i 7% ostrych przypadków WZW B było prawidłowo zgłaszanych do systemu nadzoru⁵⁵.
Zakłócenia związane z pandemią COVID-19 – pandemia spowodowała znaczne zakłócenia w testowaniu i raportowaniu przypadków WZW B. W USA odnotowano 32-procentowy spadek zgłaszanych przypadków ostrego WZW B w 2020 roku w porównaniu z 2019 rokiem, co prawdopodobnie odzwierciedla zmniejszoną liczbę testów, a nie rzeczywisty spadek zapadalności⁵⁶.
Problemy dostępu do terenów objętych konfliktami – w niektórych regionach konflikty zbrojne i problemy bezpieczeństwa utrudniają dostęp do miejsc pobierania próbek i prowadzenia nadzoru⁵⁷.

Trendy epidemiologiczne WZW B

Analiza trendów epidemiologicznych WZW B dostarcza cennych informacji na temat skuteczności programów profilaktycznych i zmian w epidemiologii tej choroby na przestrzeni lat.

Globalne trendy epidemiologiczne

Globalnie, wskaźniki zakażeń HBV zmieniają się w różnych regionach. W wielu krajach wprowadzenie powszechnych programów szczepień przeciwko WZW B przyczyniło się do znacznego spadku zapadalności na ostre WZW B, szczególnie wśród dzieci⁵⁸⁵⁹.

Na przykład, na Tajwanie rozpowszechnienie HBV spadło z 10% w 1984 roku (przed wprowadzeniem programów szczepień) do mniej niż 1% w 1994 roku po wdrożeniu programów szczepień, a częstość występowania raka wątrobowokomórkowego zmniejszyła się z 0,52% do 0,13% w tym samym okresie⁶⁰.

Podobnie w Chinach, populacja prowincji Guangdong doświadczyła znacznego spadku rozpowszechnienia HBsAg z 16,67% do 11,10% między 1992 a 2006 rokiem, co oznacza ogólny spadek o prawie 5,6%⁶¹.

Trendy epidemiologiczne w USA

W Stanach Zjednoczonych, zapadalność na ostre WZW B osiągnęła szczyt w 1985 roku, a następnie spadała do 2010 roku. Wskaźniki zakażeń pozostawały względnie stabilne od 2010 do 2019 roku, po czym zmniejszyły się w latach 2020-2022⁶².

Od 2012 do 2019 roku w USA corocznie występowało około 20 000 nowych zakażeń HBV, ze spadkiem do 14 000 w 2020 roku. Wyższe wskaźniki ostrego zakażenia HBV odnotowano u mężczyzn niż u kobiet oraz u osób w wieku 30-49 lat⁶³.

W 2022 roku w USA wystąpiło szacunkowo 13 800 przypadków ostrego zakażenia HBV. Wśród nowo zgłoszonych przypadków przewlekłego WZW B 89% wystąpiło u osób w wieku 30 lat i starszych⁶⁴.

Trendy epidemiologiczne w innych krajach

W Kanadzie, w 2021 roku zgłoszono łącznie 3 524 przypadki WZW B (ostre, przewlekłe i nieokreślone), co daje wskaźnik 9,2 przypadków na 100 000 mieszkańców. Wskaźnik ostrych przypadków WZW B wynosił 0,30 na 100 000 populacji, natomiast wskaźnik przewlekłych i nieokreślonych przypadków WZW B wynosił 8,9 na 100 000 populacji⁶⁵.

W Irlandii odnotowano znaczący spadek zakażeń WZW B wśród dzieci dzięki programom szczepień. W ciągu ostatnich pięciu lat nie było zgłoszeń WZW B u dzieci poniżej 16 roku życia urodzonych w Irlandii. W 2023 roku 98% zgłoszonych przypadków stanowiły zakażenia przewlekłe, a tylko 2% ostre. Zaobserwowano 16% wzrost wskaźnika zgłoszeń przypadków przewlekłych w 2023 roku w porównaniu z 2022 rokiem (11,1 na 100 000 populacji wobec 9,5 na 100 000 populacji)⁶⁶⁶⁷.

W Ghanie, obciążenie przewlekłym WZW B spadło z szacowanych 17,1% populacji ogólnej w latach 90. XX wieku (przed wprowadzeniem szczepień) do 10,5% w 2015 roku po wprowadzeniu rutynowych szczepień przeciwko WZW B dla dzieci. Obecne rozpowszechnienie na poziomie 9,1% (dotykające 2,8 miliona Ghańczyków) jest nadal wysokie, powyżej 8%, co wskazuje na utrzymującą się transmisję wertykalną⁶⁸.

Region/Kraj	Szacowana liczba osób z przewlekłym WZW B	Wskaźnik rozpowszechnienia	Uwagi
Świat	254-257 milionów	3,2-3,3%	Około 1,1-1,2 miliona zgonów rocznie
Region Zachodniego Pacyfiku WHO	96,8-116 milionów	Najwyższy	Region o najwyższym obciążeniu chorobą
Region Afryki WHO	64,7-81 milionów	Wysoki	Drugi region pod względem obciążenia
Region Południowo-Wschodniej Azji WHO	61,4 miliona	Wysoki	Trzeci region pod względem obciążenia
Region Wschodniego Śródziemnomorza WHO	15,1 miliona	Umiarkowany	Czwarty region pod względem obciążenia
Region Europejski WHO	10,6-14 milionów	Niski do umiarkowanego	Piąty region pod względem obciążenia
Region Ameryk WHO	5 milionów	Najniższy	Region o najniższym obciążeniu
Stany Zjednoczone	640 000 – 2,2 miliona	0,26-0,7%	13 800 nowych ostrych zakażeń w 2022 r.
Unia Europejska/EOG	3,6 miliona	Zróżnicowany	Około 64 000 zgonów rocznie
Australia	Około 218 000	0,9%	Trzykrotny spadek zapadalności 2000-2019
Kanada	Brak dokładnych danych	Wskaźnik zgłoszeń: 9,2/100 000	3 524 przypadki zgłoszone w 2021 r.
Chiny	Brak dokładnych danych	6,89% (2019)	Na granicy wysokiego rozpowszechnienia
Ghana	2,8 miliona	9,1%	Spadek z 17,1% w latach 90. XX wieku

Wpływ programów szczepień na epidemiologię WZW B

Wprowadzenie skutecznych programów szczepień przeciwko WZW B miało znaczący wpływ na zmniejszenie zapadalności i rozpowszechnienia zakażeń HBV na całym świecie⁶⁹⁷⁰.

Strategie szczepień przeciwko WZW B

Różne kraje przyjęły różne strategie szczepień przeciwko WZW B, które można podzielić na kilka głównych kategorii:

Uniwersalne szczepienia niemowląt – ta strategia, wprowadzona w wielu krajach od lat 90. XX wieku, okazała się najbardziej skuteczna w zmniejszaniu rozpowszechnienia HBV⁷¹.
Dawka porodowa szczepionki – podawanie pierwszej dawki szczepionki przeciwko WZW B w ciągu 24 godzin po urodzeniu jest kluczowe w zapobieganiu transmisji wertykalnej od matki do dziecka⁷²⁷³.
Szczepienia grup wysokiego ryzyka – skierowane do osób najbardziej narażonych na zakażenie, takich jak pracownicy ochrony zdrowia, osoby przyjmujące narkotyki drogą dożylną, partnerzy seksualni osób zakażonych⁷⁴.
Nadrabianie szczepień u nastolatków i dorosłych – programy uzupełniające dla osób, które nie zostały zaszczepione jako niemowlęta⁷⁵.

Efekty programów szczepień

Programy szczepień przeciwko WZW B przyniosły wymierne efekty w wielu krajach:

Na Tajwanie rozpowszechnienie HBV spadło z 10% do mniej niż 1% w ciągu dekady po wprowadzeniu powszechnych szczepień, a częstość występowania raka wątrobowokomórkowego zmniejszyła się o ponad 70%⁷⁶.
W Australii odnotowano trzykrotny spadek wskaźnika nowo nabytych zakażeń WZW B między 2000 a 2019 rokiem. Wskaźniki hospitalizacji zmniejszyły się o połowę między 2001 a 2019 rokiem⁷⁷.
Globalne rozpowszechnienie przewlekłego WZW B wśród dzieci poniżej piątego roku życia spadło do 0,9% w 2020 roku, co odzwierciedla skuteczność globalnego programu szczepień przeciwko WZW B⁷⁸.
W Irlandii programy szczepień niemowląt i dzieci okazały się bardzo skuteczne, zapobiegając zakażeniom u dzieci. W ciągu ostatnich pięciu lat nie odnotowano przypadków WZW B u dzieci poniżej 16 roku życia urodzonych w Irlandii⁷⁹.

Wyzwania w programach szczepień

Pomimo znaczących postępów, programy szczepień przeciwko WZW B nadal napotykają na pewne wyzwania:

Nierówny dostęp do szczepień – w niektórych regionach świata dostęp do szczepionek jest ograniczony ze względu na czynniki ekonomiczne, geograficzne lub kulturowe⁸⁰.
Niska świadomość – brak wiedzy na temat WZW B i dostępności szczepionek, szczególnie wśród grup marginalizowanych⁸¹.
Problemy z dawką porodową – w niektórych krajach, zwłaszcza tam, gdzie znaczna liczba porodów odbywa się poza placówkami medycznymi, podanie dawki porodowej szczepionki może być utrudnione⁸².
Migracja – migracja osób z regionów o wysokim rozpowszechnieniu do regionów o niskim rozpowszechnieniu stanowi wyzwanie dla kontroli WZW B⁸³.

Nadzór nad powikłaniami WZW B

Przewlekłe zakażenie HBV może prowadzić do poważnych powikłań, takich jak marskość wątroby i rak wątrobowokomórkowy (HCC). Nadzór nad tymi powikłaniami jest istotnym elementem kompleksowej strategii kontroli WZW B⁸⁴.

Nadzór nad rakiem wątrobowokomórkowym

Rak wątrobowokomórkowy jest jednym z najpoważniejszych powikłań przewlekłego WZW B. Przewlekłe WZW B odpowiada za około połowę wszystkich przypadków HCC⁸⁵. Badania epidemiologiczne wykazały, że istnieje spójny i specyficzny związek przyczynowy między zakażeniem HBV a HCC. U pacjentów z przetrwałym zakażeniem HBV ryzyko HCC było 100 razy wyższe niż u osób niezakażonych⁸⁶.

Aktualne wytyczne zalecają nadzór nad HCC co sześć miesięcy za pomocą badania ultrasonograficznego jamy brzusznej i oznaczania poziomu alfa-fetoproteiny⁸⁷. Jeśli wyniki USG są nieprawidłowe, zaleca się tomografię komputerową lub rezonans magnetyczny wątroby⁸⁸. Należy zauważyć, że leczenie nie eliminuje ryzyka HCC, dlatego nadzór nad HCC powinien być kontynuowany⁸⁹.

Badania wykazują, że wczesne wykrycie HCC przez nadzór prowadzi do znacznej poprawy przeżywalności pacjentów. Randomizowane badanie obejmujące 18 816 osób z przewlekłym zakażeniem HBV wykazało zmniejszenie śmiertelności o 37% po roku u osób objętych badaniami przesiewowymi w porównaniu z osobami nieobjętymi takimi badaniami⁹⁰.

Nadzór nad leczeniem WZW B

Nadzór nad leczeniem WZW B obejmuje monitorowanie dostępu do leczenia, przestrzegania zaleceń terapeutycznych i skuteczności leczenia. Według WHO, w 2022 roku tylko 3% (7 milionów) osób żyjących z przewlekłym WZW B było leczonych⁹¹.

Zgodnie z zaktualizowanymi wytycznymi WHO dotyczącymi WZW B, szacuje się, że ponad 50% osób z przewlekłym zakażeniem HBV będzie wymagało leczenia, w zależności od warunków i kryteriów kwalifikacji⁹². Dostępne są leki doustne do leczenia przewlekłego WZW B, w tym tenofowir lub entekawir⁹³.

W Australii szacuje się, że prawie połowa wszystkich Australijczyków żyjących z przewlekłym WZW B pozostaje niezdiagnozowana, co utrudnia dostęp do odpowiedniego leczenia i zwiększa ryzyko niekorzystnych wyników u osób zakażonych oraz ryzyko dalszej transmisji do podatnych kontaktów⁹⁴.

Perspektywy eliminacji WZW B

Światowa Organizacja Zdrowia przyjęła Globalną Strategię dotyczącą Wirusowego Zapalenia Wątroby, która ma na celu zmniejszenie liczby nowych zakażeń wirusowym zapaleniem wątroby o 90% i liczby zgonów o 65% między 2016 a 2030 rokiem⁹⁵.

Wskaźniki eliminacji WZW B

Kluczowy aspekt strategii eliminacji WZW B obejmuje identyfikację konkretnych, mierzalnych celów i wskaźników, w tym:

Zwiększenie odsetka osób żyjących z przewlekłym WZW B, które zostały zdiagnozowane⁹⁶
Zwiększenie wykorzystania leczenia u osób dotkniętych chorobą⁹⁷
Zmniejszenie obciążenia związaną z chorobą zachorowalnością i śmiertelnością⁹⁸
Osiągnięcie wysokiego wskaźnika pokrycia szczepieniami, szczególnie dawką porodową⁹⁹
Zmniejszenie rozpowszechnienia HBsAg w populacji ogólnej do mniej niż 7%¹⁰⁰

Wyzwania w eliminacji WZW B

Eliminacja WZW B jako problemu zdrowia publicznego napotyka na szereg wyzwań:

Niski poziom świadomości i diagnostyki – większość osób zakażonych HBV nie jest świadoma swojego statusu, co utrudnia wczesne rozpoczęcie leczenia i zapobieganie transmisji¹⁰¹.
Nierówności w dostępie do opieki zdrowotnej – niektóre populacje, w tym mniejszości etniczne, migranci i osoby o niskim statusie społeczno-ekonomicznym, mają ograniczony dostęp do badań przesiewowych, szczepień i leczenia¹⁰².
Problemy z nadzorem – dokładność i kompletność danych nadzoru nad WZW B różni się znacznie w zależności od kraju i regionu¹⁰³.
Bariery w leczeniu – w wielu krajach dostęp do leczenia WZW B jest ograniczony ze względu na koszty, geografię lub politykę zdrowotną¹⁰⁴.

Pomimo tych wyzwań, postępy w zakresie szczepień, badań przesiewowych i leczenia dają nadzieję na realizację celów eliminacji WZW B. Przykładowo, Irlandia prawdopodobnie osiągnęła niektóre z celów WHO na 2030 rok dotyczących eliminacji wirusowego zapalenia wątroby jako zagrożenia dla zdrowia publicznego¹⁰⁵.

Znaczenie danych epidemiologicznych w kontroli WZW B

Dokładne dane epidemiologiczne odgrywają kluczową rolę w skutecznej kontroli WZW B. Pozwalają one na identyfikację populacji wysokiego ryzyka, ocenę skuteczności interwencji i opracowanie ukierunkowanych strategii profilaktycznych¹⁰⁶.

Wykorzystanie danych epidemiologicznych w praktyce

Dane epidemiologiczne są wykorzystywane w różny sposób w kontroli WZW B:

Planowanie programów szczepień – dane o rozpowszechnieniu WZW B w różnych populacjach pomagają w określeniu priorytetów szczepień¹⁰⁷.
Identyfikacja ognisk zakażeń – nadzór pozwala na szybkie wykrycie skupisk przypadków i wdrożenie środków kontroli¹⁰⁸.
Ocena efektywności interwencji – monitorowanie trendów w zapadalności i umieralności pomaga ocenić skuteczność programów profilaktycznych i leczniczych¹⁰⁹.
Alokacja zasobów – dane o obciążeniu chorobą pomagają w podejmowaniu decyzji o przydziale zasobów na badania przesiewowe, szczepienia i leczenie¹¹⁰.

Przykładem praktycznego wykorzystania danych epidemiologicznych są tablice wyników dla szpitali w Nowym Jorku, które wykorzystują dane nadzoru Departamentu Zdrowia do przedstawienia wyników szpitali i placówek opieki zdrowotnej, które zapewniają opiekę nad WZW C mieszkańcom Nowego Jorku. Celem tych tablic jest poprawa opieki i leczenia WZW C w Nowym Jorku¹¹¹.

Poprawa nadzoru epidemiologicznego nad WZW B

Istnieje kilka obszarów, w których można poprawić nadzór nad WZW B:

Standaryzacja definicji przypadków – przyjęcie jednolitych definicji przypadków ostrego i przewlekłego WZW B w różnych systemach nadzoru¹¹².
Poprawa badań laboratoryjnych – szersze wykorzystanie testów przeciwciał anty-HBc IgM w celu dokładniejszego rozróżnienia ostrych i przewlekłych zakażeń¹¹³.
Szkolenie personelu medycznego – poprawa zdolności klinicystów do dokładnego diagnozowania i zgłaszania przypadków WZW B¹¹⁴.
Integracja systemów nadzoru – łączenie danych z różnych źródeł, w tym laboratoriów, szpitali i opieki podstawowej, w celu uzyskania pełniejszego obrazu epidemiologii WZW B¹¹⁵.
Zwiększenie zasięgu badań przesiewowych – poszerzenie dostępu do badań przesiewowych, szczególnie wśród grup wysokiego ryzyka i trudno dostępnych populacji¹¹⁶.

Regularne oceny systemów nadzoru, takie jak te przeprowadzone w Chinach, mogą pomóc w identyfikacji obszarów wymagających poprawy i opracowaniu strategii wzmocnienia nadzoru epidemiologicznego nad WZW B¹¹⁷.

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Materiały źródłowe

#1
https://www.who.int/news-room/fact-sheets/detail/hepatitis-b
Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic disease. […] WHO estimates that 254 million people were living with chronic hepatitis B infection in 2022, with 1.2 million new infections each year. […] In 2022, hepatitis B resulted in an estimated 1.1 million deaths, mostly from cirrhosis and hepatocellular carcinoma (primary liver cancer). […] Hepatitis B is a major global health problem. The burden of infection is highest in the WHO Western Pacific Region and the WHO African Region, where 97 million and 65 million people, respectively, are chronically infected. […] Hepatitis B is also spread by needlestick injury, tattooing, piercing and exposure to infected blood and body fluids, such as saliva and menstrual, vaginal and seminal fluids.
#2 Epidemiology, transmission, and prevention of hepatitis B virus infection – UpToDate
https://www.uptodate.com/contents/epidemiology-transmission-and-prevention-of-hepatitis-b-virus-infection/print
Epidemiology, transmission, and prevention of hepatitis B virus infection […] Hepatitis B virus (HBV) infection is a global public health problem. The World Health Organization estimated that, in 2022, there were 245 million HBV carriers, 1.2 million new infections per year, and an annual mortality of 1.1 million individuals (mostly from complications of liver cirrhosis and hepatocellular carcinoma). […] It is estimated that approximately two billion people worldwide have evidence of past or present infection with HBV, and 245 million individuals are chronic carriers (ie, positive for hepatitis B surface antigen [HBsAg]). The overall prevalence of HBsAg is reported to be 3.2 percent; however, it varies depending upon the geographic area. The prevalence is highest in the Western Pacific (96.8 million infections), followed by the African region (64.7 million infections), Southeast Asia (61.4 million infections), the Eastern Mediterranean region (15.1 million infections), the European region (10.6 million infections), and the Americas (5 million infections).
#3 Hepatitis B – Annual Epidemiological Report for 2022
https://www.ecdc.europa.eu/en/publications-data/hepatitis-b-annual-epidemiological-report-2022
Hepatitis B is a major public health threat worldwide. In 2022, the global prevalence was estimated at 257 million people living with HBV infection (3.2%), with an estimated incidence of 1.5 million new cases per year. […] In the European Union/European Economic Area (EU/EEA), the disease burden remains high, with an estimated 3.6 million people living with CHB and 64 000 deaths attributed to chronic viral hepatitis in 2015.
#4 Hepatitis B Surveillance | 2022 Hepatitis Surveillance | CDC
https://www.cdc.gov/hepatitis-surveillance-2022/hepatitis-b/index.html
There were 2,126 new cases of acute hepatitis B reported during 2022. […] There were 13,800 estimated acute HBV infections during 2022. […] There were 16,729 cases of newly reported chronic hepatitis B during 2022. […] There were 1,797 hepatitis B-related deaths reported during 2022. […] During 2022, 16,729 cases of chronic hepatitis B were newly reported by 43 states and the District of Columbia, corresponding to a rate of 5.8 cases per 100,000 people. […] The rate of newly reported chronic hepatitis B cases among non-Hispanic Asian/Pacific Islander (A/PI) persons (20.1 cases per 100,000 population) was 11.2 times as high as the rate among non-Hispanic White persons (1.8 cases per 100,000 population). […] In 2022, the rate of newly reported chronic hepatitis B cases among non-Hispanic A/PI persons was 11.2 times as high as among non-Hispanic White persons. […] 89% of newly reported chronic hepatitis B cases occurred in persons 30 years and older.
#5 Hepatitis B: What It Is, Symptoms, Transmission & Treatment
https://my.clevelandclinic.org/health/diseases/4246-hepatitis-b
Hepatitis B is the most common liver infection in the world. The World Health Organization (WHO) estimates that 254 million people worldwide are living with hepatitis B. The U.S. Centers for Disease Control and Prevention (CDC) estimates that approximately 14,000 people in the U.S. have acute hepatitis. The CDC also estimates that 640,000 people in the U.S. have chronic hepatitis B. […] Chronic hepatitis B treatment varies depending on your symptoms and your overall health. Treatment options are: […] Surveillance. This may sound scary. But it just means your healthcare provider is keeping an eye on your overall health. Youll have follow-up appointments every three to six months. Your provider may do blood and imaging tests to look for signs of the virus.
#6 Hepatitis B Basics | HHS.govLock
https://www.hhs.gov/hepatitis/learn-about-viral-hepatitis/hepatitis-b-basics/index.html
Hepatitis B is a vaccine-preventable liver infection caused by the hepatitis B virus (HBV) that can lead to chronic infection causing cirrhosis, liver cancer and death. […] Progress toward hepatitis B elimination has stalled. Since 2012, the rate of reported acute hepatitis B cases has ranged from 0.9 to 1.1 per 100,000 population. […] In the United States, an estimated 880,000 to 1.89 million people are chronically infected with HBV. New cases of HBV infection in the United States had been decreasing until 2012. Since that time, reported cases of acute hepatitis B have been fluctuating around 3,000 cases per year. […] The highest rates of chronic hepatitis B infection in the United States occur among foreign-born individuals, especially people born in Asia, the Pacific Islands, and Africa. Approximately 70% of cases in the United States are among people who were born outside of the United States.
#7 Epidemiology, transmission, and prevention of hepatitis B virus infection – UpToDate
https://www.uptodate.com/contents/epidemiology-transmission-and-prevention-of-hepatitis-b-virus-infection/print
Epidemiology, transmission, and prevention of hepatitis B virus infection […] Hepatitis B virus (HBV) infection is a global public health problem. The World Health Organization estimated that, in 2022, there were 245 million HBV carriers, 1.2 million new infections per year, and an annual mortality of 1.1 million individuals (mostly from complications of liver cirrhosis and hepatocellular carcinoma). […] It is estimated that approximately two billion people worldwide have evidence of past or present infection with HBV, and 245 million individuals are chronic carriers (ie, positive for hepatitis B surface antigen [HBsAg]). The overall prevalence of HBsAg is reported to be 3.2 percent; however, it varies depending upon the geographic area. The prevalence is highest in the Western Pacific (96.8 million infections), followed by the African region (64.7 million infections), Southeast Asia (61.4 million infections), the Eastern Mediterranean region (15.1 million infections), the European region (10.6 million infections), and the Americas (5 million infections).
#8 Hepatitis B | The Australian Immunisation Handbook
https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/hepatitis-b
Of the notifications where country of birth was known, 75% of newly acquired hepatitis B were in people born in Australia and the vast majority (93%) were acquired within Australia, with a small proportion (3%) acquired in South-East Asia. More than two-thirds of people living with chronic hepatitis B in Australia were born (and likely acquired hepatitis B) overseas. […] The World Health Organization estimates that 296 million people were living with chronic hepatitis B infection in 2019, with 1.5 million new infections each year. In 2019, hepatitis B resulted in an estimated 820,000 deaths, mostly from cirrhosis and hepatocellular carcinoma (primary liver cancer). […] The burden due to chronically infected people is highest in the WHO Western Pacific Region (116 million) and the WHO African Region (81 million). This is followed by the WHO Eastern Mediterranean Region (60 million), the WHO South-East Asia Region (18 million), the WHO European Region (14 million) and the WHO Region of the Americas (5 million).
#9 Epidemiology and Prevention of Hepatitis B Virus Infection
https://pmc.ncbi.nlm.nih.gov/articles/PMC1142225/
Hepatitis B is one of the most common infectious diseases globally. It has been estimated that there are 350 million chronic hepatitis B virus (HBV) carriers worldwide. The prevalence of chronic HBV infection varies geographically, from high (8%), intermediate (2-7%) to low (2%) prevalence. […] The prevalence of chronic HBV infection varies greatly in different part of the world. The prevalence of chronic HBV infection worldwide could be categorized as high, intermediate and low endemicity. […] Hepatitis B is highly endemic in developing regions with large population such as South East Asia, China, sub-Saharan Africa and the Amazon Basin, where at least 8% of the population are HBV chronic carriers. […] Hepatitis B is moderately endemic in part of Eastern and Southern Europe, the Middle East, Japan, and part of South America.
#10 Epidemiology and Prevention of Hepatitis B Virus Infection
https://pmc.ncbi.nlm.nih.gov/articles/PMC1142225/
Hepatitis B is one of the most common infectious diseases globally. It has been estimated that there are 350 million chronic hepatitis B virus (HBV) carriers worldwide. The prevalence of chronic HBV infection varies geographically, from high (8%), intermediate (2-7%) to low (2%) prevalence. […] The prevalence of chronic HBV infection varies greatly in different part of the world. The prevalence of chronic HBV infection worldwide could be categorized as high, intermediate and low endemicity. […] Hepatitis B is highly endemic in developing regions with large population such as South East Asia, China, sub-Saharan Africa and the Amazon Basin, where at least 8% of the population are HBV chronic carriers. […] Hepatitis B is moderately endemic in part of Eastern and Southern Europe, the Middle East, Japan, and part of South America.
#11 Epidemiology and Prevention of Hepatitis B Virus Infection
https://pmc.ncbi.nlm.nih.gov/articles/PMC1142225/
The endemicity of HBV is low in most developed areas, such as North America, Northern and Western Europe and Australia. […] Epidemiologic studies have demonstrated that there is a consistent and specific causal association between HBV infection and HCC. In patients with persistent HBV infection, the risk of HCC was 100 times higher than in non-infected individuals. The global distribution of hepatocellular carcinoma correlates with the geographic prevalence of chronic carriers of HBV, who number 400 million worldwide. […] Three main strategies are available for the prevention of HBV infection: (1) behavior modification to prevent disease transmission, (2) passive immunoprophylaxis, and (3) active immunization.
#12 Hepatitis B – Wikipedia
https://en.wikipedia.org/wiki/Hepatitis_B
In moderate prevalence areas where 27% of the population is chronically infected, the disease is predominantly spread horizontally, often among children, but also vertically. China’s HBV infection rate is at the higher end of the moderate prevalence classification with an infection rate of 6.89% as of 2019. […] Countries with low HBV prevalence include Australia (0.9%), those in the WHO European Region (which average 1.5%), and most countries in North and South America (which average 0.28%). In the United States, an estimated 0.26% of the population was living with HBV infection as of 2018.
#13 Hepatitis B | The Australian Immunisation Handbook
https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/hepatitis-b
Hepatitis B remains the most common blood-borne viral infection in Australia. The estimated prevalence of chronic hepatitis B in 2020 was 0.9%. Populations most affected by hepatitis B within Australia are Aboriginal and Torres Strait Islander people and those born overseas. […] Since the introduction of funded universal infant hepatitis B immunisation, Australia has seen a three-fold decline in the rate of newly acquired hepatitis B notifications between 2000 and 2019. There were 4,945 notifications reported during this period (average annual rate 1.13 per 100,000 population per year). Similarly, between 2001 and 2019 annual hospitalisation rates have halved. […] The average annual notification rate was highest among young adults aged 25â29 years and lowest among young children <10 years of age. Notification rates and mortality were three-fold higher in males compared to females. Although notification rates have halved among Aboriginal and Torres Strait Islander people, both notification and hospitalisation rates remain higher than other people.
#14 Hepatitis B Basics | HHS.govLock
https://www.hhs.gov/hepatitis/learn-about-viral-hepatitis/hepatitis-b-basics/index.html
Hepatitis B is a vaccine-preventable liver infection caused by the hepatitis B virus (HBV) that can lead to chronic infection causing cirrhosis, liver cancer and death. […] Progress toward hepatitis B elimination has stalled. Since 2012, the rate of reported acute hepatitis B cases has ranged from 0.9 to 1.1 per 100,000 population. […] In the United States, an estimated 880,000 to 1.89 million people are chronically infected with HBV. New cases of HBV infection in the United States had been decreasing until 2012. Since that time, reported cases of acute hepatitis B have been fluctuating around 3,000 cases per year. […] The highest rates of chronic hepatitis B infection in the United States occur among foreign-born individuals, especially people born in Asia, the Pacific Islands, and Africa. Approximately 70% of cases in the United States are among people who were born outside of the United States.
#15 Epidemiology, virology, transmission, clinical manifestation and vaccine for hepatitis virus B: a review – MedCrave online
https://medcraveonline.com/IJVV/epidemiology-virology-transmission-clinical-manifestation-and-vaccine-for-hepatitis-virus-b-a-review.html
Hepatitis B virus (HBV) is a DNA virus of the family Hepadnaviridae and the causative agent of hepatitis B infection. Hepatitis B is one of the most common infectious diseases in the world and a major health problem. The prevalence of HBV varies between 2% in developed countries where the prevalence is low to about 8% in developing countries where infection is endemic with sex, age and socio-economic status as important risk factors for infection. […] Hepatitis B infection is considered as a disease of significant health importance as there are more than 2 billion infected persons worldwide. The disease accounted for about 40% of all hepatitis cases in the United State. […] The commonly accepted high risk group worldwide include; children born to hepatitis B positive mother, homosexual men, health care workers, intravenous drug users, hemodialysis patients, household contact, institutionalized populations, sexual partners of infected person, recipients of certain plasma derived products and population living in area where the disease is endemic.
#16 Core Concepts – HBV Epidemiology – Screening and Diagnosis – Hepatitis B Online
https://www.hepatitisb.uw.edu/go/screening-diagnosis/hbv-epidemiology/core-concept/all
Injection-drug use and sexual exposure are the major risk factors for HBV acquisition in the United States, with injection-drug use playing an increasingly important role in transmission as a result of the ongoing opioid epidemic. […] The CDC has established uniform case definitions for acute HBV, chronic HBV, and HBV perinatal infection to assist with public health reporting. […] In the United States, in 2020, there were 1,752 deaths with HBV listed as the cause of death, corresponding to a mortality rate of 0.45 HBV-related deaths per 100,000 population.
#17 Core Concepts – HBV Epidemiology – Screening and Diagnosis – Hepatitis B Online
https://www.hepatitisb.uw.edu/go/screening-diagnosis/hbv-epidemiology/core-concept/all
Injection-drug use and sexual exposure are the major risk factors for HBV acquisition in the United States, with injection-drug use playing an increasingly important role in transmission as a result of the ongoing opioid epidemic. […] The CDC has established uniform case definitions for acute HBV, chronic HBV, and HBV perinatal infection to assist with public health reporting. […] In the United States, in 2020, there were 1,752 deaths with HBV listed as the cause of death, corresponding to a mortality rate of 0.45 HBV-related deaths per 100,000 population.
#18 Epidemiology, virology, transmission, clinical manifestation and vaccine for hepatitis virus B: a review – MedCrave online
https://medcraveonline.com/IJVV/epidemiology-virology-transmission-clinical-manifestation-and-vaccine-for-hepatitis-virus-b-a-review.html
Hepatitis B virus (HBV) is a DNA virus of the family Hepadnaviridae and the causative agent of hepatitis B infection. Hepatitis B is one of the most common infectious diseases in the world and a major health problem. The prevalence of HBV varies between 2% in developed countries where the prevalence is low to about 8% in developing countries where infection is endemic with sex, age and socio-economic status as important risk factors for infection. […] Hepatitis B infection is considered as a disease of significant health importance as there are more than 2 billion infected persons worldwide. The disease accounted for about 40% of all hepatitis cases in the United State. […] The commonly accepted high risk group worldwide include; children born to hepatitis B positive mother, homosexual men, health care workers, intravenous drug users, hemodialysis patients, household contact, institutionalized populations, sexual partners of infected person, recipients of certain plasma derived products and population living in area where the disease is endemic.
#19 Epidemiology, virology, transmission, clinical manifestation and vaccine for hepatitis virus B: a review – MedCrave online
https://medcraveonline.com/IJVV/epidemiology-virology-transmission-clinical-manifestation-and-vaccine-for-hepatitis-virus-b-a-review.html
Hepatitis B virus (HBV) is a DNA virus of the family Hepadnaviridae and the causative agent of hepatitis B infection. Hepatitis B is one of the most common infectious diseases in the world and a major health problem. The prevalence of HBV varies between 2% in developed countries where the prevalence is low to about 8% in developing countries where infection is endemic with sex, age and socio-economic status as important risk factors for infection. […] Hepatitis B infection is considered as a disease of significant health importance as there are more than 2 billion infected persons worldwide. The disease accounted for about 40% of all hepatitis cases in the United State. […] The commonly accepted high risk group worldwide include; children born to hepatitis B positive mother, homosexual men, health care workers, intravenous drug users, hemodialysis patients, household contact, institutionalized populations, sexual partners of infected person, recipients of certain plasma derived products and population living in area where the disease is endemic.
#20 Epidemiology, virology, transmission, clinical manifestation and vaccine for hepatitis virus B: a review – MedCrave online
https://medcraveonline.com/IJVV/epidemiology-virology-transmission-clinical-manifestation-and-vaccine-for-hepatitis-virus-b-a-review.html
Hepatitis B virus (HBV) is a DNA virus of the family Hepadnaviridae and the causative agent of hepatitis B infection. Hepatitis B is one of the most common infectious diseases in the world and a major health problem. The prevalence of HBV varies between 2% in developed countries where the prevalence is low to about 8% in developing countries where infection is endemic with sex, age and socio-economic status as important risk factors for infection. […] Hepatitis B infection is considered as a disease of significant health importance as there are more than 2 billion infected persons worldwide. The disease accounted for about 40% of all hepatitis cases in the United State. […] The commonly accepted high risk group worldwide include; children born to hepatitis B positive mother, homosexual men, health care workers, intravenous drug users, hemodialysis patients, household contact, institutionalized populations, sexual partners of infected person, recipients of certain plasma derived products and population living in area where the disease is endemic.
#21 Changing epidemiology and viral interplay of hepatitis B, C and D among injecting drug user-dominant prisoners in Taiwan | Scientific Reports
https://www.nature.com/articles/s41598-021-87975-5
The spreading of viral hepatitis among injecting drug users (IDU) is an emerging public health concern. This study explored the prevalence and the risks of hepatitis B virus (HBV), hepatitis C virus (HCV) and hepatitis D virus (HDV) among IDU-dominant prisoners in Taiwan. The prevalence of HBsAg, anti-HCV, dual HBsAg/anti-HCV, HBsAg/anti-HDV, and triple HBsAg/anti-HCV/anti-HDV was 13.6%, 34.8%, 4.9%, 3.4%, and 2.8%, respectively. The disease burden of HBV and HCV will gradually decrease in general population, but increases in injecting drug users (IDU). The HBV prevalence in IDUs was around 16% in both hospital-based cohort and prisoners. However, the HCV prevalence rate was up to around 98% in IDUs with immunodeficiency virus (HIV) infection and 89% in IDUs without HIV infection. The transmission of hepatitis B, C and D among IDUs has been an emerging public health concern in Taiwan. The aims of this study were to explore the prevalence of hepatitis B, C and D, to analyze the risk factors of viral hepatitis in HIV-uninfected IDUs-dominant prisoners and to evaluate the status of HCV treatment in the DAA era. This study revealed the prevalence of hepatitis B, C, and D in Penghu Prison was 13.6%, 34.8%, 3.4%, respectively. IDU was significantly associated with HCV and HDV, but not HBV infection. The prevalence rates of HBV/HCV, HBV/HDV dual infections and HBV/HCV/HDV triple infections was 5%, 3.4% and 2.8%, respectively. The risk of HBV viremia was significantly reduced in the anti-HCV seropositive subjects. Positive for anti-HCV antibody significantly increased the risk of HDV infection. This study revealed a marked decline in the prevalence of HBV, HCV, and HDV among HIV-uninfected IDUs over the past fifteen years in Taiwan. Despite high efficacy DAAs been on the market for several years, there is a wide gap between awareness of viral hepatitis and antiviral therapy among IDUs. More effective public health policy is required to eliminate the epidemic in these high-risk groups.
#22 Hepatitis B | The Australian Immunisation Handbook
https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/hepatitis-b
Hepatitis B remains the most common blood-borne viral infection in Australia. The estimated prevalence of chronic hepatitis B in 2020 was 0.9%. Populations most affected by hepatitis B within Australia are Aboriginal and Torres Strait Islander people and those born overseas. […] Since the introduction of funded universal infant hepatitis B immunisation, Australia has seen a three-fold decline in the rate of newly acquired hepatitis B notifications between 2000 and 2019. There were 4,945 notifications reported during this period (average annual rate 1.13 per 100,000 population per year). Similarly, between 2001 and 2019 annual hospitalisation rates have halved. […] The average annual notification rate was highest among young adults aged 25â29 years and lowest among young children <10 years of age. Notification rates and mortality were three-fold higher in males compared to females. Although notification rates have halved among Aboriginal and Torres Strait Islander people, both notification and hospitalisation rates remain higher than other people.
#23 Hepatitis B Surveillance | 2022 Hepatitis Surveillance | CDC
https://www.cdc.gov/hepatitis-surveillance-2022/hepatitis-b/index.html
There were 2,126 new cases of acute hepatitis B reported during 2022. […] There were 13,800 estimated acute HBV infections during 2022. […] There were 16,729 cases of newly reported chronic hepatitis B during 2022. […] There were 1,797 hepatitis B-related deaths reported during 2022. […] During 2022, 16,729 cases of chronic hepatitis B were newly reported by 43 states and the District of Columbia, corresponding to a rate of 5.8 cases per 100,000 people. […] The rate of newly reported chronic hepatitis B cases among non-Hispanic Asian/Pacific Islander (A/PI) persons (20.1 cases per 100,000 population) was 11.2 times as high as the rate among non-Hispanic White persons (1.8 cases per 100,000 population). […] In 2022, the rate of newly reported chronic hepatitis B cases among non-Hispanic A/PI persons was 11.2 times as high as among non-Hispanic White persons. […] 89% of newly reported chronic hepatitis B cases occurred in persons 30 years and older.
#24 Hepatitis B Foundation raises alarm about findings from new federal viral hepatitis surveillance report » Hepatitis B Foundation
https://www.hepb.org/news-and-events/news-2/hepatitis-b-foundation-raises-alarm-about-findings-from-new-federal-viral-hepatitis-surveillance-report/
Asian Americans and Pacific Islanders also bore a disproportionate burden of hepatitis B-related deaths in 2020 with a rate 9 times higher than that of non-Hispanic White adults. […] We wont be able to decrease hepatitis B-related deaths and reach our goal of eliminating the disease unless we make major investments in surveillance for chronic cases, noted Frank Hood, associate director of policy and partnerships at the Hepatitis B Foundation.
#25 Viral Hepatitis Surveillance and Case Management – Hepatitis B | CDC
https://www.cdc.gov/hepatitis/statistics/surveillanceguidance/HepatitisB.htm
Hepatitis B is a disease caused by the hepatitis B virus (HBV) that can be self-limited for some and lifelong for others. HBV is transmitted through the blood or bodily fluids of an infected person. In the United States, injection drug use (IDU) and having multiple sexual partners are the first and second most common risk behaviors or exposures reported for acute hepatitis B, respectively. Approximately 50-70% of people with acute hepatitis B are not symptomatic, resulting in many undiagnosed and unreported infections. The epidemiology of hepatitis B in the United States has evolved since the hepatitis B vaccine first became available in 1982. National chronic hepatitis B prevalence and death rates have remained relatively stable. During January 2017-March 2020, approximately 0.2% of the non-institutionalized US population, representing approximately 660,000 people, were estimated to be living with chronic hepatitis B. The prevalence of chronic hepatitis B was highest among non-US-born people and those of Asian/Pacific Islander descent. Approximately 50% of people living with chronic hepatitis B were unaware of their infection status. Recommendations for universal adult hepatitis B screening were released by the CDC. They recommend that all adults 18 years of age be screened at least once. All pregnant women are recommended for universal hepatitis B screening, preferably during the first trimester and regardless of vaccination status or testing history, because of the risk for perinatal transmission. Without preventive interventions, chronic infection develops in approximately 90% of infected infants compared with 25%-30% of children who acquire HBV infection during 1-5 years of age and about 10% of people infected at 5 years of age. The purpose of this section is to provide guidance to jurisdictions as they implement and improve hepatitis B surveillance. It contains information regarding reporting requirements, collection of relevant laboratory data, and case investigation. The national incidence of acute hepatitis B dramatically declined after incremental recommendations for vaccinating people at-risk for infection and severe outcomes were released beginning in 1982 and for infants and children in 1991. The number of acute hepatitis B cases reported each year in the United States has remained relatively stable during 2014-2019 but decreased abruptly in 2020 and 2021. The decrease in reported cases could be due to prevention efforts as well as disruptions of the COVID-19 pandemic. IDU and having multiple sexual partners are major risk behaviors associated with acute hepatitis B in the United States, and incidence is highest among non-Hispanic White people, non-Hispanic Black people, and those 30-59 years of age. CDC has provided guidelines for hepatitis B screening among all adults 18 years of age at least once during a lifetime and pregnant women during each pregnancy. Periodic testing among susceptible people with ongoing risks for exposures is recommended while risks for exposures persist. Improving hepatitis B surveillance by improving screening is an important component of national and jurisdictional strategies for the prevention and control of hepatitis B.
#26 Hepatitis B – Wikipedia
https://en.wikipedia.org/wiki/Hepatitis_B
Approximately 254 million people had chronic HBV infection as of 2022. Another 1.2 million cases of acute HBV infection also occurred that year. Regional prevalences across the globe range from around 7.5% in Africa to 0.5% in the Americas. […] The primary method of HBV transmission and the prevalence of chronic HBV infection in specific regions often correspond with one another. In populations where HBV infection rates are 8% or higher, which are classified as high prevalence, vertical transmission (usually occurring during birth) is most common, though rates of early childhood transmission can also be significant among these populations. […] In 2021, 19 African countries had infection rates ranging between 8-19%, placing them in the high prevalence category. High prevalence of HBV also exists in Mongolia.
#27 Epidemiology of Hepatitis B Virus Infection | IntechOpen
https://www.intechopen.com/online-first/1207206
Vertical or perinatal transmission of HBV is more common in Asian countries and Oceania regions. […] In areas with high endemicity, especially Southeast Asia, transmission of HBV from carrier mothers to their children during the perinatal period is the most common cause. […] Hepatitis B is considered a sexually transmitted disease (STD), and for a long time, gay men were considered to be at the highest risk of infection through sexual contact. […] However, heterosexual transmission accounts for an increasing proportion of HBV infections. […] Parenteral transmission includes injection drug use, blood transfusions and hemodialysis, acupuncture, handling contaminated objects, tattoos, and household contact. […] Reduction of HBV-related chronic liver damage and chronic HBV infection is the primary goal of hepatitis B prevention initiatives.
#28 Viral Hepatitis Surveillance and Case Management – Hepatitis B | CDC
https://www.cdc.gov/hepatitis/statistics/surveillanceguidance/HepatitisB.htm
Hepatitis B is a disease caused by the hepatitis B virus (HBV) that can be self-limited for some and lifelong for others. HBV is transmitted through the blood or bodily fluids of an infected person. In the United States, injection drug use (IDU) and having multiple sexual partners are the first and second most common risk behaviors or exposures reported for acute hepatitis B, respectively. Approximately 50-70% of people with acute hepatitis B are not symptomatic, resulting in many undiagnosed and unreported infections. The epidemiology of hepatitis B in the United States has evolved since the hepatitis B vaccine first became available in 1982. National chronic hepatitis B prevalence and death rates have remained relatively stable. During January 2017-March 2020, approximately 0.2% of the non-institutionalized US population, representing approximately 660,000 people, were estimated to be living with chronic hepatitis B. The prevalence of chronic hepatitis B was highest among non-US-born people and those of Asian/Pacific Islander descent. Approximately 50% of people living with chronic hepatitis B were unaware of their infection status. Recommendations for universal adult hepatitis B screening were released by the CDC. They recommend that all adults 18 years of age be screened at least once. All pregnant women are recommended for universal hepatitis B screening, preferably during the first trimester and regardless of vaccination status or testing history, because of the risk for perinatal transmission. Without preventive interventions, chronic infection develops in approximately 90% of infected infants compared with 25%-30% of children who acquire HBV infection during 1-5 years of age and about 10% of people infected at 5 years of age. The purpose of this section is to provide guidance to jurisdictions as they implement and improve hepatitis B surveillance. It contains information regarding reporting requirements, collection of relevant laboratory data, and case investigation. The national incidence of acute hepatitis B dramatically declined after incremental recommendations for vaccinating people at-risk for infection and severe outcomes were released beginning in 1982 and for infants and children in 1991. The number of acute hepatitis B cases reported each year in the United States has remained relatively stable during 2014-2019 but decreased abruptly in 2020 and 2021. The decrease in reported cases could be due to prevention efforts as well as disruptions of the COVID-19 pandemic. IDU and having multiple sexual partners are major risk behaviors associated with acute hepatitis B in the United States, and incidence is highest among non-Hispanic White people, non-Hispanic Black people, and those 30-59 years of age. CDC has provided guidelines for hepatitis B screening among all adults 18 years of age at least once during a lifetime and pregnant women during each pregnancy. Periodic testing among susceptible people with ongoing risks for exposures is recommended while risks for exposures persist. Improving hepatitis B surveillance by improving screening is an important component of national and jurisdictional strategies for the prevention and control of hepatitis B.
#29
https://www.who.int/publications/m/item/vaccine-preventable-diseases-surveillance-standards-hepb
Hepatitis B virus (HBV) is transmitted by exposure of mucosal membranes or non-intact skin to infected blood or other body fluids. […] The incubation period for acute hepatitis B is 75 days on average, but may vary from about 30 to 180 days. […] Most new infections are asymptomatic. […] Acute hepatitis B occurs in approximately 1% of perinatal infections, 10% of early childhood infections and 30% of infections among persons 5 years of age. […] Children are frequently asymptomatic when they become infected with HBV, making surveillance challenging in this population. […] Chronic hepatitis B occurs in 80% of perinatal infections, but in 5% of those infected as healthy adults. […] Chronic hepatitis B infection has a spectrum of clinical severity, from asymptomatic to liver cirrhosis and hepatocellular carcinoma. […] The introduction of hepatitis B vaccines in the 1980s has resulted in dramatic decrease in chronic hepatitis B prevalence worldwide among children.
#30
https://www.who.int/news-room/fact-sheets/detail/hepatitis-b
Hepatitis B is preventable with a vaccine. […] All babies should receive the hepatitis B vaccine as soon as possible after birth (within 24 hours). […] To reduce the risk of getting or spreading hepatitis B: practice safe sex by using condoms and reducing the number of sexual partners. […] WHO organizes annual World Hepatitis Day campaigns to increase awareness and understanding of viral hepatitis.
#31 Viral Hepatitis Surveillance and Case Management – Hepatitis B | CDC
https://www.cdc.gov/hepatitis/statistics/surveillanceguidance/HepatitisB.htm
Hepatitis B is a disease caused by the hepatitis B virus (HBV) that can be self-limited for some and lifelong for others. HBV is transmitted through the blood or bodily fluids of an infected person. In the United States, injection drug use (IDU) and having multiple sexual partners are the first and second most common risk behaviors or exposures reported for acute hepatitis B, respectively. Approximately 50-70% of people with acute hepatitis B are not symptomatic, resulting in many undiagnosed and unreported infections. The epidemiology of hepatitis B in the United States has evolved since the hepatitis B vaccine first became available in 1982. National chronic hepatitis B prevalence and death rates have remained relatively stable. During January 2017-March 2020, approximately 0.2% of the non-institutionalized US population, representing approximately 660,000 people, were estimated to be living with chronic hepatitis B. The prevalence of chronic hepatitis B was highest among non-US-born people and those of Asian/Pacific Islander descent. Approximately 50% of people living with chronic hepatitis B were unaware of their infection status. Recommendations for universal adult hepatitis B screening were released by the CDC. They recommend that all adults 18 years of age be screened at least once. All pregnant women are recommended for universal hepatitis B screening, preferably during the first trimester and regardless of vaccination status or testing history, because of the risk for perinatal transmission. Without preventive interventions, chronic infection develops in approximately 90% of infected infants compared with 25%-30% of children who acquire HBV infection during 1-5 years of age and about 10% of people infected at 5 years of age. The purpose of this section is to provide guidance to jurisdictions as they implement and improve hepatitis B surveillance. It contains information regarding reporting requirements, collection of relevant laboratory data, and case investigation. The national incidence of acute hepatitis B dramatically declined after incremental recommendations for vaccinating people at-risk for infection and severe outcomes were released beginning in 1982 and for infants and children in 1991. The number of acute hepatitis B cases reported each year in the United States has remained relatively stable during 2014-2019 but decreased abruptly in 2020 and 2021. The decrease in reported cases could be due to prevention efforts as well as disruptions of the COVID-19 pandemic. IDU and having multiple sexual partners are major risk behaviors associated with acute hepatitis B in the United States, and incidence is highest among non-Hispanic White people, non-Hispanic Black people, and those 30-59 years of age. CDC has provided guidelines for hepatitis B screening among all adults 18 years of age at least once during a lifetime and pregnant women during each pregnancy. Periodic testing among susceptible people with ongoing risks for exposures is recommended while risks for exposures persist. Improving hepatitis B surveillance by improving screening is an important component of national and jurisdictional strategies for the prevention and control of hepatitis B.
#32 Epidemiology of Hepatitis B Virus Infection | IntechOpen
https://www.intechopen.com/online-first/1207206
Vertical or perinatal transmission of HBV is more common in Asian countries and Oceania regions. […] In areas with high endemicity, especially Southeast Asia, transmission of HBV from carrier mothers to their children during the perinatal period is the most common cause. […] Hepatitis B is considered a sexually transmitted disease (STD), and for a long time, gay men were considered to be at the highest risk of infection through sexual contact. […] However, heterosexual transmission accounts for an increasing proportion of HBV infections. […] Parenteral transmission includes injection drug use, blood transfusions and hemodialysis, acupuncture, handling contaminated objects, tattoos, and household contact. […] Reduction of HBV-related chronic liver damage and chronic HBV infection is the primary goal of hepatitis B prevention initiatives.
#33 Viral Hepatitis Surveillance and Case Management – Hepatitis B | CDC
https://www.cdc.gov/hepatitis/statistics/surveillanceguidance/HepatitisB.htm
Hepatitis B is a disease caused by the hepatitis B virus (HBV) that can be self-limited for some and lifelong for others. HBV is transmitted through the blood or bodily fluids of an infected person. In the United States, injection drug use (IDU) and having multiple sexual partners are the first and second most common risk behaviors or exposures reported for acute hepatitis B, respectively. Approximately 50-70% of people with acute hepatitis B are not symptomatic, resulting in many undiagnosed and unreported infections. The epidemiology of hepatitis B in the United States has evolved since the hepatitis B vaccine first became available in 1982. National chronic hepatitis B prevalence and death rates have remained relatively stable. During January 2017-March 2020, approximately 0.2% of the non-institutionalized US population, representing approximately 660,000 people, were estimated to be living with chronic hepatitis B. The prevalence of chronic hepatitis B was highest among non-US-born people and those of Asian/Pacific Islander descent. Approximately 50% of people living with chronic hepatitis B were unaware of their infection status. Recommendations for universal adult hepatitis B screening were released by the CDC. They recommend that all adults 18 years of age be screened at least once. All pregnant women are recommended for universal hepatitis B screening, preferably during the first trimester and regardless of vaccination status or testing history, because of the risk for perinatal transmission. Without preventive interventions, chronic infection develops in approximately 90% of infected infants compared with 25%-30% of children who acquire HBV infection during 1-5 years of age and about 10% of people infected at 5 years of age. The purpose of this section is to provide guidance to jurisdictions as they implement and improve hepatitis B surveillance. It contains information regarding reporting requirements, collection of relevant laboratory data, and case investigation. The national incidence of acute hepatitis B dramatically declined after incremental recommendations for vaccinating people at-risk for infection and severe outcomes were released beginning in 1982 and for infants and children in 1991. The number of acute hepatitis B cases reported each year in the United States has remained relatively stable during 2014-2019 but decreased abruptly in 2020 and 2021. The decrease in reported cases could be due to prevention efforts as well as disruptions of the COVID-19 pandemic. IDU and having multiple sexual partners are major risk behaviors associated with acute hepatitis B in the United States, and incidence is highest among non-Hispanic White people, non-Hispanic Black people, and those 30-59 years of age. CDC has provided guidelines for hepatitis B screening among all adults 18 years of age at least once during a lifetime and pregnant women during each pregnancy. Periodic testing among susceptible people with ongoing risks for exposures is recommended while risks for exposures persist. Improving hepatitis B surveillance by improving screening is an important component of national and jurisdictional strategies for the prevention and control of hepatitis B.
#34 Core Concepts – HBV Epidemiology – Screening and Diagnosis – Hepatitis B Online
https://www.hepatitisb.uw.edu/go/screening-diagnosis/hbv-epidemiology/core-concept/all
Injection-drug use and sexual exposure are the major risk factors for HBV acquisition in the United States, with injection-drug use playing an increasingly important role in transmission as a result of the ongoing opioid epidemic. […] The CDC has established uniform case definitions for acute HBV, chronic HBV, and HBV perinatal infection to assist with public health reporting. […] In the United States, in 2020, there were 1,752 deaths with HBV listed as the cause of death, corresponding to a mortality rate of 0.45 HBV-related deaths per 100,000 population.
#35 Epidemiology, virology, transmission, clinical manifestation and vaccine for hepatitis virus B: a review – MedCrave online
https://medcraveonline.com/IJVV/epidemiology-virology-transmission-clinical-manifestation-and-vaccine-for-hepatitis-virus-b-a-review.html
Hepatitis B virus predominantly spread by percutaneous or mucosal exposure to infected blood and other body fluids such as saliva, vaginal, menstrual and seminal fluids which have all been implicated as vehicles of human transmission. […] In many part of the world, perinatal transmission is the major route of HBV transmission, and an important factor considered in maintaining the reservoir of the infection in some part of the world particularly China and South East Asia. […] Horizontal transmission of HBV include transmission through household, intra-familial especially child-to-child. […] The transmission route for hepatitis B infection is by contact with infected blood, semen and other fluid primarily through; children born to hepatitis B positive mother, sexual intercourse with hepatitis B positive person, sharing of contaminated objects such as syringes, needle, razor blade or injection drug equipments.
#36
https://www.who.int/news-room/fact-sheets/detail/hepatitis-b
Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic disease. […] WHO estimates that 254 million people were living with chronic hepatitis B infection in 2022, with 1.2 million new infections each year. […] In 2022, hepatitis B resulted in an estimated 1.1 million deaths, mostly from cirrhosis and hepatocellular carcinoma (primary liver cancer). […] Hepatitis B is a major global health problem. The burden of infection is highest in the WHO Western Pacific Region and the WHO African Region, where 97 million and 65 million people, respectively, are chronically infected. […] Hepatitis B is also spread by needlestick injury, tattooing, piercing and exposure to infected blood and body fluids, such as saliva and menstrual, vaginal and seminal fluids.
#37 Epidemiology of Hepatitis B Virus Infection | IntechOpen
https://www.intechopen.com/online-first/1207206
Vertical or perinatal transmission of HBV is more common in Asian countries and Oceania regions. […] In areas with high endemicity, especially Southeast Asia, transmission of HBV from carrier mothers to their children during the perinatal period is the most common cause. […] Hepatitis B is considered a sexually transmitted disease (STD), and for a long time, gay men were considered to be at the highest risk of infection through sexual contact. […] However, heterosexual transmission accounts for an increasing proportion of HBV infections. […] Parenteral transmission includes injection drug use, blood transfusions and hemodialysis, acupuncture, handling contaminated objects, tattoos, and household contact. […] Reduction of HBV-related chronic liver damage and chronic HBV infection is the primary goal of hepatitis B prevention initiatives.
#38 Hepatitis Surveillance and Reporting
https://www.health.ny.gov/diseases/communicable/hepatitis/surveillance.htm
Surveillance is the ongoing and systematic collection, analysis, and interpretation of health data for the purposes of planning, implementing and evaluating public health programs. The goals of viral hepatitis surveillance are to measure the burden of disease; determine risk factors; identify outbreaks; monitor trends; evaluate control measures, interventions and programs; and identify infected persons for medical referral, education and counseling. […] Annual reports on the number of cases and rates per 100,000 population of hepatitis A, hepatitis B and hepatitis C by county and by age group can be found at Communicable Disease Annual Reports. […] New York State Department of Health Communicable Disease Reporting Requirements (PDF) […] Centers for Disease Control and Prevention Screening and Testing Recommendations for Chronic Hepatitis B Virus Infection) […] Centers for Disease Control and Prevention Testing Recommendations for Hepatitis C Virus Infection […] Laboratory Reporting Guidelines 2020, New York State Department of Health (PDF)
#39 Hepatitis Surveillance and Reporting
https://www.health.ny.gov/diseases/communicable/hepatitis/surveillance.htm
Surveillance is the ongoing and systematic collection, analysis, and interpretation of health data for the purposes of planning, implementing and evaluating public health programs. The goals of viral hepatitis surveillance are to measure the burden of disease; determine risk factors; identify outbreaks; monitor trends; evaluate control measures, interventions and programs; and identify infected persons for medical referral, education and counseling. […] Annual reports on the number of cases and rates per 100,000 population of hepatitis A, hepatitis B and hepatitis C by county and by age group can be found at Communicable Disease Annual Reports. […] New York State Department of Health Communicable Disease Reporting Requirements (PDF) […] Centers for Disease Control and Prevention Screening and Testing Recommendations for Chronic Hepatitis B Virus Infection) […] Centers for Disease Control and Prevention Testing Recommendations for Hepatitis C Virus Infection […] Laboratory Reporting Guidelines 2020, New York State Department of Health (PDF)
#40 Hepatitis Surveillance and Reporting
https://www.health.ny.gov/diseases/communicable/hepatitis/surveillance.htm
Surveillance is the ongoing and systematic collection, analysis, and interpretation of health data for the purposes of planning, implementing and evaluating public health programs. The goals of viral hepatitis surveillance are to measure the burden of disease; determine risk factors; identify outbreaks; monitor trends; evaluate control measures, interventions and programs; and identify infected persons for medical referral, education and counseling. […] Annual reports on the number of cases and rates per 100,000 population of hepatitis A, hepatitis B and hepatitis C by county and by age group can be found at Communicable Disease Annual Reports. […] New York State Department of Health Communicable Disease Reporting Requirements (PDF) […] Centers for Disease Control and Prevention Screening and Testing Recommendations for Chronic Hepatitis B Virus Infection) […] Centers for Disease Control and Prevention Testing Recommendations for Hepatitis C Virus Infection […] Laboratory Reporting Guidelines 2020, New York State Department of Health (PDF)
#41 Hepatitis Surveillance and Reporting
https://www.health.ny.gov/diseases/communicable/hepatitis/surveillance.htm
Surveillance is the ongoing and systematic collection, analysis, and interpretation of health data for the purposes of planning, implementing and evaluating public health programs. The goals of viral hepatitis surveillance are to measure the burden of disease; determine risk factors; identify outbreaks; monitor trends; evaluate control measures, interventions and programs; and identify infected persons for medical referral, education and counseling. […] Annual reports on the number of cases and rates per 100,000 population of hepatitis A, hepatitis B and hepatitis C by county and by age group can be found at Communicable Disease Annual Reports. […] New York State Department of Health Communicable Disease Reporting Requirements (PDF) […] Centers for Disease Control and Prevention Screening and Testing Recommendations for Chronic Hepatitis B Virus Infection) […] Centers for Disease Control and Prevention Testing Recommendations for Hepatitis C Virus Infection […] Laboratory Reporting Guidelines 2020, New York State Department of Health (PDF)
#42 Hepatitis Surveillance and Reporting
https://www.health.ny.gov/diseases/communicable/hepatitis/surveillance.htm
Surveillance is the ongoing and systematic collection, analysis, and interpretation of health data for the purposes of planning, implementing and evaluating public health programs. The goals of viral hepatitis surveillance are to measure the burden of disease; determine risk factors; identify outbreaks; monitor trends; evaluate control measures, interventions and programs; and identify infected persons for medical referral, education and counseling. […] Annual reports on the number of cases and rates per 100,000 population of hepatitis A, hepatitis B and hepatitis C by county and by age group can be found at Communicable Disease Annual Reports. […] New York State Department of Health Communicable Disease Reporting Requirements (PDF) […] Centers for Disease Control and Prevention Screening and Testing Recommendations for Chronic Hepatitis B Virus Infection) […] Centers for Disease Control and Prevention Testing Recommendations for Hepatitis C Virus Infection […] Laboratory Reporting Guidelines 2020, New York State Department of Health (PDF)
#43 Hepatitis Surveillance and Reporting
https://www.health.ny.gov/diseases/communicable/hepatitis/surveillance.htm
Surveillance is the ongoing and systematic collection, analysis, and interpretation of health data for the purposes of planning, implementing and evaluating public health programs. The goals of viral hepatitis surveillance are to measure the burden of disease; determine risk factors; identify outbreaks; monitor trends; evaluate control measures, interventions and programs; and identify infected persons for medical referral, education and counseling. […] Annual reports on the number of cases and rates per 100,000 population of hepatitis A, hepatitis B and hepatitis C by county and by age group can be found at Communicable Disease Annual Reports. […] New York State Department of Health Communicable Disease Reporting Requirements (PDF) […] Centers for Disease Control and Prevention Screening and Testing Recommendations for Chronic Hepatitis B Virus Infection) […] Centers for Disease Control and Prevention Testing Recommendations for Hepatitis C Virus Infection […] Laboratory Reporting Guidelines 2020, New York State Department of Health (PDF)
#44 Hepatitis Surveillance and Reporting
https://www.health.ny.gov/diseases/communicable/hepatitis/surveillance.htm
Surveillance is the ongoing and systematic collection, analysis, and interpretation of health data for the purposes of planning, implementing and evaluating public health programs. The goals of viral hepatitis surveillance are to measure the burden of disease; determine risk factors; identify outbreaks; monitor trends; evaluate control measures, interventions and programs; and identify infected persons for medical referral, education and counseling. […] Annual reports on the number of cases and rates per 100,000 population of hepatitis A, hepatitis B and hepatitis C by county and by age group can be found at Communicable Disease Annual Reports. […] New York State Department of Health Communicable Disease Reporting Requirements (PDF) […] Centers for Disease Control and Prevention Screening and Testing Recommendations for Chronic Hepatitis B Virus Infection) […] Centers for Disease Control and Prevention Testing Recommendations for Hepatitis C Virus Infection […] Laboratory Reporting Guidelines 2020, New York State Department of Health (PDF)
#45 Surveillance Reports – Health Protection Surveillance Centre
https://www.hpsc.ie/a-z/hepatitis/hepatitisb/surveillancereports/
There was a 16% increase in notification rate (2023 v 2022) for chronic cases (11.1 per 100,000 population v 9.5 per 100,000 population). […] The higher hepatitis B notification rates in Ireland in 2022 and 2023 should be interpreted with caution. Chronic cases may have been infected for years or decades without symptoms before being detected in targeted screening programmes among groups at higher risk of infection. […] Country of birth data (available for 54% of chronic cases in 2023) show that 2% were born in Ireland, with most cases notified in persons from endemic countries with higher rates of hepatitis B infection: 37% in eastern or central Europe, 30% in sub-Saharan Africa and 26% in Asia. […] Ireland is likely to have achieved some of the WHO 2030 targets to eliminate viral hepatitis as a public health threat. More work is needed to improve monitoring of hepatitis B prevention and mitigation measures so that Ireland can demonstrate its progress to reach the goal of making hepatitis B a rare disease and no longer a public health threat.
#46 Core Concepts – HBV Epidemiology – Screening and Diagnosis – Hepatitis B Online
https://www.hepatitisb.uw.edu/go/screening-diagnosis/hbv-epidemiology/core-concept/all
Hepatitis B virus (HBV) is an enveloped, partially double-stranded DNA virus that is transmitted via infected blood and bodily fluids. Infection with the hepatitis B virus causes hepatocellular necrosis and inflammation, and chronic infection can lead to liver fibrosis, cirrhosis and hepatocellular carcinoma (HCC). In the United States, the estimates for the number of persons living with chronic HBV infection range from 850,000 to 2.2 million persons. Globally, an estimated 296 million people are chronically infected with hepatitis B, making it one of the most prevalent viral infections worldwide and a major public health priority, particularly in highly endemic areas. […] The incidence of HBV infection is defined as the number of new HBV infections in a given population over a given time period. The Centers for Disease Control and Prevention (CDC) uses the 2012 acute hepatitis B case definition to determine the annual reported incidence of HBV infection in the United States.
#47 Core Concepts – HBV Epidemiology – Screening and Diagnosis – Hepatitis B Online
https://www.hepatitisb.uw.edu/go/screening-diagnosis/hbv-epidemiology/core-concept/all
Injection-drug use and sexual exposure are the major risk factors for HBV acquisition in the United States, with injection-drug use playing an increasingly important role in transmission as a result of the ongoing opioid epidemic. […] The CDC has established uniform case definitions for acute HBV, chronic HBV, and HBV perinatal infection to assist with public health reporting. […] In the United States, in 2020, there were 1,752 deaths with HBV listed as the cause of death, corresponding to a mortality rate of 0.45 HBV-related deaths per 100,000 population.
#48 Accuracy of hepatitis B disease surveillance, Gannan prefecture, Gansu province, China; 2017 | PLOS One
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0274798
Hepatitis B is a major global public health threat. According to Chinas National Notifiable Disease Reporting System (NNDRS), Gannan Tibetan Autonomous Prefecture (Gannan) had the highest incidence of hepatitis B in Gansu Province during 2004 to 2016. We evaluated NNDRS hepatitis B case reports from Gannan to determine accuracy of diagnosis and to understand factors associated with inaccuracy. […] China has not established a standalone surveillance system for hepatitis B, relying instead on the decades old National Notifiable Disease Reporting System (NNDRS) for hepatitis B surveillance. In 2004, China developed a disease control network with direct reporting of hepatitis B cases categorized by reporting clinicians as acute or chronic according to the Diagnostic Criteria of Viral Hepatitis B. Reports from this network are transferred to NNDRS.
#49 Using a hepatitis B surveillance system evaluation in Fujian, Hainan, and Gansu provinces to improve data quality and assess program effectiveness, China, 2015 | BMC Infectious Diseases | Full Text
https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-020-05265-3
Monitoring hepatitis B surveillance data is important for evaluating progress towards global hepatitis B elimination goals. Accurate classification of acute and chronic hepatitis infections is essential for assessing program effectiveness. […] We identified discrepancies in the accuracy of HBV case-reporting in the project hospitals. Onsite training on the use of anti-HBc IgM testing as well as on HBV case definitions and reporting procedures are needed to accurately assess program effectiveness and ensure case-patients are referred to appropriate treatment and care. Routine surveillance evaluations such as this can be useful for improving data quality and monitoring program effectiveness. […] Our evaluation identified discrepancies in the classification of HBV cases reported to NNDRSonly 60% of chronic HBV cases and 7% of acute HBV cases were reported correctly to NNDRS. Most misclassifications involved patients with chronic HBV or HBV carriers or patients without the required diagnostic information who were reported as having an acute infection. Misclassification varied by province, hospital grade, and ward type. Additionally, only a few patients received anti-HBc IgM laboratory tests for differentiating acute and chronic infections as recommended. These discrepancies can be addressed through training, possible revisions to reporting procedures, and development of feedback mechanisms to hospital staff. Our project highlights the importance of routine surveillance evaluations for assessing data quality and monitoring program effectiveness. […] Our findings support the use of similar evaluations in other locations as a possible complement to resource-intensive HBV sero-surveys.
#50 Evaluation of the acute hepatitis B surveillance system in the Republic of Korea following the transition to mandatory surveillance
https://ophrp.org/journal/view.php?number=788
The prevalence of hepatitis B in the Republic of Korea has declined, yet the disease burden persists. […] The national hepatitis B surveillance system now exclusively monitors acute cases. […] The evaluation of the Republic of Korea’s acute hepatitis B surveillance system revealed high positive predictive value, data quality, and timeliness. […] Improvements can be made in the misreporting of chronic cases and the system’s usefulness. […] The Republic of Korea currently employs 2 methods for monitoring hepatitis B outbreaks. […] The Korea Disease Control and Prevention Agency (KDCA) has designated hepatitis B as a class 3 notifiable infectious disease and maintains a surveillance system for the condition. […] Consequently, surveillance efforts are exclusively focused on acute cases to better understand the patterns of horizontal transmission of the disease.
#51 Hepatitis B – Annual Epidemiological Report for 2022
https://www.ecdc.europa.eu/en/publications-data/hepatitis-b-annual-epidemiological-report-2022
Hepatitis B is a major public health threat worldwide. In 2022, the global prevalence was estimated at 257 million people living with HBV infection (3.2%), with an estimated incidence of 1.5 million new cases per year. […] In the European Union/European Economic Area (EU/EEA), the disease burden remains high, with an estimated 3.6 million people living with CHB and 64 000 deaths attributed to chronic viral hepatitis in 2015.
#52 Viral Hepatitis Surveillance and Case Management – Hepatitis B | CDC
https://www.cdc.gov/hepatitis/statistics/surveillanceguidance/HepatitisB.htm
Hepatitis B is a disease caused by the hepatitis B virus (HBV) that can be self-limited for some and lifelong for others. HBV is transmitted through the blood or bodily fluids of an infected person. In the United States, injection drug use (IDU) and having multiple sexual partners are the first and second most common risk behaviors or exposures reported for acute hepatitis B, respectively. Approximately 50-70% of people with acute hepatitis B are not symptomatic, resulting in many undiagnosed and unreported infections. The epidemiology of hepatitis B in the United States has evolved since the hepatitis B vaccine first became available in 1982. National chronic hepatitis B prevalence and death rates have remained relatively stable. During January 2017-March 2020, approximately 0.2% of the non-institutionalized US population, representing approximately 660,000 people, were estimated to be living with chronic hepatitis B. The prevalence of chronic hepatitis B was highest among non-US-born people and those of Asian/Pacific Islander descent. Approximately 50% of people living with chronic hepatitis B were unaware of their infection status. Recommendations for universal adult hepatitis B screening were released by the CDC. They recommend that all adults 18 years of age be screened at least once. All pregnant women are recommended for universal hepatitis B screening, preferably during the first trimester and regardless of vaccination status or testing history, because of the risk for perinatal transmission. Without preventive interventions, chronic infection develops in approximately 90% of infected infants compared with 25%-30% of children who acquire HBV infection during 1-5 years of age and about 10% of people infected at 5 years of age. The purpose of this section is to provide guidance to jurisdictions as they implement and improve hepatitis B surveillance. It contains information regarding reporting requirements, collection of relevant laboratory data, and case investigation. The national incidence of acute hepatitis B dramatically declined after incremental recommendations for vaccinating people at-risk for infection and severe outcomes were released beginning in 1982 and for infants and children in 1991. The number of acute hepatitis B cases reported each year in the United States has remained relatively stable during 2014-2019 but decreased abruptly in 2020 and 2021. The decrease in reported cases could be due to prevention efforts as well as disruptions of the COVID-19 pandemic. IDU and having multiple sexual partners are major risk behaviors associated with acute hepatitis B in the United States, and incidence is highest among non-Hispanic White people, non-Hispanic Black people, and those 30-59 years of age. CDC has provided guidelines for hepatitis B screening among all adults 18 years of age at least once during a lifetime and pregnant women during each pregnancy. Periodic testing among susceptible people with ongoing risks for exposures is recommended while risks for exposures persist. Improving hepatitis B surveillance by improving screening is an important component of national and jurisdictional strategies for the prevention and control of hepatitis B.
#53
https://www.who.int/news-room/fact-sheets/detail/hepatitis-b
Hepatitis B infection acquired in adulthood leads to chronic hepatitis in less than 5% of cases, whereas infection in infancy and early childhood leads to chronic hepatitis in about 95% of cases. […] As of 2022, 13% of all people estimated to be living with hepatitis B were aware of their infection, while 3% (7 million) of the people living with chronic hepatitis B were on treatment. […] WHO recommends that all blood donations be tested for hepatitis B to ensure blood safety and avoid accidental transmission. […] Chronic hepatitis B infection can be treated with oral medicines, including tenofovir or entecavir. […] With the updated Hepatitis B Guidelines, it is estimated that more than 50% of people with chronic hepatitis B infection will require treatment, depending on setting and eligibility criteria.
#54 Hepatitis B Basics | HHS.govLock
https://www.hhs.gov/hepatitis/learn-about-viral-hepatitis/hepatitis-b-basics/index.html
About 2% of people with HIV in the United States are coinfected with HBV; both infections have similar routes of transmission. […] Hepatitis B is spread in several distinct ways: sexual contact; sharing needles, syringes, or other drug-injection equipment; or from mother-to-child at birth. […] Hepatitis B is a vaccine-preventable disease. The best way to prevent hepatitis B is to get vaccinated. The hepatitis B vaccine is safe and effective. […] The CDC estimates that 68% of people with chronic hepatitis B are unaware of their infection. […] There are several antiviral treatments available for chronic hepatitis B. Everyone with chronic hepatitis B should be linked to care, considered for treatment, and regularly checked for liver damage and liver cancer.
#55 Using a hepatitis B surveillance system evaluation in Fujian, Hainan, and Gansu provinces to improve data quality and assess program effectiveness, China, 2015 | BMC Infectious Diseases | Full Text
https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-020-05265-3
Monitoring hepatitis B surveillance data is important for evaluating progress towards global hepatitis B elimination goals. Accurate classification of acute and chronic hepatitis infections is essential for assessing program effectiveness. […] We identified discrepancies in the accuracy of HBV case-reporting in the project hospitals. Onsite training on the use of anti-HBc IgM testing as well as on HBV case definitions and reporting procedures are needed to accurately assess program effectiveness and ensure case-patients are referred to appropriate treatment and care. Routine surveillance evaluations such as this can be useful for improving data quality and monitoring program effectiveness. […] Our evaluation identified discrepancies in the classification of HBV cases reported to NNDRSonly 60% of chronic HBV cases and 7% of acute HBV cases were reported correctly to NNDRS. Most misclassifications involved patients with chronic HBV or HBV carriers or patients without the required diagnostic information who were reported as having an acute infection. Misclassification varied by province, hospital grade, and ward type. Additionally, only a few patients received anti-HBc IgM laboratory tests for differentiating acute and chronic infections as recommended. These discrepancies can be addressed through training, possible revisions to reporting procedures, and development of feedback mechanisms to hospital staff. Our project highlights the importance of routine surveillance evaluations for assessing data quality and monitoring program effectiveness. […] Our findings support the use of similar evaluations in other locations as a possible complement to resource-intensive HBV sero-surveys.
#56 Hepatitis B Foundation raises alarm about findings from new federal viral hepatitis surveillance report » Hepatitis B Foundation
https://www.hepb.org/news-and-events/news-2/hepatitis-b-foundation-raises-alarm-about-findings-from-new-federal-viral-hepatitis-surveillance-report/
A new CDC report shows major COVID-related disruptions in hepatitis B testing and significant health equity concerns about the virus impact on the Asian American/Pacific Islander community. […] The CDC report shows an estimated 14,000 new acute hepatitis B cases in 2020, a dramatic 32 percent decrease from 2019. […] This drop in acute hepatitis B cases in 2020 is unfortunately not a sign of progress toward reducing new cases, but instead is an alarm bell to find and help those individuals not being tested, said Hepatitis B Foundation President Chari A. Cohen, DrPH, MPH. […] The report found the highest number of new acute cases of hepatitis B were among non-Hispanic White and Black adults, and persons aged 30-59. […] The CDC reported a total of 11,600 newly identified cases of chronic hepatitis B in 2020, with alarming rates among Asian Americans and Pacific Islanders of more than 12 times those of non-Hispanic White adults.
#57 With support from Canada and PAHO, Haiti scales up vaccination and disease surveillance amid security crisis – PAHO/WHO | Pan American Health Organization
https://www.paho.org/en/stories/support-canada-and-paho-haiti-scales-vaccination-and-disease-surveillance-amid-security
In Haiti, gangs control an estimated 85% of the Port-au-Prince metropolitan area and other neighboring localities, said Dr. Oscar Martin Barreneche, the Pan American Health Organization (PAHO) Representative in Haiti. […] The security crisis has also impacted some critical epidemiological surveillance activities. For example, wastewater collection sites in Cite Soleil in Port-au-Prince can no longer be accessed by MSPP supervision teams because of gang activity. […] But with Canadian support, PAHO provided transportation for epidemiological investigation of suspected cases of VPDs in 341 health facilities and communities in eight of Haitis 10 departments. PAHO also provided transportation for training 77 VPD surveillance professionals from the Center Department and 47 from Artibonite. […] We are looking for cases of diphtheria, like the one recently treated by the Departmental Investigation and Response Team (EDIR), said Dr. Jose Raphael, Epidemiology Assistant in the Northeast Health Department. As part of epidemiological surveillance, we are also monitoring measles, rubella, and congenital rubella syndrome in children under one year of age, as well as acute flaccid paralysis in children under 15.
#58
https://www.who.int/publications/m/item/vaccine-preventable-diseases-surveillance-standards-hepb
Hepatitis B virus (HBV) is transmitted by exposure of mucosal membranes or non-intact skin to infected blood or other body fluids. […] The incubation period for acute hepatitis B is 75 days on average, but may vary from about 30 to 180 days. […] Most new infections are asymptomatic. […] Acute hepatitis B occurs in approximately 1% of perinatal infections, 10% of early childhood infections and 30% of infections among persons 5 years of age. […] Children are frequently asymptomatic when they become infected with HBV, making surveillance challenging in this population. […] Chronic hepatitis B occurs in 80% of perinatal infections, but in 5% of those infected as healthy adults. […] Chronic hepatitis B infection has a spectrum of clinical severity, from asymptomatic to liver cirrhosis and hepatocellular carcinoma. […] The introduction of hepatitis B vaccines in the 1980s has resulted in dramatic decrease in chronic hepatitis B prevalence worldwide among children.
#59 Hepatitis B: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/177632-overview
Hepatitis B infection is a worldwide healthcare problem, especially in developing areas. The hepatitis B virus (HBV) is commonly transmitted via body fluids such as blood, semen, and vaginal secretions. […] An estimated one third of the global population is infected with the hepatitis B virus (HBV). Approximately 250-350 million people have lifelong chronic infection, with approximately 1.5 million new cases every year. […] Since the 1970s, considerable progress has also been made regarding the knowledge of the epidemiology, virology, natural history, and treatment of the hepatitis B virion, a hepatotropic virus particle. In addition, ongoing vaccination programs have been successful in many countries and territories in decreasing the prevalence of HBV disease (eg, Taiwan). […] The prevalence of HBV infection has significantly declined in individuals born in the United States.
#60 Hepatitis B: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/177632-overview
It is estimated that there are around 60,000 new cases annually. Two million or more people in the United States have chronic HBV infection; it is estimated that foreign-born persons from high endemic areas represent more than half of the total cases. […] Globally, chronic HBV infection affects 250-350 million people, with disease prevalence varying among geographic regions, from 1-20%. […] Vaccination programs implemented in highly endemic areas seem to have reduced the prevalence of HBV infection. In Taiwan, for example, HBV seroprevalence declined from 10% in 1984 (before vaccination programs) to less than 1% in 1994 after the implementation of vaccination programs, and the incidence of HCC declined from 0.52% to 0.13% during the same period.
#61 Epidemiology of hepatitis B virus infection: results from a community-based study of 0.15 million residents in South China | Scientific Reports
https://www.nature.com/articles/srep36186
Overall, this study reports that the prevalence of HBsAg in the general population in the study region was 8.76%. […] In fact, the population in Guangdong province experienced a significant decline in HBsAg prevalence from 16.67% to 11.10% between 1992 and 2006, with an overall decrease of nearly 5.6%. […] To achieve the national goal of decreasing the prevalence of HBsAg of the entire population to less than 7%, free immunization for infants should be implemented strictly, and there is an emergent demand to expand vaccination to adults, including migrants and minority populations.
#62 Core Concepts – HBV Epidemiology – Screening and Diagnosis – Hepatitis B Online
https://www.hepatitisb.uw.edu/go/screening-diagnosis/hbv-epidemiology/core-concept/all
Although most adults and children over the age of 12 months with acute HBV infection do not have progression to chronic HBV infection, data on the incidence of acute HBV infection provide critical information regarding trends in transmission, identification of outbreaks, and effectiveness of prevention interventions. […] In 2022, in the United States, there were 13,000 estimated cases of acute HBV infection. The incidence of reported acute HBV cases peaked in 1985 and subsequently declined from 1985 to 2010. The HBV incidence remained relatively stable from 2010 to 2019, but then declined during 2020-2022. […] The prevalence of hepatitis B infection is defined as the number of persons living with chronic HBV infection in the total population. […] The estimates for the number of persons living with chronic HBV in the United States have varied significantly, ranging from approximately 850,000 to 2.2 million. These estimates equate to a general population prevalence of chronic hepatitis B of 0.3 to 0.7% in the United States.
#63 Core Concepts – HBV Epidemiology – Screening and Diagnosis – Hepatitis B Online
https://www.hepatitisb.uw.edu/go/screening-diagnosis/hbv-epidemiology/core-concept/all
Overall, available data suggest that a minority of persons living with chronic HBV are aware of their HBV infection status. […] In 2022, the World Health Organization (WHO) estimated that approximately 254 million people, or 3.3% of the global population, are living with chronic hepatitis B infection. […] Among the six WHO global regions, the Western Pacific and Africa regions have the highest prevalence of chronic HBV infection, followed sequentially by the Southeast Asia region, Eastern Mediterranean region, European region, and region of the Americas. […] In the United States, from 2012-2019, approximately 20,000 new HBV infections occurred each year, with a decline to 14,000 in 2020. Higher rates of acute HBV infection were reported in men than women and in persons 30 to 49 years of age.
#64 Hepatitis B Surveillance | 2022 Hepatitis Surveillance | CDC
https://www.cdc.gov/hepatitis-surveillance-2022/hepatitis-b/index.html
There were 2,126 new cases of acute hepatitis B reported during 2022. […] There were 13,800 estimated acute HBV infections during 2022. […] There were 16,729 cases of newly reported chronic hepatitis B during 2022. […] There were 1,797 hepatitis B-related deaths reported during 2022. […] During 2022, 16,729 cases of chronic hepatitis B were newly reported by 43 states and the District of Columbia, corresponding to a rate of 5.8 cases per 100,000 people. […] The rate of newly reported chronic hepatitis B cases among non-Hispanic Asian/Pacific Islander (A/PI) persons (20.1 cases per 100,000 population) was 11.2 times as high as the rate among non-Hispanic White persons (1.8 cases per 100,000 population). […] In 2022, the rate of newly reported chronic hepatitis B cases among non-Hispanic A/PI persons was 11.2 times as high as among non-Hispanic White persons. […] 89% of newly reported chronic hepatitis B cases occurred in persons 30 years and older.
#65 Hepatitis B in Canada: 2021 surveillance data update – Canada.ca
https://www.canada.ca/en/public-health/services/publications/diseases-conditions/hepatitis-b-canada-2021-surveillance-data-update.html
In 2021, 3,524 cases of hepatitis B (acute, chronic and unspecified cases combined) were reported from all 13 Canadian provinces and territories for a rate of 9.2 cases per 100,000 people living in Canada. […] In 2021, a total of 114 acute hepatitis B cases were reported from nine provinces and three territories for a rate of 0.30 cases per 100,000 population. […] In 2021, the national rate of reported acute hepatitis B cases was 0.30 cases per 100,000 people living in Canada. […] In 2021, the national rate of chronic and unspecified hepatitis B was 8.9 cases per 100,000 people living in Canada.
#66 Surveillance Reports – Health Protection Surveillance Centre
https://www.hpsc.ie/a-z/hepatitis/hepatitisb/surveillancereports/
Epidemiology of Hepatitis B in Ireland, Trends up to Q1 2024 […] The Health Protection Surveillance Centre (HPSC) has published the Epidemiology of Hepatitis B in Ireland, Trends up to Q1 2024 in advance of World Hepatitis Day 2024. […] Notification data indicate that antenatal screening for hepatitis B, with appropriate care for mothers to prevent infection in infants, and universal hepatitis B vaccination as part of the primary immunisation schedule are working. There have been no notifications of hepatitis B in children under 16 born in Ireland in the past five years. […] The notification rate for acute cases (recent infections) of hepatitis B was low in Ireland in 2023, similar to EU/EEA countries in 2022. […] Most cases of hepatitis B in Ireland are chronically infected at notification: In 2023: 98% were chronic infections and 2% were acute.
#67 Surveillance Reports – Health Protection Surveillance Centre
https://www.hpsc.ie/a-z/hepatitis/hepatitisb/surveillancereports/
There was a 16% increase in notification rate (2023 v 2022) for chronic cases (11.1 per 100,000 population v 9.5 per 100,000 population). […] The higher hepatitis B notification rates in Ireland in 2022 and 2023 should be interpreted with caution. Chronic cases may have been infected for years or decades without symptoms before being detected in targeted screening programmes among groups at higher risk of infection. […] Country of birth data (available for 54% of chronic cases in 2023) show that 2% were born in Ireland, with most cases notified in persons from endemic countries with higher rates of hepatitis B infection: 37% in eastern or central Europe, 30% in sub-Saharan Africa and 26% in Asia. […] Ireland is likely to have achieved some of the WHO 2030 targets to eliminate viral hepatitis as a public health threat. More work is needed to improve monitoring of hepatitis B prevention and mitigation measures so that Ireland can demonstrate its progress to reach the goal of making hepatitis B a rare disease and no longer a public health threat.
#68 A hepatitis B-free future looms for Ghana
https://www.ghanaweb.com/GhanaHomePage/features/A-hepatitis-B-free-future-looms-for-Ghana-1982059
Viral hepatitis is a descriptive medical term for liver infection caused by hepatitis viruses of which the most significant in Ghana is hepatitis B virus. […] Ghana has had a high chronic hepatitis B burden over the years. In the 1990s, when no vaccine was routinely deployed, the burden was estimated to be 17.1% of the general population. This declined to 10.5% in 2015 after the Ministry of Health introduced routine hepatitis B-containing pentavalent vaccine for children at 6, 10 and 14 weeks of life. […] The recorded declines in disease burden are accompanied by declining death rates from the disease. This means that although more people are surviving the disease by living longer, the general picture is one of decline in disease burden. […] For a disease that can be eliminated, the current prevalence of 9.1% (that is affecting 2.8 million Ghanaians) is still high, being above 8%, which indicates persisting vertical transmission.
#69 Hepatitis B: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/177632-overview
Hepatitis B infection is a worldwide healthcare problem, especially in developing areas. The hepatitis B virus (HBV) is commonly transmitted via body fluids such as blood, semen, and vaginal secretions. […] An estimated one third of the global population is infected with the hepatitis B virus (HBV). Approximately 250-350 million people have lifelong chronic infection, with approximately 1.5 million new cases every year. […] Since the 1970s, considerable progress has also been made regarding the knowledge of the epidemiology, virology, natural history, and treatment of the hepatitis B virion, a hepatotropic virus particle. In addition, ongoing vaccination programs have been successful in many countries and territories in decreasing the prevalence of HBV disease (eg, Taiwan). […] The prevalence of HBV infection has significantly declined in individuals born in the United States.
#70 Hepatitis B Virus Epidemiology
https://pmc.ncbi.nlm.nih.gov/articles/PMC4448582/
As a result, HBV infection was ranked 15th among all causes of human mortality (Lozano et al. 2012). […] However, the burden of HBV infection is geographically disparate, dependent on the differing modes of transmission predominant in the population and the resulting age at infection, which determines the probability of progression to chronic infection. […] In addition, the epidemiology of HBV infection globally is changing because of the impact of universal infant vaccination programs (Chang et al. 1997; Liang et al. 2009; Ott et al. 2012; Zoulim and Durantel 2015), and through migration between high- and low-prevalence populations (Hahne et al. 2004; Marschall et al. 2008; Kowdley et al. 2012; MacLachlan et al. 2013).
#71 Viral Hepatitis Surveillance and Case Management – Hepatitis B | CDC
https://www.cdc.gov/hepatitis/statistics/surveillanceguidance/HepatitisB.htm
Hepatitis B is a disease caused by the hepatitis B virus (HBV) that can be self-limited for some and lifelong for others. HBV is transmitted through the blood or bodily fluids of an infected person. In the United States, injection drug use (IDU) and having multiple sexual partners are the first and second most common risk behaviors or exposures reported for acute hepatitis B, respectively. Approximately 50-70% of people with acute hepatitis B are not symptomatic, resulting in many undiagnosed and unreported infections. The epidemiology of hepatitis B in the United States has evolved since the hepatitis B vaccine first became available in 1982. National chronic hepatitis B prevalence and death rates have remained relatively stable. During January 2017-March 2020, approximately 0.2% of the non-institutionalized US population, representing approximately 660,000 people, were estimated to be living with chronic hepatitis B. The prevalence of chronic hepatitis B was highest among non-US-born people and those of Asian/Pacific Islander descent. Approximately 50% of people living with chronic hepatitis B were unaware of their infection status. Recommendations for universal adult hepatitis B screening were released by the CDC. They recommend that all adults 18 years of age be screened at least once. All pregnant women are recommended for universal hepatitis B screening, preferably during the first trimester and regardless of vaccination status or testing history, because of the risk for perinatal transmission. Without preventive interventions, chronic infection develops in approximately 90% of infected infants compared with 25%-30% of children who acquire HBV infection during 1-5 years of age and about 10% of people infected at 5 years of age. The purpose of this section is to provide guidance to jurisdictions as they implement and improve hepatitis B surveillance. It contains information regarding reporting requirements, collection of relevant laboratory data, and case investigation. The national incidence of acute hepatitis B dramatically declined after incremental recommendations for vaccinating people at-risk for infection and severe outcomes were released beginning in 1982 and for infants and children in 1991. The number of acute hepatitis B cases reported each year in the United States has remained relatively stable during 2014-2019 but decreased abruptly in 2020 and 2021. The decrease in reported cases could be due to prevention efforts as well as disruptions of the COVID-19 pandemic. IDU and having multiple sexual partners are major risk behaviors associated with acute hepatitis B in the United States, and incidence is highest among non-Hispanic White people, non-Hispanic Black people, and those 30-59 years of age. CDC has provided guidelines for hepatitis B screening among all adults 18 years of age at least once during a lifetime and pregnant women during each pregnancy. Periodic testing among susceptible people with ongoing risks for exposures is recommended while risks for exposures persist. Improving hepatitis B surveillance by improving screening is an important component of national and jurisdictional strategies for the prevention and control of hepatitis B.
#72
https://www.who.int/news-room/fact-sheets/detail/hepatitis-b
Hepatitis B is preventable with a vaccine. […] All babies should receive the hepatitis B vaccine as soon as possible after birth (within 24 hours). […] To reduce the risk of getting or spreading hepatitis B: practice safe sex by using condoms and reducing the number of sexual partners. […] WHO organizes annual World Hepatitis Day campaigns to increase awareness and understanding of viral hepatitis.
#73 A hepatitis B-free future looms for Ghana
https://www.ghanaweb.com/GhanaHomePage/features/A-hepatitis-B-free-future-looms-for-Ghana-1982059
The tool for enabling newborns to fight against the virus at birth or during the early days of life till six weeks when pentavalent vaccination is received, is the hepatitis B birth dose vaccine. […] A timely birth dose is highly protective, and when given to all newborns, it will result in a drastic reduction of vertical transmission and early childhood infection. […] From latter part of this year 2025, a future hepatitis B-free Ghana looms into view, thanks to government of Ghana and its partners, especially GAVI. […] If the public sector fails its responsibility to maximise birth dose vaccination of children born under its care, a hepatitis B-free future will become elusive and a mirage. […] A successful interplay between these sectors can ensure all facility births receive a timely birth dose. Anything else will undermine the realisation of the desired future hepatitis B-free Ghana.
#74 Epidemiology and Prevention of Hepatitis B Virus Infection
https://pmc.ncbi.nlm.nih.gov/articles/PMC1142225/
The endemicity of HBV is low in most developed areas, such as North America, Northern and Western Europe and Australia. […] Epidemiologic studies have demonstrated that there is a consistent and specific causal association between HBV infection and HCC. In patients with persistent HBV infection, the risk of HCC was 100 times higher than in non-infected individuals. The global distribution of hepatocellular carcinoma correlates with the geographic prevalence of chronic carriers of HBV, who number 400 million worldwide. […] Three main strategies are available for the prevention of HBV infection: (1) behavior modification to prevent disease transmission, (2) passive immunoprophylaxis, and (3) active immunization.
#75 Epidemiology of hepatitis B virus infection: results from a community-based study of 0.15 million residents in South China | Scientific Reports
https://www.nature.com/articles/srep36186
Overall, this study reports that the prevalence of HBsAg in the general population in the study region was 8.76%. […] In fact, the population in Guangdong province experienced a significant decline in HBsAg prevalence from 16.67% to 11.10% between 1992 and 2006, with an overall decrease of nearly 5.6%. […] To achieve the national goal of decreasing the prevalence of HBsAg of the entire population to less than 7%, free immunization for infants should be implemented strictly, and there is an emergent demand to expand vaccination to adults, including migrants and minority populations.
#76 Hepatitis B: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/177632-overview
It is estimated that there are around 60,000 new cases annually. Two million or more people in the United States have chronic HBV infection; it is estimated that foreign-born persons from high endemic areas represent more than half of the total cases. […] Globally, chronic HBV infection affects 250-350 million people, with disease prevalence varying among geographic regions, from 1-20%. […] Vaccination programs implemented in highly endemic areas seem to have reduced the prevalence of HBV infection. In Taiwan, for example, HBV seroprevalence declined from 10% in 1984 (before vaccination programs) to less than 1% in 1994 after the implementation of vaccination programs, and the incidence of HCC declined from 0.52% to 0.13% during the same period.
#77 Hepatitis B | The Australian Immunisation Handbook
https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/hepatitis-b
Hepatitis B remains the most common blood-borne viral infection in Australia. The estimated prevalence of chronic hepatitis B in 2020 was 0.9%. Populations most affected by hepatitis B within Australia are Aboriginal and Torres Strait Islander people and those born overseas. […] Since the introduction of funded universal infant hepatitis B immunisation, Australia has seen a three-fold decline in the rate of newly acquired hepatitis B notifications between 2000 and 2019. There were 4,945 notifications reported during this period (average annual rate 1.13 per 100,000 population per year). Similarly, between 2001 and 2019 annual hospitalisation rates have halved. […] The average annual notification rate was highest among young adults aged 25â29 years and lowest among young children <10 years of age. Notification rates and mortality were three-fold higher in males compared to females. Although notification rates have halved among Aboriginal and Torres Strait Islander people, both notification and hospitalisation rates remain higher than other people.
#78 Epidemiology, transmission, and prevention of hepatitis B virus infection – UpToDate
https://www.uptodate.com/contents/epidemiology-transmission-and-prevention-of-hepatitis-b-virus-infection/print
Among children less than five years of age, the prevalence of chronic HBV was 0.9 percent in 2020. The lower prevalence in children less than five years old reflects the effectiveness of the global vaccination program against hepatitis B. However, there is a need for higher vaccination coverage, in particular birth-dose HBV vaccine, to completely eliminate HBV infection among children.
#79 Surveillance Reports – Health Protection Surveillance Centre
https://www.hpsc.ie/a-z/hepatitis/hepatitisb/surveillancereports/
Notification data show that infant and childhood vaccination programmes are very successful. They are preventing infection in children, an important achievement, as those who become infected in early childhood are likely to develop chronic infection. There have been no notifications of hepatitis B in children under 16 years, who were born in Ireland, in the past five years.
#80 Epidemiology of hepatitis B virus infection: results from a community-based study of 0.15 million residents in South China | Scientific Reports
https://www.nature.com/articles/srep36186
Overall, this study reports that the prevalence of HBsAg in the general population in the study region was 8.76%. […] In fact, the population in Guangdong province experienced a significant decline in HBsAg prevalence from 16.67% to 11.10% between 1992 and 2006, with an overall decrease of nearly 5.6%. […] To achieve the national goal of decreasing the prevalence of HBsAg of the entire population to less than 7%, free immunization for infants should be implemented strictly, and there is an emergent demand to expand vaccination to adults, including migrants and minority populations.
#81 Epidemiology of hepatitis B virus infection in people living in poverty in the central-west region of Brazil | BMC Public Health | Full Text
https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-6828-8
The association between age and HBV exposure may also reflect the cumulative risk of HBV infection associated with lifelong sexual and parenteral exposure. […] The results support the need for public health policies to promote the access of hard-to-reach groups by the existing healthcare services, especially the immunisation programme against hepatitis B.
#82 A hepatitis B-free future looms for Ghana
https://www.ghanaweb.com/GhanaHomePage/features/A-hepatitis-B-free-future-looms-for-Ghana-1982059
A third challenge is to ensure that most out-of-facility births receive the timely birth dose. This requires a lot of innovation from community health officers, working together with traditional birth attendants, community volunteers, and families of the newborn. […] Ultimately, health system improvements that ensure all births are attended to at health facilities will be good for timely birth dose administration. […] The benefits of Hepatitis B vaccination significantly outweigh the risks of potential side effects.
#83 Hepatitis B Virus Epidemiology
https://pmc.ncbi.nlm.nih.gov/articles/PMC4448582/
As a result, HBV infection was ranked 15th among all causes of human mortality (Lozano et al. 2012). […] However, the burden of HBV infection is geographically disparate, dependent on the differing modes of transmission predominant in the population and the resulting age at infection, which determines the probability of progression to chronic infection. […] In addition, the epidemiology of HBV infection globally is changing because of the impact of universal infant vaccination programs (Chang et al. 1997; Liang et al. 2009; Ott et al. 2012; Zoulim and Durantel 2015), and through migration between high- and low-prevalence populations (Hahne et al. 2004; Marschall et al. 2008; Kowdley et al. 2012; MacLachlan et al. 2013).
#84 Hepatitis B: Screening, Prevention, Diagnosis, and Treatment | AAFP
https://www.aafp.org/pubs/afp/issues/2019/0301/p314.html
Chronic hepatitis B accounts for approximately one-half of all HCC cases.23 Recent guidelines recommend screening for HCC every six months with abdominal ultrasonography and alpha fetoprotein testing.24 If ultrasound findings are abnormal, then computed tomography or magnetic resonance imaging of the liver is recommended.23 Treatment does not eliminate the risk of HCC; therefore, surveillance for HCC should continue.2
#85 Hepatitis B: Screening, Prevention, Diagnosis, and Treatment | AAFP
https://www.aafp.org/pubs/afp/issues/2019/0301/p314.html
Chronic hepatitis B accounts for approximately one-half of all HCC cases.23 Recent guidelines recommend screening for HCC every six months with abdominal ultrasonography and alpha fetoprotein testing.24 If ultrasound findings are abnormal, then computed tomography or magnetic resonance imaging of the liver is recommended.23 Treatment does not eliminate the risk of HCC; therefore, surveillance for HCC should continue.2
#86 Epidemiology and Prevention of Hepatitis B Virus Infection
https://pmc.ncbi.nlm.nih.gov/articles/PMC1142225/
The endemicity of HBV is low in most developed areas, such as North America, Northern and Western Europe and Australia. […] Epidemiologic studies have demonstrated that there is a consistent and specific causal association between HBV infection and HCC. In patients with persistent HBV infection, the risk of HCC was 100 times higher than in non-infected individuals. The global distribution of hepatocellular carcinoma correlates with the geographic prevalence of chronic carriers of HBV, who number 400 million worldwide. […] Three main strategies are available for the prevention of HBV infection: (1) behavior modification to prevent disease transmission, (2) passive immunoprophylaxis, and (3) active immunization.
#87 Hepatitis B: Screening, Prevention, Diagnosis, and Treatment | AAFP
https://www.aafp.org/pubs/afp/issues/2019/0301/p314.html
Chronic hepatitis B accounts for approximately one-half of all HCC cases.23 Recent guidelines recommend screening for HCC every six months with abdominal ultrasonography and alpha fetoprotein testing.24 If ultrasound findings are abnormal, then computed tomography or magnetic resonance imaging of the liver is recommended.23 Treatment does not eliminate the risk of HCC; therefore, surveillance for HCC should continue.2
#88 Hepatitis B: Screening, Prevention, Diagnosis, and Treatment | AAFP
https://www.aafp.org/pubs/afp/issues/2019/0301/p314.html
Chronic hepatitis B accounts for approximately one-half of all HCC cases.23 Recent guidelines recommend screening for HCC every six months with abdominal ultrasonography and alpha fetoprotein testing.24 If ultrasound findings are abnormal, then computed tomography or magnetic resonance imaging of the liver is recommended.23 Treatment does not eliminate the risk of HCC; therefore, surveillance for HCC should continue.2
#89 Hepatitis B: Screening, Prevention, Diagnosis, and Treatment | AAFP
https://www.aafp.org/pubs/afp/issues/2019/0301/p314.html
Chronic hepatitis B accounts for approximately one-half of all HCC cases.23 Recent guidelines recommend screening for HCC every six months with abdominal ultrasonography and alpha fetoprotein testing.24 If ultrasound findings are abnormal, then computed tomography or magnetic resonance imaging of the liver is recommended.23 Treatment does not eliminate the risk of HCC; therefore, surveillance for HCC should continue.2
#90 Hepatitis B: Diagnosis and Treatment | AAFP
https://www.aafp.org/pubs/afp/issues/2010/0415/p965.html
The Centers for Disease Control and Prevention recommends routine HBV screening in populations in which HBsAg prevalence is at least 2 percent, including immigrants from these regions. […] Hepatitis B vaccination and hepatitis B immune globulin are effective at preventing HBV infection in newborns of mothers infected with HBV. […] All persons who meet criteria for chronic HBV infection should be evaluated for treatment. […] Patients in the active phase of chronic HBV infection should receive treatment. […] Hepatocellular carcinoma surveillance in patients with chronic HBV infection is often performed every six to 12 months using -fetoprotein levels and abdominal ultrasonography; however, a Cochrane review found insufficient evidence to demonstrate that hepatocellular carcinoma surveillance improves survival. […] A randomized trial of 18,816 persons with chronic HBV infection found a mortality reduction of 37 percent at one year in those screened versus those not screened.
#91
https://www.who.int/news-room/fact-sheets/detail/hepatitis-b
Hepatitis B infection acquired in adulthood leads to chronic hepatitis in less than 5% of cases, whereas infection in infancy and early childhood leads to chronic hepatitis in about 95% of cases. […] As of 2022, 13% of all people estimated to be living with hepatitis B were aware of their infection, while 3% (7 million) of the people living with chronic hepatitis B were on treatment. […] WHO recommends that all blood donations be tested for hepatitis B to ensure blood safety and avoid accidental transmission. […] Chronic hepatitis B infection can be treated with oral medicines, including tenofovir or entecavir. […] With the updated Hepatitis B Guidelines, it is estimated that more than 50% of people with chronic hepatitis B infection will require treatment, depending on setting and eligibility criteria.
#92
https://www.who.int/news-room/fact-sheets/detail/hepatitis-b
Hepatitis B infection acquired in adulthood leads to chronic hepatitis in less than 5% of cases, whereas infection in infancy and early childhood leads to chronic hepatitis in about 95% of cases. […] As of 2022, 13% of all people estimated to be living with hepatitis B were aware of their infection, while 3% (7 million) of the people living with chronic hepatitis B were on treatment. […] WHO recommends that all blood donations be tested for hepatitis B to ensure blood safety and avoid accidental transmission. […] Chronic hepatitis B infection can be treated with oral medicines, including tenofovir or entecavir. […] With the updated Hepatitis B Guidelines, it is estimated that more than 50% of people with chronic hepatitis B infection will require treatment, depending on setting and eligibility criteria.
#93
https://www.who.int/news-room/fact-sheets/detail/hepatitis-b
Hepatitis B infection acquired in adulthood leads to chronic hepatitis in less than 5% of cases, whereas infection in infancy and early childhood leads to chronic hepatitis in about 95% of cases. […] As of 2022, 13% of all people estimated to be living with hepatitis B were aware of their infection, while 3% (7 million) of the people living with chronic hepatitis B were on treatment. […] WHO recommends that all blood donations be tested for hepatitis B to ensure blood safety and avoid accidental transmission. […] Chronic hepatitis B infection can be treated with oral medicines, including tenofovir or entecavir. […] With the updated Hepatitis B Guidelines, it is estimated that more than 50% of people with chronic hepatitis B infection will require treatment, depending on setting and eligibility criteria.
#94 Chronic hepatitis B Whatâs new?
https://www.racgp.org.au/afp/2013/july/chronic-hepatitis-b
With recent developments in clinical and public health approaches, recognition of the need to address chronic hepatitis B has gained urgency, with current estimates suggesting that approximately 218 000 Australians are living with the disease, and that liver cancer is now the fastest increasing cause of cancer death in the country. […] It is estimated that nearly half of all Australians living with CHB remain undiagnosed; this facilitates poor outcomes in those infected and ongoing transmission to susceptible contacts. […] Chronic hepatitis B is a leading cause of hepatocellular carcinoma in Australia. […] Research from Australia and overseas indicate that those whose liver cancer is detected through screening have significantly improved survival, and that in combination with appropriate treatment for CHB, HCC surveillance is cost effective as a cancer prevention intervention.
#95 Epidemiology of Hepatitis B Virus Infection | IntechOpen
https://www.intechopen.com/online-first/1207206
The best way to reduce the prevalence of HBV infection is by vaccination and routine infant vaccination, which has been the main approach in nations in eastern Europe. […] The hepatitis B vaccine has now been available for over 30 years, being a very effective tool for preventing infections among the population. […] In developing countries, HBV incidence is medium to high, even if the number of chronic HBV carriers has decreased since the introduction of the vaccine in the 1990s. […] In the sub-Saharan region of Africa, the endemicity of HBV infection exceeds 8% of the general population. […] The WHO Global Hepatitis Strategy, endorsed by all WHO Member States, aims to reduce new hepatitis infections by 90% and deaths by 65% between 2016 and 2030.
#96 BBV STI surveillance and research programme: surveillance for hepatitis B indicators | Doherty Website
https://www.doherty.edu.au/viralhepatitis/centre-activities/bbv-sti-surveillance-and-research-programme-surveillance-for-hepatitis-b-indicators
A key aspect of Australias National Hepatitis B Strategy is the identification of specific measurable aims and targets, including increasing the proportion of people living with chronic hepatitis B (CHB) who have been diagnosed, increasing treatment uptake in those affected, and reducing the burden of attributable morbidity and mortality associated with the disease. The Surveillance for Hepatitis B Indicators project tracks progress towards these targets. […] To develop disease burden estimation and mathematical modelling approaches to inform the surveillance, monitoring and evaluation of progress towards achieving the objectives of the Second National Hepatitis B Strategy, reporting against Hepatitis B Indicators in the National Blood-borne Viruses and Sexually Transmissible Infections Surveillance and Monitoring Plan.
#97 BBV STI surveillance and research programme: surveillance for hepatitis B indicators | Doherty Website
https://www.doherty.edu.au/viralhepatitis/centre-activities/bbv-sti-surveillance-and-research-programme-surveillance-for-hepatitis-b-indicators
A key aspect of Australias National Hepatitis B Strategy is the identification of specific measurable aims and targets, including increasing the proportion of people living with chronic hepatitis B (CHB) who have been diagnosed, increasing treatment uptake in those affected, and reducing the burden of attributable morbidity and mortality associated with the disease. The Surveillance for Hepatitis B Indicators project tracks progress towards these targets. […] To develop disease burden estimation and mathematical modelling approaches to inform the surveillance, monitoring and evaluation of progress towards achieving the objectives of the Second National Hepatitis B Strategy, reporting against Hepatitis B Indicators in the National Blood-borne Viruses and Sexually Transmissible Infections Surveillance and Monitoring Plan.
#98 BBV STI surveillance and research programme: surveillance for hepatitis B indicators | Doherty Website
https://www.doherty.edu.au/viralhepatitis/centre-activities/bbv-sti-surveillance-and-research-programme-surveillance-for-hepatitis-b-indicators
A key aspect of Australias National Hepatitis B Strategy is the identification of specific measurable aims and targets, including increasing the proportion of people living with chronic hepatitis B (CHB) who have been diagnosed, increasing treatment uptake in those affected, and reducing the burden of attributable morbidity and mortality associated with the disease. The Surveillance for Hepatitis B Indicators project tracks progress towards these targets. […] To develop disease burden estimation and mathematical modelling approaches to inform the surveillance, monitoring and evaluation of progress towards achieving the objectives of the Second National Hepatitis B Strategy, reporting against Hepatitis B Indicators in the National Blood-borne Viruses and Sexually Transmissible Infections Surveillance and Monitoring Plan.
#99 Epidemiology, transmission, and prevention of hepatitis B virus infection – UpToDate
https://www.uptodate.com/contents/epidemiology-transmission-and-prevention-of-hepatitis-b-virus-infection/print
Among children less than five years of age, the prevalence of chronic HBV was 0.9 percent in 2020. The lower prevalence in children less than five years old reflects the effectiveness of the global vaccination program against hepatitis B. However, there is a need for higher vaccination coverage, in particular birth-dose HBV vaccine, to completely eliminate HBV infection among children.
#100 Epidemiology of hepatitis B virus infection: results from a community-based study of 0.15 million residents in South China | Scientific Reports
https://www.nature.com/articles/srep36186
Overall, this study reports that the prevalence of HBsAg in the general population in the study region was 8.76%. […] In fact, the population in Guangdong province experienced a significant decline in HBsAg prevalence from 16.67% to 11.10% between 1992 and 2006, with an overall decrease of nearly 5.6%. […] To achieve the national goal of decreasing the prevalence of HBsAg of the entire population to less than 7%, free immunization for infants should be implemented strictly, and there is an emergent demand to expand vaccination to adults, including migrants and minority populations.
#101 Core Concepts – HBV Epidemiology – Screening and Diagnosis – Hepatitis B Online
https://www.hepatitisb.uw.edu/go/screening-diagnosis/hbv-epidemiology/core-concept/all
Overall, available data suggest that a minority of persons living with chronic HBV are aware of their HBV infection status. […] In 2022, the World Health Organization (WHO) estimated that approximately 254 million people, or 3.3% of the global population, are living with chronic hepatitis B infection. […] Among the six WHO global regions, the Western Pacific and Africa regions have the highest prevalence of chronic HBV infection, followed sequentially by the Southeast Asia region, Eastern Mediterranean region, European region, and region of the Americas. […] In the United States, from 2012-2019, approximately 20,000 new HBV infections occurred each year, with a decline to 14,000 in 2020. Higher rates of acute HBV infection were reported in men than women and in persons 30 to 49 years of age.
#102 Hepatitis B Foundation raises alarm about findings from new federal viral hepatitis surveillance report » Hepatitis B Foundation
https://www.hepb.org/news-and-events/news-2/hepatitis-b-foundation-raises-alarm-about-findings-from-new-federal-viral-hepatitis-surveillance-report/
A new CDC report shows major COVID-related disruptions in hepatitis B testing and significant health equity concerns about the virus impact on the Asian American/Pacific Islander community. […] The CDC report shows an estimated 14,000 new acute hepatitis B cases in 2020, a dramatic 32 percent decrease from 2019. […] This drop in acute hepatitis B cases in 2020 is unfortunately not a sign of progress toward reducing new cases, but instead is an alarm bell to find and help those individuals not being tested, said Hepatitis B Foundation President Chari A. Cohen, DrPH, MPH. […] The report found the highest number of new acute cases of hepatitis B were among non-Hispanic White and Black adults, and persons aged 30-59. […] The CDC reported a total of 11,600 newly identified cases of chronic hepatitis B in 2020, with alarming rates among Asian Americans and Pacific Islanders of more than 12 times those of non-Hispanic White adults.
#103 Using a hepatitis B surveillance system evaluation in Fujian, Hainan, and Gansu provinces to improve data quality and assess program effectiveness, China, 2015 | BMC Infectious Diseases | Full Text
https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-020-05265-3
Monitoring hepatitis B surveillance data is important for evaluating progress towards global hepatitis B elimination goals. Accurate classification of acute and chronic hepatitis infections is essential for assessing program effectiveness. […] We identified discrepancies in the accuracy of HBV case-reporting in the project hospitals. Onsite training on the use of anti-HBc IgM testing as well as on HBV case definitions and reporting procedures are needed to accurately assess program effectiveness and ensure case-patients are referred to appropriate treatment and care. Routine surveillance evaluations such as this can be useful for improving data quality and monitoring program effectiveness. […] Our evaluation identified discrepancies in the classification of HBV cases reported to NNDRSonly 60% of chronic HBV cases and 7% of acute HBV cases were reported correctly to NNDRS. Most misclassifications involved patients with chronic HBV or HBV carriers or patients without the required diagnostic information who were reported as having an acute infection. Misclassification varied by province, hospital grade, and ward type. Additionally, only a few patients received anti-HBc IgM laboratory tests for differentiating acute and chronic infections as recommended. These discrepancies can be addressed through training, possible revisions to reporting procedures, and development of feedback mechanisms to hospital staff. Our project highlights the importance of routine surveillance evaluations for assessing data quality and monitoring program effectiveness. […] Our findings support the use of similar evaluations in other locations as a possible complement to resource-intensive HBV sero-surveys.
#104 Hepatitis B Virus Epidemiology
https://pmc.ncbi.nlm.nih.gov/articles/PMC4448582/
The epidemiology of hepatitis B virus (HBV) infection is geographically diverse, with population prevalence, age and mode of acquisition, and likelihood of progression to chronic infection mutually interdependent. […] The burden of chronic HBV infection is increasingly being recognized, with cirrhosis and liver cancer attributable to HBV continuing to increase. […] The outcomes of chronic HBV infection are affected by a range of factors, including viral genotype, the presence of coinfections with other blood-borne viruses, and the impact of other causes of liver disease. […] The increased recognition of HBV infection as a leading cause of death globally has resulted in the development of new structures and policies at the international level; immediate attention to implementing these strategies is now required.
#105 Surveillance Reports – Health Protection Surveillance Centre
https://www.hpsc.ie/a-z/hepatitis/hepatitisb/surveillancereports/
There was a 16% increase in notification rate (2023 v 2022) for chronic cases (11.1 per 100,000 population v 9.5 per 100,000 population). […] The higher hepatitis B notification rates in Ireland in 2022 and 2023 should be interpreted with caution. Chronic cases may have been infected for years or decades without symptoms before being detected in targeted screening programmes among groups at higher risk of infection. […] Country of birth data (available for 54% of chronic cases in 2023) show that 2% were born in Ireland, with most cases notified in persons from endemic countries with higher rates of hepatitis B infection: 37% in eastern or central Europe, 30% in sub-Saharan Africa and 26% in Asia. […] Ireland is likely to have achieved some of the WHO 2030 targets to eliminate viral hepatitis as a public health threat. More work is needed to improve monitoring of hepatitis B prevention and mitigation measures so that Ireland can demonstrate its progress to reach the goal of making hepatitis B a rare disease and no longer a public health threat.
#106 Hepatitis Surveillance and Reporting
https://www.health.ny.gov/diseases/communicable/hepatitis/surveillance.htm
Surveillance is the ongoing and systematic collection, analysis, and interpretation of health data for the purposes of planning, implementing and evaluating public health programs. The goals of viral hepatitis surveillance are to measure the burden of disease; determine risk factors; identify outbreaks; monitor trends; evaluate control measures, interventions and programs; and identify infected persons for medical referral, education and counseling. […] Annual reports on the number of cases and rates per 100,000 population of hepatitis A, hepatitis B and hepatitis C by county and by age group can be found at Communicable Disease Annual Reports. […] New York State Department of Health Communicable Disease Reporting Requirements (PDF) […] Centers for Disease Control and Prevention Screening and Testing Recommendations for Chronic Hepatitis B Virus Infection) […] Centers for Disease Control and Prevention Testing Recommendations for Hepatitis C Virus Infection […] Laboratory Reporting Guidelines 2020, New York State Department of Health (PDF)
#107 Epidemiology of hepatitis B virus infection in people living in poverty in the central-west region of Brazil | BMC Public Health | Full Text
https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-6828-8
The association between age and HBV exposure may also reflect the cumulative risk of HBV infection associated with lifelong sexual and parenteral exposure. […] The results support the need for public health policies to promote the access of hard-to-reach groups by the existing healthcare services, especially the immunisation programme against hepatitis B.
#108 Data & Statistics
https://www.michigan.gov/mdhhs/keep-mi-healthy/chronicdiseases/hepatitis/data-and-statistics
Annual report detailing yearly hepatitis statistics. Within the report is information on hepatitis B and C infection by age, gender and race, the risk behaviors associated with hepatitis B and C infection, and hepatitis coinfection with HIV in Michigan. […] This quarterly report is designed to inform local health departments of Hepatitis C Virus (HCV) cases reported to the Michigan Disease Surveillance System (MDSS) that may be related to injection drug use. These cases include all acute HCV cases and chronic HCV cases among persons aged 18 to 29. Also included are the number of ED visits related to injection drug use that were reported to the Michigan Syndromic Surveillance System (MSSS). The purpose of the report is to highlight areas where transmission of HCV may be occurring among people who inject drugs. The goal is that, when warranted, this information will lead to more timely and effective public health intervention.
#109 Hepatitis Surveillance and Reporting
https://www.health.ny.gov/diseases/communicable/hepatitis/surveillance.htm
Surveillance is the ongoing and systematic collection, analysis, and interpretation of health data for the purposes of planning, implementing and evaluating public health programs. The goals of viral hepatitis surveillance are to measure the burden of disease; determine risk factors; identify outbreaks; monitor trends; evaluate control measures, interventions and programs; and identify infected persons for medical referral, education and counseling. […] Annual reports on the number of cases and rates per 100,000 population of hepatitis A, hepatitis B and hepatitis C by county and by age group can be found at Communicable Disease Annual Reports. […] New York State Department of Health Communicable Disease Reporting Requirements (PDF) […] Centers for Disease Control and Prevention Screening and Testing Recommendations for Chronic Hepatitis B Virus Infection) […] Centers for Disease Control and Prevention Testing Recommendations for Hepatitis C Virus Infection […] Laboratory Reporting Guidelines 2020, New York State Department of Health (PDF)
#110 BBV STI surveillance and research programme: surveillance for hepatitis B indicators | Doherty Website
https://www.doherty.edu.au/viralhepatitis/centre-activities/bbv-sti-surveillance-and-research-programme-surveillance-for-hepatitis-b-indicators
Proposed tasks include: Number of people living with chronic hepatitis B in Australia, Proportion of people living with chronic hepatitis B in Australia who have been diagnosed, Proportion of people living with chronic hepatitis B who are dispensed drugs for the treatment of hepatitis B through the Pharmaceutical Benefits Scheme, Burden of disease attributable to chronic hepatitis B in Australia. […] Indicator data estimate outputs will be incorporated into The Kirby Institute Annual Surveillance Report and the National Viral Hepatitis Mapping Project Reports, along with supporting interpretive and methodological information.
#111 Hepatitis Reports – NYC Health
https://www.nyc.gov/site/doh/data/data-publications/hepatitis-abc-surveillance-data.page
These reports feature hepatitis A, B and C surveillance data and summaries of viral hepatitis programs and services delivered in NYC for the calendar year, or most recent available data. […] Appendices describe newly reported cases of hepatitis A, B, and C; people with hepatitis A, B, and C; and deaths among people with hepatitis B and C for NYC overall and by sex, gender, race and ethnicity, age, borough, transmission category, and neighborhood. […] The Hepatitis B Vaccine Birth Dose Coverage Annual Report uses Health Department data to show the performance of delivery facilities. […] The goal of these reports is to achieve a hepatitis B birth dose coverage rate of 90% or greater. […] The Hepatitis C Hospital Dashboards use Health Department surveillance data to show the performance of hospitals and health care facilities that provide hepatitis C care to NYC residents. […] The goal of these dashboards is to improve hepatitis C care and treatment in NYC.
#112 Core Concepts – HBV Epidemiology – Screening and Diagnosis – Hepatitis B Online
https://www.hepatitisb.uw.edu/go/screening-diagnosis/hbv-epidemiology/core-concept/all
Injection-drug use and sexual exposure are the major risk factors for HBV acquisition in the United States, with injection-drug use playing an increasingly important role in transmission as a result of the ongoing opioid epidemic. […] The CDC has established uniform case definitions for acute HBV, chronic HBV, and HBV perinatal infection to assist with public health reporting. […] In the United States, in 2020, there were 1,752 deaths with HBV listed as the cause of death, corresponding to a mortality rate of 0.45 HBV-related deaths per 100,000 population.
#113 Using a hepatitis B surveillance system evaluation in Fujian, Hainan, and Gansu provinces to improve data quality and assess program effectiveness, China, 2015 | BMC Infectious Diseases | Full Text
https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-020-05265-3
Monitoring hepatitis B surveillance data is important for evaluating progress towards global hepatitis B elimination goals. Accurate classification of acute and chronic hepatitis infections is essential for assessing program effectiveness. […] We identified discrepancies in the accuracy of HBV case-reporting in the project hospitals. Onsite training on the use of anti-HBc IgM testing as well as on HBV case definitions and reporting procedures are needed to accurately assess program effectiveness and ensure case-patients are referred to appropriate treatment and care. Routine surveillance evaluations such as this can be useful for improving data quality and monitoring program effectiveness. […] Our evaluation identified discrepancies in the classification of HBV cases reported to NNDRSonly 60% of chronic HBV cases and 7% of acute HBV cases were reported correctly to NNDRS. Most misclassifications involved patients with chronic HBV or HBV carriers or patients without the required diagnostic information who were reported as having an acute infection. Misclassification varied by province, hospital grade, and ward type. Additionally, only a few patients received anti-HBc IgM laboratory tests for differentiating acute and chronic infections as recommended. These discrepancies can be addressed through training, possible revisions to reporting procedures, and development of feedback mechanisms to hospital staff. Our project highlights the importance of routine surveillance evaluations for assessing data quality and monitoring program effectiveness. […] Our findings support the use of similar evaluations in other locations as a possible complement to resource-intensive HBV sero-surveys.
#114 Accuracy of hepatitis B disease surveillance, Gannan prefecture, Gansu province, China; 2017 | PLOS One
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0274798
There are concerns about the accuracy of hepatitis B cases reported to NNDRS. For example, an eight-province study in China by Wang and colleagues found that only 35% of cases reported as acute hepatitis B (AHB) in 2007 were able to be verified by chart review as actual AHB cases. […] Our study showed that the actual incidence of hepatitis B in Gannan prefecture in 2016 was substantially lower than the incidence reported by Gansu province. […] The falsely high incidence of hepatitis B in Gannan was due to diagnostic and reporting inaccuracies. The survey concluded that many clinicians in Gannan do not have a clear understanding of the diagnostic and reporting criteria of hepatitis B. Training for medical personnel on the diagnostic criteria and reporting standards of hepatitis B is needed to improve the ability to accurately diagnose and report hepatitis B. Surveillance reports should be routinely reviewed by public health staff.
#115 HIV, hepatitis and STIs in Australia | Data @ Kirby Institute
https://www.data.kirby.unsw.edu.au/
The Kirby Institute collates national data for HIV, viral hepatitis, and sexually transmissible infections in Australia from many sources. These data are used as a reference for organisations and individuals interested in the occurrence and epidemiology of these infectious diseases in Australia. […] The ongoing substantial contribution to national surveillance for HIV, viral hepatitis and sexually transmissible infections by the organisations listed in the Acknowledgements, is gratefully acknowledged.
#116 Epidemiology of hepatitis B virus infection in people living in poverty in the central-west region of Brazil | BMC Public Health | Full Text
https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-6828-8
The association between age and HBV exposure may also reflect the cumulative risk of HBV infection associated with lifelong sexual and parenteral exposure. […] The results support the need for public health policies to promote the access of hard-to-reach groups by the existing healthcare services, especially the immunisation programme against hepatitis B.
#117 Using a hepatitis B surveillance system evaluation in Fujian, Hainan, and Gansu provinces to improve data quality and assess program effectiveness, China, 2015 | BMC Infectious Diseases | Full Text
https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-020-05265-3
Monitoring hepatitis B surveillance data is important for evaluating progress towards global hepatitis B elimination goals. Accurate classification of acute and chronic hepatitis infections is essential for assessing program effectiveness. […] We identified discrepancies in the accuracy of HBV case-reporting in the project hospitals. Onsite training on the use of anti-HBc IgM testing as well as on HBV case definitions and reporting procedures are needed to accurately assess program effectiveness and ensure case-patients are referred to appropriate treatment and care. Routine surveillance evaluations such as this can be useful for improving data quality and monitoring program effectiveness. […] Our evaluation identified discrepancies in the classification of HBV cases reported to NNDRSonly 60% of chronic HBV cases and 7% of acute HBV cases were reported correctly to NNDRS. Most misclassifications involved patients with chronic HBV or HBV carriers or patients without the required diagnostic information who were reported as having an acute infection. Misclassification varied by province, hospital grade, and ward type. Additionally, only a few patients received anti-HBc IgM laboratory tests for differentiating acute and chronic infections as recommended. These discrepancies can be addressed through training, possible revisions to reporting procedures, and development of feedback mechanisms to hospital staff. Our project highlights the importance of routine surveillance evaluations for assessing data quality and monitoring program effectiveness. […] Our findings support the use of similar evaluations in other locations as a possible complement to resource-intensive HBV sero-surveys.