Hepatitis B in Poland in 2018.

Objective: Evaluation of the epidemiological situation of hepatitis B in Poland in 2018 compared to the situation in previous years.

Material And Methods: The epidemiological situation was assessed based on the results of the analysis of individual data on hepatitis B cases and HBV infections registered by Local Sanitary- Epidemiological Stations in the central database using Epidemiological Interview Registration System (SRWE). Aggregate data published in the annual bulletins "Infectious Diseases and Poisonings in Poland" and "Vaccinations in Poland" were also used.

Results: In 2018, a total of 3 196 hepatitis B cases were registered, which corresponds to an incidence of 8.3 cases per 100,000 population. Acute hepatitis B cases accounted for about 1.3 % of total. The incidence of acute hepatitis B was lower by 33% than in 2017 and lower by 44% than median of the years 2012-2016. No acute cases were reported among children and adolescents aged 0-19 years and in the age group 20-24. The incidence of chronic and unknown (in terms of the stage) was lower by 4.5% than in the previous year however, in comparison to median incidence of chronic hepatitis B in 2012-2016 an increase of 17% was noted. As in the previous years, acute, chronic and unknown stage (UNK) hepatitis B were more often detected in men and in urban residents. The dominant route of transmission of HBV infections still remains procedures performed in medical settings - 86% of cases with a known transmission route. The coverage with the third HBV vaccine dose in children aged two years was 91 % and remains ( since 2017) below the 95% required in the elimination strategy. In 2018 three people died due to acute hepatitis B and 35 people due to chronic hepatitis B.

Conclusions: In 2018 decrease in the incidence of acute and chronic hepatitis B was observed. In group of persons born after 1994 covered by obligatory hepatitis B vaccinations as newborns no acute cases have been reported, however, a progressive decline in children's vaccination coverage poses a risk for new HBV infection also among people subjected to mandatory vaccinations. Maintenance of a low incidence of acute hepatitis B requires improvement in carrying out of mandatory vaccination among newborns and further recommendation of vaccination for all persons previously unvaccinated. A slight decline in the detection of chronic and UNK cases may be related to the number of tests performed in a given year.