Hepatitis B infection prevalence by country of birth in migrant populations in a large UK city

Background: Many countries with low prevalence of Hepatitis B Virus (HBV) infection recommend that migrants born in countries with higher prevalence are HBV tested. The cost effectiveness depends on the prevalence of HBV infection in the migrant population. In the UK the National Institute for Health and Care Excellence recommended HBV testing of migrants born in countries with HBV infection prevalence >2%, but the prevalence in migrant populations in the UK is not routinely measured.

Objectives: To estimate HBV infection prevalence by region of birth in migrant populations in a large UK city.

Study design: By retrospective data linkage HBV infection prevalence in migrant women tested in pregnancy was determined by UN region and sub-region of birth.

Results: Of 5840 migrant women born in regions with HBV infection prevalence >2%, 101 were infected (prevalence 1.7%; 95% CI 1.4-2.1). Sub-regions of birth with low (<2%), intermediate (2-8%) and high (>8%) prevalence in the study population were: low - Northern Africa, Southern Asia, Western Asia, Eastern Europe, South Europe, Central America, Latin America and The Caribbean; intermediate - Eastern Africa, Middle Africa, Western Africa, and South Eastern Asia; high - Eastern Asia. Prevalence in the study populations, was generally lower than published estimates for the region of origin.

Conclusion: In a large ethnically diverse city in the UK the hepatitis B prevalence in migrant populations for whom HBV screening is recommended is below the estimated cost effectiveness threshold. We recommend more targeted screening based on measured prevalence in migrant populations.