Hepatitis B 2018 - acute and chronic

Acute hepatitis B 2018

In 2018, the Department of Infectious Epidemiology and Prevention received nine notifications of acute hepatitis B; seven of the cases were men. The median age was 30 years (range 16-72 years).

Eight persons were of Danish origin and one was a second-generation immigrant. Four persons had become infected in Denmark; two by heterosexual transmission and two by homosexual transmission. The remaining persons had presumably become infected in Morocco, Spain, Vietnam, Nepal and Turkey, respectively. Two of the persons infected abroad were registered as cases of homosexual transmission, one as heterosexual transmission; and in the other two cases, the mode of infection was not established. They had engaged in vacational travels to Nepal and Turkey, respectively, before presenting with symptoms, and it was assumed that they had become infected while travelling.

Chronic hepatitis B 2018

In 2018, the Department of Infectious Epidemiology and Prevention received 155 notifications of people with chronic hepatitis B; Table 1. A total of 101 (65%) were women, Table 2. The median age for women was 32 years (range: 15-81 years), for men 36 years (range 7-74 years).

A total of 45% (n = 69) of the women were detected as part of the general screening of pregnant women.

Only five Danish persons were notified with chronic hepatitis B in 2018, Table 3.

hepatitis_b_2018_table1 

hepatitis_b_2018_table2

The remaining 150 (97%) persons were of non-Danish origin, including three adoptees as well as nine second-generation immigrants of whom seven were notified as having become infected at birth in Denmark before the introduction of the general screening of pregnant women in November 2005. Among the remaining two, no information was provided on mode of transmission, but both had been born in Denmark by mothers from high-endemic areas, why mother-to-child transmission is likely.

The notified persons of foreign origin were distributed on a total of 40 countries, including 34 persons (23%) from The Middle East.

Because of the general screening of pregnant women, women predominated among the notified cases of foreign origin, Figure 1. Particularly women from South-East Asia and Eastern Europe were over-represented relative to men, as they comprised 77% and 67%, respectively.

hepatitis_b_2018_figure1

Among the 109 persons for whom information on mode of transmission was available, the most frequent mode of transmission was mother-to-child transmission (n = 95, 87%), Table 3.

hepatitis_b_2018_table3

No transmission to neonates was reported, but a total of three children were notified with chronic hepatitis B in 2018. Two were born abroad and had become infected before their arrival to Denmark.

One child was born in Denmark by a mother from a high-endemic country before the introduction of pregnancy screening in Denmark. All three children were notified as cases of mother-to-child transmission.

A total of five persons were infected heterosexually; two in Denmark and three abroad. One person was notified as having been infected by close social contact in Vietnam.

Three persons were notified as having become infected via IV drug use in Denmark.

Five were notified as nosocomial infection, three in Eastern Europe, two in The Middle East. All had become infected before their arrival to Denmark. For 46 persons, no source of infection was provided.

This report is also described in EPI-NEWS 47/19.