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Hepatitis B virus transmission in pre-adolescent schoolchildren in four multi-ethnic areas of England

  • M. A. BALOGUN (a1), J. V. PARRY (a2) (a3), K. MUTTON (a4), C. OKOLO (a5), L. BENONS (a5), H. BAXENDALE (a6), T. HARDIMAN (a6), E. H. BOXALL (a7) (a8), J. SIRA (a8), M. BROWN (a8), S. BARNETT (a2), U. GUNGABISSOON (a1), A. WILLIAMS (a9), D. A. KELLY (a8), S. VIJERATNAM (a10), S. IJAZ (a2), B. TAYLOR (a6), C. G. TEO (a2) and M. E. RAMSAY (a1)...

The aim of this study was to estimate the amount of childhood hepatitis B virus transmission in children born in the UK, a very low-prevalence country, that is preventable only by universal hepatitis B immunization of infants. Oral fluid specimens were collected from schoolchildren aged 7–11 years in four inner city multi-ethnic areas and tested for the presence of antibody to hepatitis B core antigen (anti-HBc). Those found positive or indeterminate were followed up with testing on serum to confirm their hepatitis B status. The overall prevalence of anti-HBc in children was low [0·26%, 95% confidence interval (CI) 0·14–0·44]. The estimated average annual incidence of hepatitis B was estimated to be 29·26/100 000 children (95% CI 16·00–49·08). The total incidence that is preventable only by a universal infant immunization programme in the UK was estimated to be between 5·00 and 12·49/100 000. The study demonstrates that the extent of horizontal childhood hepatitis B virus transmission is low in children born in the UK and suggests that schools in the UK are an uncommon setting for the transmission of the virus. Targeted hepatitis B testing and immunization of migrants from intermediate- and high-prevalence countries is likely to be a more effective measure to reduce childhood transmission than a universal infant immunization programme.

Corresponding author
*Author for correspondence: Dr M. A. Balogun, Health Protection Agency, Immunisation, Hepatitis and Blood Safety Department, 61 Colindale Avenue, London NW9 5EQ, UK. (Email:
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Epidemiology & Infection
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