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Abstract

Background

Belgium is a low-endemic country for hepatitis B. Universal hepatitis B vaccination in infants with catch-up in the age cohort of 10–13 year-olds began in 1999.

Aims

Our objective was to evaluate the effect of prevention and control strategies on acute hepatitis B notification rates in Flanders (Belgium) from 2009 to 2017.

Methods

This observational study collected demographic data and risk factors for acute hepatitis B from mandatory notifications to the Agency for Care and Health.

Results

In Flanders, acute hepatitis B notification rates per 100,000 population decreased from 1.6 in 2009 to 0.7 in 2017. These rates declined in all age groups: 0–4-year-olds: 0.6 to 0.0, 5–14-year-olds: 0.2 to 0.0, 15–24-year-olds: 0.8 to 0.7, 25–34-year-olds: 3.4 to 1.1 and ≥ 35-year-olds: 1.59 to 0.7. There was also a downward trend in acute hepatitis B notification rates in native Belgians and first-generation migrants. Among 15–24-year-olds and 25–34-year-olds, a possible reversal of the decreasing trend was observed in 2016 and 2015, respectively. Among 548 acute hepatitis B cases, the main route of transmission was sexual activity (30.7%), and the pattern of transmission routes over time showed an increasing proportion of sexual transmission in men who have sex with men (MSM) after 2014. During the period from 2009 to 2017, five mother-to-child transmissions were reported.

Conclusions

Prevention and control strategies were effective in reducing the acute hepatitis B notification rate. However, stronger prevention and control measures are needed in adult risk groups, particularly MSM.

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/content/10.2807/1560-7917.ES.2019.24.30.1900064
2019-07-25
2024-11-23
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2019.24.30.1900064
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References

  1. World Health Organization (WHO). Hepatitis B. Geneva: WHO; 2018. Available from: https://www.who.int/en/news-room/fact-sheets/detail/hepatitis-b
  2. McMahon BJ, Alward WL, Hall DB, Heyward WL, Bender TR, Francis DP, et al. Acute hepatitis B virus infection: relation of age to the clinical expression of disease and subsequent development of the carrier state. J Infect Dis. 1985;151(4):599-603.  https://doi.org/10.1093/infdis/151.4.599  PMID: 3973412 
  3. Inoue T, Tanaka Y. Hepatitis B virus and its sexually transmitted infection - an update. Microb Cell. 2016;3(9):420-37.  https://doi.org/10.15698/mic2016.09.527  PMID: 28357379 
  4. Stanaway JD, Flaxman AD, Naghavi M, Fitzmaurice C, Vos T, Abubakar I, et al. The global burden of viral hepatitis from 1990 to 2013: findings from the Global Burden of Disease Study 2013. Lancet. 2016;388(10049):1081-8.  https://doi.org/10.1016/S0140-6736(16)30579-7  PMID: 27394647 
  5. European Centre for Disease Prevention and Control (ECDC). Systematic review on hepatitis B and C prevalence in the EU/EEA. Stockholm: ECDC; 2016. Available from: https://ecdc.europa.eu/en/publications-data/systematic-review-hepatitis-b-and-c-prevalence-eueea
  6. Beutels M, Van Damme P, Aelvoet W, Desmyter J, Dondeyne F, Goilav C, et al. Prevalence of hepatitis A, B and C in the Flemish population. Eur J Epidemiol. 1997;13(3):275-80.  https://doi.org/10.1023/A:1007393405966  PMID: 9258525 
  7. Quoilin S, Hutse V, Vandenberghe H, Claeys F, Verhaegen E, De Cock L, et al. A population-based prevalence study of hepatitis A, B and C virus using oral fluid in Flanders, Belgium. Eur J Epidemiol. 2007;22(3):195-202.  https://doi.org/10.1007/s10654-007-9105-6  PMID: 17356926 
  8. Koc OM, Kremer C, Bielen R, Buscchots D, Hens N, Nevens F, et al. Prevalence and risk factors of hepatitis B virus infection in Middle-Limburg Belgium, year 2017: Importance of migration. J Med Virol. 2019;91(8):1479-88.  https://doi.org/10.1002/jmv.25457  PMID: 30870580 
  9. Van Kerschaver E. The Belgian Expanded Programme on Immunization (EPI) and hepatitis B vaccination. South Afr J Epidemiol Infect. 2008;23(1):40-4.  https://doi.org/10.1080/10158782.2008.11441300 
  10. Theeten H, Hutse V, Hoppenbrouwers K, Beutels P, VAN Damme P. Universal hepatitis B vaccination in Belgium: impact on serological markers 3 and 7 years after implementation. Epidemiol Infect. 2014;142(2):251-61.  https://doi.org/10.1017/S0950268813001064  PMID: 23689103 
  11. Larney S, Peacock A, Leung J, Colledge S, Hickman M, Vickerman P, et al. Global, regional, and country-level coverage of interventions to prevent and manage HIV and hepatitis C among people who inject drugs: a systematic review. Lancet Glob Health. 2017;5(12):e1208-20.  https://doi.org/10.1016/S2214-109X(17)30373-X  PMID: 29074410 
  12. European Centre for Disease Prevention and Control (ECDC). Antenatal screening for HIV, hepatitis B, syphilis and rubella susceptibility in the EU/EEA. Stockholm: ECDC; 2016. Available from: https://ecdc.europa.eu/en/publications-data/antenatal-screening-hiv-hepatitis-b-syphilis-and-rubella-susceptibility-eueea
  13. Ward JW, Hinman AR. What is needed to eliminate hepatitis b virus and hepatitis C virus as global health threats. Gastroenterology. 2019;156(2):297-310.  https://doi.org/10.1053/j.gastro.2018.10.048  PMID: 30391470 
  14. European Centre for Disease Prevention and Control (ECDC). Hepatitis B – Annual epidemiological report for 2016. Stockholm: ECDC; 2018. Available from: https://ecdc.europa.eu/en/publications-data/hepatitis-b-annual-epidemiological-report-2016
  15. Statbel. Structuur van de bevolking. [Population structure]. Brussels: Statbel. [Accessed: 26 Jul 2018]. Dutch. Available from: https://statbel.fgov.be/nl/themas/bevolking/structuur-van-de-bevolking
  16. Schweitzer A, Horn J, Mikolajczyk RT, Krause G, Ott JJ. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet. 2015;386(10003):1546-55.  https://doi.org/10.1016/S0140-6736(15)61412-X  PMID: 26231459 
  17. Theeten H, Hens N, Vandermeulen C, Depoorter AM, Roelants M, Aerts M, et al. Infant vaccination coverage in 2005 and predictive factors for complete or valid vaccination in Flanders, Belgium: an EPI-survey. Vaccine. 2007;25(26):4940-8.  https://doi.org/10.1016/j.vaccine.2007.03.032  PMID: 17524528 
  18. Vandermeulen C, Roelants M, Theeten H, Depoorter AM, Van Damme P, Hoppenbrouwers K. Vaccination coverage in 14-year-old adolescents: documentation, timeliness, and sociodemographic determinants. Pediatrics. 2008;121(3):e428-34.  https://doi.org/10.1542/peds.2007-1415  PMID: 18310163 
  19. Hoppenbrouwers K, Vandermeulen C, Roelants M, Boonen M, Van Damme P, Theeten H, et al. Studie van de vaccinatiegraad bij jonge kinderen en adolescenten in Vlaanderen in 2008. [Study on the vaccination rate among young children and adolescents in Flanders in 2008]. Brussels: Vlaams Agentschap Zorg en Gezondheid; 2009. 110p. Dutch. Available from: http://docs.vlaamsparlement.be/pfile?id=195060
  20. Theeten H, Roelants M, Lernout T, Braeckman T, Hens N, Hoppenbrouwers K, et al. Vaccinatiegraad bij jonge kinderen en adolescenten in Vlaanderen in 2012. [Vaccination rate in young children and adolescents in Flanders in 2012]. Vlaams Infectieziektebulletin. 2013;4:6-12. Dutch. Available from: https://www.zorg-en-gezondheid.be/sites/default/files/atoms/files/2013-4_vaccinatiegraad%20bij%20jonge%20kinderen_adolescenten%20in%20Vlaanderen_Heidi%20Theeten.pdf
  21. Vandermeulen C, Hoppenbrouwers K, Roelants M, Theeten H, Braeckman T, Maertens K, et al. Studie van de vaccinatiegraad in Vlaanderen 2016. [Study on the vaccination rate in Flanders in 2016]. Brussels: Vlaams Agentschap Zorg en Gezondheid; 2017. 188p. Dutch. Available from: https://www.zorg-en-gezondheid.be/sites/default/files/atoms/files/Vaccinatiegraadstudie%202016.pdf
  22. Trépo C, Chan HL, Lok A. Hepatitis B virus infection. Lancet. 2014;384(9959):2053-63.  https://doi.org/10.1016/S0140-6736(14)60220-8  PMID: 24954675 
  23. Mak R, Traen A, Claeyssens M, Van Renterghem L, Leroux-Roels G, Van Damme P. Hepatitis B vaccination for sex workers: do outreach programmes perform better? Sex Transm Infect. 2003;79(2):157-9.  https://doi.org/10.1136/sti.79.2.157  PMID: 12690142 
  24. Leuridan E, Wouters K, Stalpaert M, Van Damme P. Male sex workers in Antwerp, Belgium: a descriptive study. Int J STD AIDS. 2005;16(11):744-8.  https://doi.org/10.1258/095646205774763072  PMID: 16303070 
  25. Van Ardenne N, Roelofs I, Leuridan E, Wouters K, Van Damme P. Audit on offering and accepting hepatitis B vaccine by sex workers. Int J STD AIDS. 2004;15(7):493-4.  https://doi.org/10.1258/0956462041211298  PMID: 15228740 
  26. Vranckx R, Jacques P, De Schrijver A, Moens G. Hepatitis B vaccination coverage in Belgian health care workers. Infection. 2004;32(5):278-81.  https://doi.org/10.1007/s15010-004-2204-3  PMID: 15624891 
  27. Zuckerman JN, Hoet B. Hepatitis B immunisation in travellers: poor risk perception and inadequate protection. Travel Med Infect Dis. 2008;6(5):315-20.  https://doi.org/10.1016/j.tmaid.2008.05.001  PMID: 18760256 
  28. De Vrieze J, De Paep DL, De Roeck Y, Dockx S, Van Damme P, Theeten H. Immunization policy in children born to hbsag seropositive mothers. Tijdschrift van de Belgische Kinderarts.2014;16(3):174-7.
  29. World Health Organization (WHO). Global health sector strategy on viral hepatitis 2016-2021. Geneva: WHO. 2016. WHO/HIV/2016.06. Available from: https://www.who.int/hepatitis/strategy2016-2021/ghss-hep/en/
  30. World Health Organization (WHO). Hepatitis B Birth dose (HepB-BD) vaccination strategies in the national immunization programme. In: Vaccine in national immunization programme update. [PowerPoint Presentation]. Geneva: WHO; [Accessed 15 May 2018]. Available from: http://www.who.int/immunization/monitoring_surveillance/VaccineIntroStatus.pptx
  31. Poethko-Müller C, Zimmermann R, Hamouda O, Faber M, Stark K, Ross RS, et al. Die Seroepidemiologie der Hepatitis A, B und C in Deutschland: Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1). [Epidemiology of hepatitis A, B, and C among adults in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2013;56(5-6):707-15. German. PMID: 23703489 
  32. Meffre C, Le Strat Y, Delarocque-Astagneau E, Dubois F, Antona D, Lemasson JM, et al. Prevalence of hepatitis B and hepatitis C virus infections in France in 2004: social factors are important predictors after adjusting for known risk factors. J Med Virol. 2010;82(4):546-55.  https://doi.org/10.1002/jmv.21734  PMID: 20166185 
  33. Pedraza-Flechas AM, García-Comas L, Ordobás-Gavín M, Sanz-Moreno JC, Ramos-Blázquez B, Astray-Mochales J, et al. Hepatitis B virus infection and vaccine-induced immunity in Madrid (Spain). Gac Sanit. 2014;28(6):492-5.  https://doi.org/10.1016/j.gaceta.2014.05.007  PMID: 25042394 
  34. Chang MH, Chen CJ, Lai MS, Hsu HM, Wu TC, Kong MS, et al. Universal hepatitis B vaccination in Taiwan and the incidence of hepatocellular carcinoma in children. N Engl J Med. 1997;336(26):1855-9.  https://doi.org/10.1056/NEJM199706263362602  PMID: 9197213 
  35. Beasley RP, Hwang LY, Lee GC, Lan CC, Roan CH, Huang FY, et al. Prevention of perinatally transmitted hepatitis B virus infections with hepatitis B immune globulin and hepatitis B vaccine. Lancet. 1983;2(8359):1099-102.  https://doi.org/10.1016/S0140-6736(83)90624-4  PMID: 6138642 
  36. Miglietta A, Quinten C, Lopalco PL, Duffell E. Impact of hepatitis B vaccination on acute hepatitis B epidemiology in European Union/European Economic Area countries, 2006 to 2014. Euro Surveill. 2018;23(6):17-00278.  https://doi.org/10.2807/1560-7917.ES.2018.23.6.17-00278  PMID: 29439751 
Acute hepatitis B notification rates in Flanders, Belgium, 2009 to 2017
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=%C3%96zg%C3%BCr++Koc&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Koc Özgür </a>, <a href="/search?value1=Pierre+Van+Damme&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Van Damme Pierre</a>, <a href="/search?value1=Dana+Busschots&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Busschots Dana</a>, <a href="/search?value1=Rob+Bielen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bielen Rob</a>, <a href="/search?value1=Anmarie+Forier&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Forier Anmarie</a>, <a href="/search?value1=Frederik+Nevens&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Nevens Frederik</a>, <a href="/search?value1=Geert+Robaeys&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Robaeys Geert</a></span>. Acute hepatitis B notification rates in Flanders, Belgium, 2009 to 2017. <a href="/content/ecdc">Euro Surveill.</a> 2019;24(30):pii=1900064. <a href="https://doi.org/10.2807/1560-7917.ES.2019.24.30.1900064" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2019.24.30.1900064</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 21 Jan 2019;&nbsp;&nbsp; <span class="generated">Accepted</span>: 01 Apr 2019 </span> </p>
/content/10.2807/1560-7917.ES.2019.24.30.1900064
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