Changing epidemiology of Hepatitis B and migration-a comparison of six Northern and North-Western European countries

Background: Increased migration volume and different Hepatitis B prevalence between immigration and emigration countries have changed the Hepatitis B virus (HBV) epidemiology considerably in Northern and North-Western European migrants-receiving countries. Due to the difference in migration status monitoring, the HBV infection data on migrants are not easily comparable among those countries. The study aims were: to compare the migration status indicators used by the national surveillance system in six Northern and North-Western European countries (the Netherlands, Germany, Finland, Denmark, Sweden and the UK); to determine the impact of the migration status on HBV infection by comparing the available data on prevalence and transmission routes of Hepatitis B in the migration and the general population in the six countries; to recommend sensible indicators and pertinent measures for HBV infection surveillance and control in the region. Methods: Literature review, statistical data analysis on migration and HBV infection in the six countries; expert interviews to identify migration status indicators used in national surveillance systems. Results: Evident differences were found between the migration and the general population in Hepatitis B prevalence and transmission routes in the six countries. Migration status is monitored differently in six surveillance systems; immigrants from high/intermediate Hepatitis B endemic countries constitute a substantial proportion of HBsAg(+) and chronic cases in all six countries. Conclusions: International migration has an obvious impact on Hepatitis B prevalence in the six countries. It is important to include common migration status indicators and to collect comparable data for HBV infection surveillance in different notification systems.