The prevalence of hepatitis B infection in adults in England 
and Wales

Cost effectiveness analyses of alternative hepatitis B vaccination programmes in England and Wales require a robust estimate of the lifetime risk of carriage. To this end, we report the prevalence of infection in 3781 anonymized individuals aged 15–44 years whose sera were submitted in 1996 to 16 microbiology laboratories in England and Wales. One hundred and forty-six individuals (3·9%) were confirmed as anti HBc positive, including 14 chronic carriers (0·37%). The prevalence of infection and carriage was higher in samples collected in London and increased with age. No increased risk of infection was seen in sera from genito-urinary (GUM) clinics. Only 15 sera positive for hepatitis B were also positive for hepatitis C. Our results confirm the low prevalence of hepatitis B in England and Wales, are consistent with previous estimates of carriage and suggest that many infections were acquired while resident outside the UK. Future prevalence studies should determine the country of birth and other risk factors for each individual in order to confirm these findings.

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Modelling the hepatitis B vaccination programme in prisons

Epidemiology and Infection ◽

10.1017/s0950268805005182 ◽

2005 ◽

Vol 134 (2) ◽

pp. 231-242 ◽

Cited By ~ 15

Author(s):

A. J. SUTTON ◽

N. J. GAY ◽

W. J. EDMUNDS ◽

N. J. ANDREWS ◽

V. D. HOPE ◽

...

Keyword(s):

Hepatitis B ◽

Vaccination Coverage ◽

Vaccination Programme ◽

Drug Users ◽

Hepatitis B Vaccination ◽

England And Wales ◽

Hbv Vaccine ◽

Hbv Vaccination ◽

Increased Risk ◽

Potential Impact

A vaccination programme offering hepatitis B (HBV) vaccine at reception into prison has been introduced into selected prisons in England and Wales. Over the coming years it is anticipated this vaccination programme will be extended. A model has been developed to assess the potential impact of the programme on the vaccination coverage of prisoners, ex-prisoners, and injecting drug users (IDUs). Under a range of coverage scenarios, the model predicts the change over time in the vaccination status of new entrants to prison, current prisoners and IDUs in the community. The model predicts that at baseline in 2012 57% of the IDU population will be vaccinated with up to 72% being vaccinated depending on the vaccination scenario implemented. These results are sensitive to the size of the IDU population in England and Wales and the average time served by an IDU during each prison visit. IDUs that do not receive HBV vaccine in the community are at increased risk from HBV infection. The HBV vaccination programme in prisons is an effective way of vaccinating this hard-to-reach population although vaccination coverage on prison reception must be increased to achieve this.

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Ruxolitinib-Associated Infections in Polycythemia Vera: Review of the Literature, Clinical Significance, and Recommendations

Cancers ◽

10.3390/cancers12113132 ◽

2020 ◽

Vol 12 (11) ◽

pp. 3132

Author(s):

Parvis Sadjadian ◽

Kai Wille ◽

Martin Griesshammer

Keyword(s):

Hepatitis B ◽

Polycythemia Vera ◽

Clinical Significance ◽

Myeloproliferative Neoplasms ◽

Normal Population ◽

Secondary Prophylaxis ◽

Risk Of Infection ◽

Mycobacterium Tuberculosis Infection ◽

Varicella Zoster ◽

Increased Risk

Ruxolitinib (RUX), a JAK1/JAK2 inhibitor, is approved for second-line therapy in patients with polycythemia vera (PV) who are resistant or intolerant to hydroxyurea. Due to the immunomodulatory and immunosuppressive effect of RUX, there is an increased susceptibility to infections. However, an increased risk of infection is inherent to even untreated myeloproliferative neoplasms (MPN). To obtain more information on the clinical significance of RUX-associated infections in PV, we reviewed the available literature. There is no evidence-based approach to managing infection risks. Most data on RUX-associated infections are available for MF. In all studies, the infection rates in the RUX and control groups were fairly similar, with the exception of infections with the varicella zoster virus (VZV). However, individual cases of bilateral toxoplasmosis retinitis, disseminated molluscum contagiosum, or a mycobacterium tuberculosis infection or a hepatitis B reactivation are reported. A careful assessment of the risk of infection for PV patients is required at the initial presentation and before the start of RUX. Screening for hepatitis B is recommended in all patients. The risk of RUX-associated infections is lower with PV than with MF, but compared to a normal population there is an increased risk of VZV infection. However, primary VZV prophylaxis for PV patients is not recommended, while secondary prophylaxis can be considered individually. As early treatment is most effective for VZV, patients should be properly informed and trained to seek medical advice immediately if cutaneous signs of VZV develop. Vaccination against influenza, herpes zoster, and pneumococci should be considered in all PV patients at risk of infection, especially if RUX treatment is planned. Current recommendations do not support adjusting or discontinuing JAK inhibition in MPN patients to reduce the risk of COVID-19.

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High coverage of hepatitis B vaccination and low prevalence of chronic hepatitis B in migrant children dictate a new catch-up vaccination strategy

Vaccine ◽

10.1016/j.vaccine.2018.06.010 ◽

2018 ◽

Vol 36 (30) ◽

pp. 4501-4506 ◽

Cited By ~ 1

Author(s):

Yves Fougère ◽

Samir El Houss ◽

Joan-Carles Suris ◽

Sylvie Rouvenaz-Defago ◽

Damien Miletto ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis B ◽

Chronic Hepatitis B ◽

Vaccination Strategy ◽

Migrant Children ◽

Hepatitis B Vaccination ◽

High Coverage ◽

Catch Up ◽

Low Prevalence

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Does ethnic diversity explain intra-UK variation in mortality? A longitudinal cohort study

BMJ Open ◽

10.1136/bmjopen-2018-024563 ◽

2019 ◽

Vol 9 (3) ◽

pp. e024563

Author(s):

Lauren Schofield ◽

David Walsh ◽

Zhiqiang Feng ◽

Duncan Buchanan ◽

Chris Dibben ◽

...

Keyword(s):

Longitudinal Study ◽

Ethnic Diversity ◽

Policy Implications ◽

Country Of Birth ◽

England And Wales ◽

All Cause Mortality ◽

Mortality Incidence ◽

And Migration ◽

The Uk

ObjectivesIt has been proposed that part of the explanation for higher mortality in Scotland compared with England and Wales, and Glasgow compared with other UK cities, relates to greater ethnic diversity in England and Wales. We sought to assess the extent to which this excess was attenuated by adjusting for ethnicity. We additionally explored the role of country of birth in any observed differences.SettingScotland and England and Wales; Glasgow and Manchester.ParticipantsWe used the Scottish Longitudinal Study and the Office for National Statistics Longitudinal Study of England and Wales (2001–2010). Participants (362 491 in total) were aged 35–74 years at baseline.Primary outcome measuresRisk of all-cause mortality between 35 and 74 years old in Scotland and England and Wales, and in Glasgow and Manchester, adjusting for age, gender, socioeconomic position (SEP), ethnicity and country of birth.Results18% of the Manchester sample was non-White compared with 3% in Glasgow (England and Wales: 10.4%; Scotland: 1.2%). The mortality incidence rate ratio was 1.33 (95% CI 1.13 to 1.56) in Glasgow compared with Manchester. This reduced to 1.25 (1.07 to 1.47) adjusting for SEP, and to 1.20 (1.02 to 1.42) adjusting for ethnicity and country of birth. For Scotland versus England and Wales, the corresponding figures were 18% higher mortality, reducing to 10%, and then 7%. Non-Whites born outside the UK had lower mortality. In the Scottish samples only, non-Whites born in the UK had significantly higher mortality than Whites born in the UK.ConclusionsThe research supports the hypothesis that ethnic diversity and migration from outside UK play a role in explaining Scottish excess mortality. In Glasgow especially, however, a large excess remains: thus, previously articulated policy implications (addressing poverty, vulnerability and inequality) still apply.

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The Prevalence of Hepatitis B Infection in Adults with no Recognized Increased Risk of Infection

Journal of Infection ◽

10.1053/jinf.2000.0722 ◽

2000 ◽

Vol 41 (2) ◽

pp. 198-199 ◽

Cited By ~ 7

Author(s):

K. Soldan ◽

N.J. Gay ◽

J.P. Allain ◽

C. Llewelyn ◽

C. Jones ◽

...

Keyword(s):

Hepatitis B ◽

Hepatitis B Infection ◽

Risk Of Infection ◽

Increased Risk

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Hepatitis B vaccination and changes in sexual risk behaviour among men who have sex with men in Amsterdam

Epidemiology and Infection ◽

10.1017/s0950268808000976 ◽

2008 ◽

Vol 137 (4) ◽

pp. 504-512 ◽

Cited By ~ 5

Author(s):

M. XIRIDOU ◽

J. WALLINGA ◽

N. DUKERS-MUIJERS ◽

R. COUTINHO

Keyword(s):

High Risk ◽

Hepatitis B ◽

Sexual Risk ◽

Vaccination Campaign ◽

Risk Behaviour ◽

Hepatitis B Vaccination ◽

Sexual Risk Behaviour ◽

Increased Risk ◽

Sex With Men ◽

The Impact

SUMMARYThe impact of hepatitis B vaccination in men having sex with men in Amsterdam has been marginal until now, possibly because of increases in sexual risk behaviour counterbalancing the effect of vaccination. A mathematical model is used to describe the hepatitis B epidemic. The model shows that, with the current vaccination coverage, the decrease in incidence is small in the beginning. However, the number of infections prevented per vaccine administered rises over time. Nevertheless, increased risk behaviour reduces the benefit of vaccination. Targeting high-risk men is more successful in reducing and containing the epidemic than targeting low-risk men. In conclusion, the vaccination campaign is effective and should be intensified. High-risk men should be targeted for vaccination and for risk reduction.

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Increased risk of developing chronic HBV infection in infants born to chronically HBV infected mothers as a result of delayed second dose of hepatitis B vaccination

Vaccine ◽

10.1016/j.vaccine.2009.08.034 ◽

2009 ◽

Vol 27 (44) ◽

pp. 6110-6115 ◽

Cited By ~ 23

Author(s):

Piyanit Tharmaphornpilas ◽

Aim-orn Rasdjarmrearnsook ◽

Saowanee Plianpanich ◽

Pattaratida Sa-nguanmoo ◽

Yong Poovorawan

Keyword(s):

Hepatitis B ◽

Hbv Infection ◽

Hepatitis B Vaccination ◽

Chronic Hbv Infection ◽

Increased Risk ◽

Chronic Hbv

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Vaccination Induced Immunity to the Hepatitis B Virus among High-Risk Groups in Glasgow 1993–2001: Evaluating the Effectiveness of the United Kingdom's Selective Immunisation Policy

Scottish Medical Journal ◽

10.1258/rsmsmj.53.4.13 ◽

2008 ◽

Vol 53 (4) ◽

pp. 13-17 ◽

Cited By ~ 4

Author(s):

KM Roy ◽

DJ Goldberg ◽

K Wilson ◽

SO Cameron

Keyword(s):

High Risk ◽

Hepatitis B ◽

Drug Users ◽

Close Contact ◽

Risk Groups ◽

Hbv Infection ◽

Risk Of Infection ◽

Selective Approach ◽

Hiv Test ◽

Increased Risk

Background and Aims The United Kingdom has adopted a selective approach to the control of hepatitis B (HBV), vaccinating those at increased risk of infection through lifestyle, occupation or other factors such as close contact with a case or carrier. This paper sought to assess the effectiveness of the targeted HBV vaccination programme, by determining the level of immunity and exposure to HBV infection among three high risk groups (injecting drug users (IDUs), men who have sex with men (MSM) and heterosexuals attending genitourinary medicine clinics) at three time points between 1993–2001 in Glasgow, Scotland. Methods Residual sera from i) IDUs having a named HIV test and ii) MSM and heterosexual men and women attending GUM clinics and undergoing routine syphilis serology testing, were tested anonymously for HBV infection. Results The overall prevalence of HBV infection remained at a low level in all three risk groups. IDUs continue to be the group at greatest risk of infection. Discussion Despite the implementation of new initiatives targeting high-risk groups, vaccination levels remain low in the populations studied.

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Low Prevalence of Hepatitis B Vaccination Among Patients Receiving Medical Care for HIV Infection in the United States, 2009 to 2012

Annals of Internal Medicine ◽

10.7326/m17-1689 ◽

2017 ◽

Vol 168 (4) ◽

pp. 245 ◽

Cited By ~ 5

Author(s):

John Weiser ◽

Alejandro Perez ◽

Heather Bradley ◽

Hope King ◽

R. Luke Shouse

Keyword(s):

United States ◽

Hepatitis B ◽

Hiv Infection ◽

Medical Care ◽

The United States ◽

Hepatitis B Vaccination ◽

Low Prevalence

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1379. Vaccination Rates among Liver Transplant Recipients at a Tertiary Care Hospital in Newark, NJ

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.1571 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S775-S776

Author(s):

Tilly Varughese ◽

Michael Song ◽

Joachim Sackey

Keyword(s):

Hepatitis B ◽

Liver Transplant ◽

Hepatitis A ◽

Hepatitis B Vaccination ◽

Care Hospital ◽

Transplant Recipients ◽

Vaccination Rates ◽

Increased Risk ◽

Transplant Candidates ◽

To Receive

Abstract Background Transplant candidates and recipients are at increased risk of infectious complications of vaccine-preventable diseases due to their longstanding immunosuppressive regimens. We assessed the rates of vaccination in our liver transplant patients at University Hospital (UH) in Newark, NJ. Methods Retrospective chart-review including patients > 18 years old who underwent liver transplantation at UH for a 3-year period from 01/01/2017 to 07/20/2020. Data collected included demographics, clinical outcomes, eligibility and receipt of vaccinations before and after transplantation, protection titers after administration of hepatitis vaccinations and presence of an ID outpatient consultation. We looked at the following receipt of vaccinations: Prevnar-13, Pneumovax-23, Influenza, TDaP, Shingrix, Varivax, Havrix and Engerix/Heplisav. Characteristics of study participants was analyzed using descriptive statistics and Chi-Square/Fisher’s Exact tests were used to test associations. Results 119 unique medical charts were reviewed and no patients were excluded. Of those patients who were eligible to receive Hepatitis A vaccination, only 44.8% were documented to receive vaccination and of those eligible to receive Hepatitis B vaccination, only 47.8% received it. Influenza vaccination pre-transplantation was 46% and 66.1% in post-transplant recipients. For the other vaccinations, during the pre-transplant period, 17.6 % of patients received Prevnar-13, 36.1% Pneumovax-23 and 20.2% TDaP and 26.1% received Shingrix. Patients who had ID consultation were significantly more likely to receive appropriate Hepatitis A and Hepatitis B vaccinations (p values 0.026 and 0.005). Conclusion We are not meeting national vaccination standards set by the American Society of Transplantation (AST) for optimal vaccination in this population. Our study can inform of possible solutions to increase vaccination rates in this population such as the simple addition of a smartphrase within EMR notes to remind providers to order appropriate vaccinations and eventually, a more long term solution of creation of a dedicated vaccination clinic and/or routine ID pre-transplant evaluations for all transplant candidates. Disclosures All Authors: No reported disclosures

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