Progress Toward Hepatitis B Control

World Health Organization European Region, 2016-2019

Nino Khetsuriani, MD, PhD; Liudmila Mosina, MD; Pierre Van Damme, MD, PhD; Antons Mozalevskis, MD; Siddhartha Datta, MD; Rania A. Tohme, MD


Morbidity and Mortality Weekly Report. 2021;70(30):1029-1035. 

In This Article

HBsAg Seroprevalence

Because most chronic HBV infections are asymptomatic, particularly among young children, the impact of hepatitis B vaccination is assessed based on the HBsAg seroprevalence among children.[6] However, in EUR, because of early regional introduction of HepB, the age group for serosurveys for validation purposes is defined as cohorts eligible for HepB vaccination. For EUR countries with low endemicity before vaccine introduction (prevaccine), where conducting large-scale hepatitis B serosurveys might not be justified, HBsAg seroprevalence of ≤0.5% among pregnant women is considered acceptable evidence that the seroprevalence target was achieved.

By December 2019, representative nationwide or regional serosurveys have demonstrated ≤0.5% HBsAg seroprevalence in at least one vaccinated or partially vaccinated age group in five countries and in a prevaccine cohort in one country (the Netherlands) (Table 2). Serosurveys initiated recently for validation purposes in several countries, in some cases with support from WHO and other international partners, have been put on hold because of the COVID-19 pandemic. HBsAg seroprevalence of ≤0.5% among pregnant women has been reported from nine (36%) of 25 countries with low endemicity, sometimes with higher prevalence among foreign-born women than among women who were not foreign-born (e.g., Denmark, Italy, and the Netherlands) (Table 2).