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Vaccination against hepatitis B in low endemic countries

Published online by Cambridge University Press:  25 April 2002

M. KRETZSCHMAR ,
G. A. DE WIT ,
L. J. M. SMITS  and
M. J. W. VAN DE LAAR
M. KRETZSCHMAR
Affiliation:
Department of Infectious Diseases Epidemiology, National Institute of Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands
G. A. DE WIT
Affiliation:
Department of Health Services Research, National Institute of Public Health and the Environment (RIVM), The Netherlands
L. J. M. SMITS
Affiliation:
Department of Health Services Research, National Institute of Public Health and the Environment (RIVM), The Netherlands Present affiliation: Department of Epidemiology, University of Maastricht, Maastricht, The Netherlands.
M. J. W. VAN DE LAAR
Affiliation:
Department of Infectious Diseases Epidemiology, National Institute of Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands
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Abstract

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A mathematical model that takes transmission by sexual contact and vertical transmission into account was employed to describe the transmission dynamics of hepatitis B virus (HBV) and vaccination against it. The model is an extension of a model by Williams et al. (Epidemiol Infect 1996; 116; 71–89) in that it takes immigration of hepatitis B carriers from countries with higher prevalence into account. Model parameters were estimated from data from The Netherlands where available. The main results were that, given the estimates for the parameters describing sexual behaviour in The Netherlands, the basic reproduction number R0 is smaller than 1 in the heterosexual population. As a consequence, the immigration of carriers into the population largely determines the prevalence of HBV carriage and therefore limits the possible success of universal vaccination. Taking into account the prevalence of hepatitis B carriage among immigrants and an age-dependent probability of becoming a carrier after infection, we estimate that a fraction of between 5 and 10% of carrier states could be prevented by universal vaccination.

Type
Research Article
Information
Epidemiology & Infection , Volume 128 , Issue 2 , April 2002 , pp. 229 - 244
Copyright
© 2002 Cambridge University Press