Chronic hepatitis B on the rise in Europe as acute cases decline

While most countries in the European Union and the European Economic Area have reported a decline in acute hepatitis B rates over the last decade, reports showed an increase in physicians discovering cases of chronic hepatitis B, according to data published by the European Center for Disease Prevention and Control.

Among the countries consistently reporting, acute HBV infections decreased from 1.1 per 100,000 persons in 2008 to 0.6 in 2017. In contrast, chronic HBV reports increased from 6.7 per 100,000 persons to 10.2 in the same period. These data reflect that 58% of newly reported HBV cases in 2017 were chronic in nature.

According to the investigators of the report, the decrease in acute HBV and increase in chronic HBV may be related to improved national vaccination and testing programs.

Countries with comprehensive testing programs had some of the highest notification rates of chronic HBV. Additionally, most of those with newly discovered chronic HBV were aged between 25 years and 34 years, whereas people aged less than 25 years with acute HBV decreased from 20% in 2008 to 12% in 2017.

Investigators of the report stated that information on transmission mode was “only complete for roughly a third of the reported acute cases in 2017 and only 13% of the notified chronic cases.”

From what was gathered, heterosexual transmission was most commonly reported for acute cases (27%), followed by nosocomial transmission (16%), sex between men (13%), non-occupational injuries (10%) and injection drug use (10%). Most health care-associated HBV infections in 2017 occurred in Italy, Poland and Romania (74%).

The most common routes for chronic HBV were health care-associated (28%) and mother-to-child transmissions (41%).

Finally, the investigators noted that 31% of HBV cases with information available were imported, therefore highlighting the “need for countries to develop evidence-based screening interventions that target the most affected migrant communities.”

The ECDC announced the launch of a monitoring framework to support EU and European Economic Area countries to implement HBV and hepatitis C control programs. The system will provide a comprehensive overview of the progress toward hepatitis elimination and allow for a “clearer picture of the actual burden of the disease.” – by Talitha Bennett

Reference: www.ecdc.europa.eu