British Liver Trust

HBV is 50 to 100 times more infectious than HIV. Morbidity and mortality statistics are significant. About two billion people worldwide have been infected with the virus and about 350 million live with chronic infection. An estimated 600,000 die each year due to the acute or chronic consequences of hepatitis B.

Areas with high prevalence of HBV (South-East Asia, the Middle and Far East, Southern parts of Eastern and Central Europe and Africa) are also regions with the highest rates of hepatocellular carcinoma (HCC), one of the most common forms of cancer.

 

Map of global prevalence of chronic hepatitis B virus infection
(Acknowledgement: U.S. Centers for Disease Control and Prevention)

With 75% of the global population currently living in areas of high infection, it is clear that hepatitis B is a major international health problem.

In the UK, hepatitis B has a low prevalence but there is significant variation across the country. It is higher in those born in high endemicity countries, many of whom will have acquired infection at birth or in early childhood. Overall, less than 1% of the population is HBsAg positive, with an estimated pool of 180,000 to 320,000 cases.

Since 1992, laboratory reports of confirmed acute hepatitis B have fluctuated between 600 and 800 cases per year. Although reliable recent data is not available, estimates suggest that only a small proportion of chronic infections are established as a result of infection acquired in the UK (around 200 per year) but an estimated 7,000 chronic cases of hepatitis B come to the UK every year as a result of immigration to the UK from high prevalence areas. The majority of this group may not present with symptoms to health workers until disease is advanced. As a result, screening of recent immigrants from high prevalence areas should be considered when they register with a GP. More formal approaches to identifying migrants with chronic infection have been suggested, as this could allow for early treatment and for vaccination of close contacts, but as yet no national recommendation exists.

Acute hepatitis Busually a self-limiting disease marked by inflammation in the liver in association with a transient HBV infection

Chronic hepatitis B