Hepatitis B prevalence systematic review

🧪 What was the study about?

Hepatitis B is a viral infection that affects the liver and remains a major global issue. Around 254 million people worldwide are living with hepatitis B, and it is responsible for approximately 1.1 million deaths each year. The prevalence of a disease is the number of people in a population who are living with the disease. In the UK, chronic (long-term) hepatitis B has a low prevalence overall, but there are some groups of people where prevalence of chronic hepatitis B is higher. Most people living with chronic hepatitis B in the UK were born in countries where the virus is more common and acquired the infection early in life, often in infancy. These individuals represent over 90% of diagnosed cases.

Current estimates of the number of people in the UK who are living with chronic hepatitis B vary. Recent estimates suggest there are around 268,000 people living with chronic hepatitis B in England and around 87,000 people in Scotland. However, these estimates are based on limited data.

This study is a systematic review of published research and data on chronic hepatitis B prevalence in the UK. Systematic reviews are an organised way of looking for research that answer a specific question and analyses and combines the results. They follow strict rules to prevent bias and ensure the findings are trustworthy.  

The aim of this study is to identify what data on chronic hepatitis B prevalence in the UK already exists and can be used to contribute to a more accurate and complete understanding of hepatitis B prevalence in the UK. The review also aims to identify gaps in current knowledge, assess the quality and consistency of the available data, and explore differences in prevalence across different population groups.

❓ Why is this important?

Understanding the prevalence of chronic hepatitis B in the UK is important for effective public health action. Having accurate and complete data allows health services to better identify populations at highest risk, and ensure that screening, vaccination, and treatment programmes are targeted to the populations that need them most. This also supports earlier diagnosis, which is crucial for preventing serious complications such as liver cirrhosis and cancer.  

Reliable estimates of chronic hepatitis B prevalence are also needed to guide policy and resource allocation decisions, and to monitor progress toward national and global hepatitis elimination goals. By identifying gaps and inconsistencies in existing data, this work can also highlight health inequalities and contribute to improving surveillance systems, ultimately leading to more equitable and effective healthcare provision.

Ultimately, the findings will help inform public health strategies, improve surveillance systems, and support more effective targeting of screening, prevention, and treatment programmes for hepatitis B in the UK.

🔍 What did we do?

We searched for articles relating to hepatitis B prevalence in the UK in 4 research databases:  Embase, Medline, Cochrane and Trip. We also searched online for surveillance publications that reported hepatitis B prevalence. We extracted data from the publications on: chronic hepatitis B prevalence (measured by the prevalence of hepatitis B surface antigen (HBsAg) confirmed by a test), study type, year, setting and/or intervention, population characteristics, location, sample size and sampling strategy. We grouped studies by population group or setting. Where there were 2 or more studies in a group, we calculated pooled estimates of chronic hepatitis B prevalence for that group.

📊 Key findings

· Pooled estimates of chronic hepatitis B prevalence varied for different population groups in the UK.

· More data are needed on chronic hepatitis B prevalence in different groups in the UK, particularly in migrant populations. These data are needed to inform modelling which will help us understand how much hepatitis B affects people across the UK and the impact of strategies to eliminate hepatitis B as a public health problem.

💡 What do these findings mean?

These data will feed into disease modelling which will help to improve understanding of the true scale and distribution of hepatitis B within the UK.

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