PLoS ONE
Volume 7, Issue 9, 2012

Seroprevalence of Chronic Hepatitis B Virus Infection and Prior Immunity in Immigrants and Refugees: A Systematic Review and Meta-Analysis (Article) (Open Access)

Rossi C.* , Shrier I. , Marshall L. , Cnossen S. , Schwartzman K. , Klein M.B. , Schwarzer G. , Greenaway C.
  • a Centre for Clinical Epidemiology and Community Studies of the Lady Davis Institute for Medical Res., Jewish General Hospital, Montreal, Canada, Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
  • b Centre for Clinical Epidemiology and Community Studies of the Lady Davis Institute for Medical Res., Jewish General Hospital, Montreal, Canada, Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
  • c Centre for Clinical Epidemiology and Community Studies of the Lady Davis Institute for Medical Res., Jewish General Hospital, Montreal, Canada
  • d Centre for Clinical Epidemiology and Community Studies of the Lady Davis Institute for Medical Res., Jewish General Hospital, Montreal, Canada
  • e Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada, Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute, McGill University, Montreal, Canada
  • f Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada, Division of Infectious Diseases, McGill University Health Centre, McGill University, Montreal, Canada
  • g Institute of Medical Biometry and Medical Informatics, University of Freiburg, Freiburg, Germany
  • h Centre for Clinical Epidemiology and Community Studies of the Lady Davis Institute for Medical Res., Jewish General Hospital, Montreal, Canada, Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada, Division of Infectious Diseases, Jewish General Hospital, McGill University, Montreal, Canada

Abstract

Background: International migrants experience increased mortality from hepatocellular carcinoma compared to host populations, largely due to undetected chronic hepatitis B infection (HBV). We conducted a systematic review of the seroprevalence of chronic HBV and prior immunity in migrants arriving in low HBV prevalence countries to identify those at highest risk in order to guide disease prevention and control strategies. Methods and Findings: Medline, Medline In-Process, EMBASE and the Cochrane Database of Systematic Reviews were searched. Studies that reported HBV surface antigen or surface antibodies in migrants were included. The seroprevalence of chronic HBV and prior immunity were pooled by region of origin and immigrant class, using a random-effects model. A random-effects logistic regression was performed to explore heterogeneity. The number of chronically infected migrants in each immigrant-receiving country was estimated using the pooled HBV seroprevalences and country-specific census data. A total of 110 studies, representing 209,822 immigrants and refugees were included. The overall pooled seroprevalence of infection was 7.2% (95% CI: 6.3%-8.2%) and the seroprevalence of prior immunity was 39.7% (95% CI: 35.7%-43.9%). HBV seroprevalence differed significantly by region of origin. Migrants from East Asia and Sub-Saharan Africa were at highest risk and migrants from Eastern Europe were at an intermediate risk of infection. Region of origin, refugee status and decade of study were independently associated with infection in the adjusted random-effects logistic model. Almost 3.5 million migrants (95% CI: 2.8-4.5 million) are estimated to be chronically infected with HBV. Conclusions: The seroprevalence of chronic HBV infection is high in migrants from most world regions, particularly among those from East Asia, Sub-Saharan Africa and Eastern Europe, and more than 50% were found to be susceptible to HBV. Targeted screening and vaccination of international migrants can become an important component of HBV disease control efforts in immigrant-receiving countries. © 2012 Rossi et al.

Author Keywords

[No Keywords available]

Index Keywords

Liver Neoplasms immigrant Europe, Eastern Embase Africa south of the Sahara regression analysis refugee logistic regression analysis Carcinoma, Hepatocellular human virus immunity Refugees Cochrane Library Asia Far East Eastern Europe Hepatitis B virus Medline Humans geography Emigrants and Immigrants high risk population population research prevalence Article disease control Hepatitis B, Chronic hepatitis B surface antibody hepatitis B vaccine hepatitis B surface antigen seroprevalence hepatitis B Seroepidemiologic Studies systematic review infection sensitivity
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84866010904&doi=10.1371%2fjournal.pone.0044611&partnerID=40&md5=8919793cf24264b2506a21d5b99b25ae
DOI: 10.1371/journal.pone.0044611
ISSN: 19326203
Cited by: 81
Original Language: English