Epidemiology of Hepatitis B Virus Infection in The Netherlands and Beyond

摘要: This Thesis resulted from a decade of studying the epidemiology hepatitis B virus (HBV) infection in Netherlands, England and Wales at European level, starting 2003. The studies aimed to improve knowledge local HBV assess effectiveness vaccination programmes, order inform public health policy for prevention control its associated burden disease death Netherlands elsewhere. HBV causes can be transmitted between humans. resolve or result chronic infection. latter lead cirrhosis hepatocellular carcinoma (HCC), which is often fatal. Safe effective vaccines prevent have been available since 1982. The first eight papers this cover Netherlands. It among countries with lowest prevalence world. First-generation adult migrants (FGMs) 13-fold greater risk being HBsAg- and/or HBV-DNA-positive than indigenous Dutch participants, are main target group secondary prevention. Men who sex men (MSM) high Children, females heterosexual males parents born endemic country also increased risk. programme behavioural high-risk groups has effectively reduced incidence mainly by preventing infections MSM. Effectiveness such on national level was never demonstrated before. The children HBsAg-positive mother effective. Children Chinese women perinatal 2003-2007 probably highly acceptable parents. vaccine used currently all infants achieved thresholds immune responses antigens that were studied. Studies carried out & early 2000s estimated annual 7.4 per 100,000 (adjusted underreporting asymptomatic infections), injecting drug use most frequently reported route transmission. Transmission during childhood rarely reported, but more frequent South Asians. Asians relatively high, particularly children. Endemic transmission gives rise only small proportion new infections, vast majority arising immigration established carriers. We studied C (HCV) cost-effectiveness screening 34 countries. We concluded HCV varies widely Anti-HCV-Ab IDUs HBsAg pregnant Public Health priorities. likely cost-effective. Lastly, provides summary what it adds already known, implications surveillance research, recommendations HBV.