Epidemiology and Infection

The prevalence of hepatitis B infection in adults in England and Wales

N. J. GAY a1c1, L. M. HESKETH a2, K. P. OSBORNE a1, C. P. FARRINGTON a3, P. MORGAN-CAPNER a2a4 and E. MILLER a1
a1 PHLS Seroepidemiology Unit, Immunisation Division, PHLS Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ, UK
a2 PHLS Seroepidemiology Unit, Preston Public Health Laboratory, Royal Preston Hospital, PO Box 202, Preston, PR2 4HG
a3 PHLS Statistics Unit, 61 Colindale Avenue, London NW9 5EQ
a4 PHLS North West, Vicarage Lane, Fulwood, Preston, PR2 8DW


Cost effectiveness analyses of alternative hepatitis B vaccination programmes in England and Wales require a robust estimate of the lifetime risk of carriage. To this end, we report the prevalence of infection in 3781 anonymized individuals aged 15–44 years whose sera were submitted in 1996 to 16 microbiology laboratories in England and Wales. One hundred and forty-six individuals (3·9%) were confirmed as anti HBc positive, including 14 chronic carriers (0·37%). The prevalence of infection and carriage was higher in samples collected in London and increased with age. No increased risk of infection was seen in sera from genito-urinary (GUM) clinics. Only 15 sera positive for hepatitis B were also positive for hepatitis C. Our results confirm the low prevalence of hepatitis B in England and Wales, are consistent with previous estimates of carriage and suggest that many infections were acquired while resident outside the UK. Future prevalence studies should determine the country of birth and other risk factors for each individual in order to confirm these findings.

(Accepted September 14 1998)

c1 Author for correspondence.