Cent Eur J Public Health 2009, 17(2):108-111 | DOI: 10.21101/cejph.a3483

The Trends and Risk Factors for Hepatitis B Occurrence in Estonia

Gerli Paat1, Anneli Uusküla2, Valentina Tefanova3, Tatjana Tallo3,4, Ljudmilla Priimägi3, Kalle Ahi5
1 PRAXIS Center for Policy Studies, Tallinn, Estonia
2 Department of Public Health, University of Tartu, Estonia
3 Department of Virology, National Institute for Health Development, Tallinn, Estonia
4 Department of Microbiology, Tumor and Cell Biology, Karolinska Institute, Stockholm, Sweden
5 Tallinn University of Technology, Tallinn, Estonia

Hepatitis B virus (HBV) infection is prevalent worldwide and is a significant cause of morbidity and mortality. This article describes the trend in HBV occurrence in Estonia from 1990 to 2005 in Estonia, with the aim of highlighting key determinants in transmission dynamics, risk groups, and possible implications for prevention and control.
A marked increase in reported numbers of new HBV cases occurred in mid 1990s (reaching 39 per 100,000 population) and decline thereafter. We present data on HBV prevalence from different population groups (persons with verified sexually transmitted infection, prisoners, medical personnel, blood donors and injection drug users). Special vaccination programmes introduced in Estonia have been successful in the prevention of HBV, however, we suggest that the main risk groups such as injection drug users (IDUs), men having sex with men (MSM) and HIV infected persons should be actively encompassed into HBV vaccination programme.

Keywords: hepatitis B, epidemiology, HIV, IDU, Estonia

Received: February 15, 2008; Revised: April 2, 2009; Accepted: April 2, 2009; Published: June 1, 2009  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Paat G, Uusküla A, Tefanova V, Tallo T, Priimägi L, Ahi K. The Trends and Risk Factors for Hepatitis B Occurrence in Estonia. Cent Eur J Public Health. 2009;17(2):108-111. doi: 10.21101/cejph.a3483. PubMed PMID: 19662830.
Download citation

References

  1. World Health Organization [homepage on the Internet]. Hepatitis B. Fact sheet no. 204. Revised Octoíber 2000 [cited 2007 Mar 19]. Available from: http://www.who.int/mediacentre/factsheets/fs204/en/index.html.
  2. LokAS. Chronic hepatitis B. N Engl J Med. 2002 May 30;346(22):1682-3. Go to original source... Go to PubMed...
  3. Kao JH, Chen DS. Global control of hepatitis B virus infection. Lancet Infect Dis. 2002 Jul;2(7):395-403. Go to original source... Go to PubMed...
  4. Mahoney FJ. Update on diagnosis, management, and prevention of hepatitis B virus infection. Clin Microbiol Rev. 1999 Apr;12(2):351-66. Go to original source... Go to PubMed...
  5. Lee WM. Hepatitis B virus infection. N Engl J Med. 1997 Dec 11;337(24):1733-45. Go to original source... Go to PubMed...
  6. Parkin DM, Bray F, Ferlay J, Pisani P. Estimating the world cancer burden: Globocan 2000. Int J Cancer. 2001 Oct 15;94(2):153-6. Go to original source... Go to PubMed...
  7. Lavanchy D. Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures. J Viral Hepat. 2004 Mar;11(2):97-107. Go to original source...
  8. Gust ID. Epidemiology of hepatitis B infection in the Western Pacific and South East Asia. Gut. 1996;38 Suppl 2:S18-23. Go to original source...
  9. Li J,Wang J,Tian K,WangY, Zhang L, Huang H. Epidemiology of hepatitis B, C, D and G viruses and cytokine levels among intravenous drug users. J Huazhong Univ Sci Technolog Med Sci. 2006;26(2):221-4. Go to original source... Go to PubMed...
  10. Highleyman L. HIV and hepatitis C coinfection. BETA. 2003;15(4):32-44. Go to PubMed...
  11. Hart G. Factors associated with hepatitis B infection. Int J STD AIDS. 1993 Mar-Apr;4(2):102-6. Go to original source... Go to PubMed...
  12. Atkins M, Nolan M. Sexual transmission of hepatitis B. Curr Opin Infect Dis. 2005 Feb;18(1):67-72. Go to original source...
  13. ShepardCW,SimardEP,FinelliL,FioreAE,BellBP.HepatitisBvirusinfection: epidemiology and vaccination. Epidemiol Rev. 2006;28(1):112-25. Go to original source... Go to PubMed...
  14. MacKellar DA, Valleroy LA, Secura GM, McFarland W, Shehan D, Ford W, et al; Young Men's Survey Study Group. Two decades after vaccine license: hepatitis B immunization and infection among young men who have sex with men. Am J Public Health. 2001 Jun;91(6):965-71. Go to original source...
  15. EuroHIV [homepage on the Internet]. European centre for the epidemiological monitoring and AIDS [cited 2007 May 20]. Available from: http://www.eurohiv.org/.
  16. WHO Regional Office for Europe [homepage on the Internet]. The centralized information system for infectious diseases (CISID). Data Analyser 1. 9009 - Hepatitis B - Incidence (cases per 100 000 population) [cited 2007 Mar 19]. Available from: http://data.euro.who.int/cisid/?TabID=126822.
  17. Health Protection Inspectorate [homepage on the Internet]. Infection diseases in Estonia [cited 2007 Mar 17]. Available from: http://www.tervisekaitse.ee/?mid=210.
  18. Ministry of Social Affairs [homepage on the Internet]. Annual reports on Estonia as a whole [cited 2007 Mar 17]. Available from: http://www.sm.ee/eng/pages/index.htm.
  19. Tefanova V, Tallo T, Jaroslavtsev N, Kiko¹ G, Krupskaja L, Lisitsina S, at al. Viral hepatitis B and C: an actual epidemiological problem in the last decade in Estonia. Eesti Arst. 2004 Nov;83(11):738-43. (In Estonian.)
  20. Communicable diseases statistics in Estonia. Part 10. Tallinn: Health Protection Inspectorate; 2001. p. 64-80.
  21. Kalikova N. The HIV epidemic in Estonia. In: Proceedings of the 3rd Congress of the Estonian Society of Sexually Transmitted Infections (EUSTI). Tartu: Tartu Trükk; 2001. p. 14-5.
  22. Tefanova V, Krupskaja L, Kikos G, Tallo T, Priimägi L. Study on hepatitis B and hepatitis C epidemiology in Tallinn. EestiArst. 1998;78(6):552-3. (In Estonian.)
  23. Priimägi L, Kremerman I, Tefanova V, Tallo T, Osadtsaja G. Study on hepatitis C and hepatitis B infected intravenous drug users. Eesti Arst. 1998;78(6):521-3. (In Estonian.)
  24. Ministry of Social Affairs [homepage on the Internet]. MOS 2005 [cited 2005 Apr 04]. Available from: http://www.sm.ee/est/pages/index.html.
  25. Estonian Health Insurance Fund [homepage on the Internet]. EHIF Annual report 2005 [cited 2005Apr 04].Available from: http://www.haigekassa.ee.
  26. Tefanova V, Tallo T, Kutsar K, Priimagi L. Urgent action needed to stop spread of hepatitis B and C in Estonian drug users. Euro Surveill. 2006 Jan 26;11(1):E060126.3. Go to original source...
  27. Paat G. Sexual transmission of hepatitis B: a case-controls study [MSC dissertation]. Tartu: University of Tartu; 2007.
  28. Priimägi L, Tefanova V, Tallo T. Emerging viral hepatitis B and C in Estonia. In: Berencsi G, KhanAS, Halou¾ka J, editors. Emerging Biological Threat. Washington,D.C.: IOS Press; 2005. p. 20-5.
  29. Uusküla A, Heimer R, Dehovitz J, Fischer K, McNutt LA. Surveillance of HIV, hepatitis B virus, and hepatitis C virus in an Estonian injection drug-using population: sensitivity and specificity of testing syringes for public health surveillance. J Infect Dis. 2006 Feb 1;193(3):455-7. Go to original source... Go to PubMed...
  30. Tallo T, Norder H, Tefanova V, Krispin T, Priimägi L, Mukomolov S, et al. Hepatitis B virus genotype D strains from Estonia share sequence similarity with strains from Siberia and may specify ayw4. J MedVirol. 2004 Oct;74(2):221-7. Go to original source...
  31. Meriste S, Oona M, Tamm E, Lutsar I. Overview of immunisation-preventable infectious disease in Europe and in Estonia. Eesti Arst. 2006 Feb;85(2):107-26. (In Estonian.)
  32. Uusküla A, Silm H, Vessin T. Sexually transmitted diseases in Estonia: past and present. Int J STD AIDS. 1997 Jul;8(7):446-50. Go to original source...
  33. Uusküla A, Kalikova A, Zilmer K, Tammai L, DeHovitz J. The role of injecting drug use in the emergence of Human Immunodeficiency Virus infection in Estonia. Int J Infect Dis. 2002 Mar;6(1):23-7. Go to original source...
  34. Rhodes T, Stimson GV, Fitch C, Ball A, Renton A. Rapid assessment, injecting drug use, and public health. Lancet. 1999 Jul 3;354(9172):65-8. Go to original source... Go to PubMed...
  35. Dehne KL, Pokrovskiy V, Kobyshcha Y, Schwartländer B. Update on epidemics of HIV and other sexually transmitted infections in the newly independent states of the former Soviet Union. AIDS. 2000;14 Suppl 3: S75-84. Go to original source... Go to PubMed...
  36. Tichonova L, Borisenko K, Ward H, Meheus A, Gromyko A, Renton A. Epidemics of syphilis in the Russian Federation: trends, origins, and priorities for control. Lancet. 1997 Jul 19;350(9072):210-3. Go to original source... Go to PubMed...
  37. Rubins A, Rubins S, Jakabsone I. Syphilis and gonorrhoea in the Baltic countries. Sex Transm Infect. 2000 Jun;76(3):214. Go to original source... Go to PubMed...
  38. Kelly JA,Amirkhanian YA. The newest epidemic: a review of HIV/AIDS in Central and Eastern Europe. Int J STD AIDS. 2003 Jun;14(6):361-71. Go to original source... Go to PubMed...
  39. Uusküla A, Rajaleid K, Talu A, Abel K, Rüütel K, Hay G. Estimating injection drug use prevalence using state wide administrative data sources: Estonia, 2004. Addict Res Theory. 2007;15(4):411-24. Go to original source...
  40. Wilson TE, Sharma A, Zilmer K, Kalikova N, Uusküla A. The HIV prevention needs of injection drug users in Estonia. Int J STD AIDS. 2007 Jun;18(6):389-91. Go to original source... Go to PubMed...
  41. UuskülaA, McNutt LA, Dehovitz J, Fischer K, Heimer R. High prevalence of blood-borne virus infections and high-risk behaviour among injecting drug users in Tallinn, Estonia. Int J STD AIDS. 2007 Jan;18(1):41-6. Go to original source... Go to PubMed...
  42. Wilson TE, UuskülaA, Feldman J, Holman S, Dehovitz J.Acase-control study of beliefs and behaviors associated with sexually transmitted disease occurrence in Estonia. Sex Transm Dis. 2001 Nov;28(11):624-9. Go to original source... Go to PubMed...
  43. Lõhmus L, Trummal A. HIV/AIDS-related knowledge and behavior among MSM visiting gay websites. Tallinn: National Institute for Health Development; 2007. (In Estonian.)
  44. Weber R, Sabin CA, Friis-Møller N, Reiss P, El-Sadr WM, Kirk O, et al. Liver-related deaths in persons infected with the human immunodeficiency virus: the D:A:D study. Arch Intern Med. 2006 Aug 1428;166(15):1632-41. Go to original source... Go to PubMed...
  45. Koziel MJ, Peters MG. Viral hepatitis in HIV infection. N Engl J Med. 2007 Apr 5;356(14):1445-54. Go to original source... Go to PubMed...
  46. Plahhova T. North-Estonian Blood Centre. 2007 Mar 1 [personal communication].