Trends in the Incidence of Acute Hepatitis B in the Polish Population and Their Determinants

Introduction: The World Health Assembly adopted the Global Health Strategy and aims to reduce the incidence of Hepatitis from up to 10 million cases per year to 0.9 million cases and to reduce deaths from 1.4 million to 0.5 million per year by 2030. However, given the prevalence of chronic Hepatitis B in many countries and the incidence of new cases of acute Hepatitis B, the task is not easy. This study investigates the trends and determinants of the incidence of acute Hepatitis B in Poland in 2005-2019. Materials and Methods: Data on the incidence of acute hepatitis B (AHBV) were obtained from the National Institute of Public Health. A case definition for AHBV was consistent with the EU definition. The incidence trends were determined by considering the sex, age and place of residence. Due to the exponential dependence model, the computations were based on the logarithm of the incidence rate. This allowed for the transformation to linear form and analysis could be conducted using linear models. Pearson's correlation was used to determine the linear trend of incidence in general and according to sex and place of residence. The values of incidence rates (independent proportions test) and the coefficients illustrating the trends under study were also compared among males and females as well as urban and rural residents. Results: The incidence of AHBV in the Polish population decreased with similar slopes in both sexes. The newly reported cases of AHBV were more frequent in the male population. The incidence of acute Hepatitis B in the urban population was significantly higher than in the rural population. The significant decreasing trends in incidence were observed in all age ranges, with the exception of two age ranges 0-4 and 10-14, where the total incidence during the whole study period was negligible. Conclusion: Despite the significant decrease in the incidence of AHBV in Poland and its position among the European countries with the lowest hepatitis B (HBV) incidence, the alarmingly high proportion of iatrogenic infections requires further improvement in the sanitary condition of health care facilities. It is also necessary to decrease the number of unvaccinated individuals.