A1 Refereed original research article in a scientific journal
Epidemiology of hepatitis B infection in Finland: Implications for immunisation policy
Authors: Tanja Karvonen, Kari Auranen, Markku Kuusi, Tuija Leino
Publisher: ELSEVIER SCI LTD
Publication year: 2017
Journal: Vaccine
Journal name in source: VACCINE
Journal acronym: VACCINE
Volume: 35
Issue: 3
First page : 412
Last page: 418
Number of pages: 7
ISSN: 0264-410X
DOI: https://doi.org/10.1016/j.vaccine.2016.11.090
Web address : http://www.sciencedirect.com/science/article/pii/S0264410X1631180X
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/20668708
Objectives: We describe the current epidemiology of acute and chronic hepatitis B infections in Finland. We estimate the total incidence of chronic hepatitis B following from the current incidence of acute infections and the influx of chronic carriers of hepatitis B associated with net immigration. We evaluate the incidence of hepatitis B infections preventable by a universal vaccination programme among infants.Methods: We analysed hepatitis B cases reported to the National Infectious Disease Register during 2004-2012 and used pre-developed methods to adjust for acute asymptomatic infections. We estimated the projected incidence of chronic infection by applying age-specific risks of chronic infection to the estimated incidence of acute infection. We estimated the influx of chronic carriers associated with immigration by utilising data on immigration during 2004-2012 and the WHO regional estimates of carriage prevalence.Results: The estimated incidence of acute hepatitis B infection in Finland, adjusted for asymptomatic infections, was 1.67 per 100,000 per year (95% Crl 1.43-1.94) which is 4.2-fold to the register-based incidence. The estimated lifetime risks of acute and chronic hepatitis B infections were 0.13% and 0.01%, respectively. We estimated that annually seven new chronic infections would result from infections acquired in Finland. These new chronic infections accounted for 1.2% of the total incidence of chronic infections. We estimated that eventually three chronic infections per year would be potentially preventable by a universal infant vaccination programme.Conclusions: Partly due to the fact that hepatitis B infections in neonates and in children are rare, a very limited number of chronic hepatitis B infections resulted from infection acquired within the country. A vast majority of chronic hepatitis B infections occurred among foreign-born persons and were therefore not preventable by a universal infant immunisation programme in Finland. Even with a targeted immunisation programme, the incidence of hepatitis B infection has remained low. (C) 2016 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license.
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