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Understanding Hepatitis B: Prevalence, Risks, and Prevention Strategies in Ireland

Hepatitis B is a highly infectious virus, 50-100 times more contagious than HIV. Chronic infection can lead to severe liver diseases, including cirrhosis and liver cancer, particularly in those infected as infants (90% risk). Globally, over 350 million people suffer from chronic HBV. In Ireland, acute infections peaked in 2006 and have declined significantly. Most chronic cases are attributed to infections acquired outside Ireland, particularly in Sub-Saharan Africa and Eastern Europe. Universal infant vaccination began in Ireland in 2008 to combat this disease.

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Understanding Hepatitis B: Prevalence, Risks, and Prevention Strategies in Ireland

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  1. Hepatitis BLast updated May 2013

  2. Hepatitis B virus • 50-100 times more infectious than HIV • Chronic HBV infection develops in 90% of those infected as infants and 1-10% infected as adults • Chronic infection can lead to chronic liver disease, cirrhosis, liver failure and liver cancer (usually over 20-30+ years) • Premature death from liver disease occurs in 15-25% of chronically infected people • >350 million people chronically infected worldwide • Vaccine preventable – universal infant vaccination introduced in Ireland in 2008

  3. Worldwide prevalence hepatitis B infection (source: WHO)

  4. Summary of acute (recent infections) hepatitis B in Ireland, 2004-2012) • 8.7% of cases notified 2004-2012 were acute infections • 577 acute notifications in this time period (annual average: n= 64) • The number of acute cases peaked in 2006 at 95 and the lowest number notified was 37 in 2012 • 82% of acute cases notified 2004-2012 were male • Mean ages at notification: 36 for males, 35 for females • Where risk factor data available, 68% of cases were sexually acquired • 42% of sexually acquired cases were in men who have sex with men • Where country of birth available, 72% born in Ireland

  5. Summary of chronic hepatitis B in Ireland, 2004-2012 • 91% of cases notified 2004-2012 were chronically infected • 5535 chronic notifications in this time period (annual average: n= 615) • Notifications peaked in 2008 (n=910) • Notifications decreased to 581 in 2012. • 54% male, 46% female • Mean ages at notification: 34 for males, 30 for females • Limited data indicate that most chronic cases were born and infected outside of Ireland, mostly in Sub-Saharan Africa, Central & Eastern Europe and Asia • It is likely that most became infected at birth or in early childhood and have been infected for decades • Trends in chronic cases are heavily influenced by trends in immigration to Ireland

  6. Number of notifications of hepatitis B, 1996-2012

  7. Mean annual notification rates for hepatitis B per 100,000 population by HSE area & acute/chronic status, 2004-2012

  8. Mean annual notification rates per 100,000 for hepatitis B by age, sex and acute/chronic status, 2004-2012

  9. Most likely risk factor (%) for acute cases of hepatitis B, 2012 (where data available, n=36, 97%)

  10. Region of birth (%) for acute cases of hepatitis B, 2012 (where data available, n=30, 81%)

  11. Risk factors (%) for chronic cases of hepatitis B, 2012 (where data available, n=244, 47%)

  12. Region of birth (%) for chronic cases of hepatitis B, 2012 (where data available, n=221, 42%)

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