Prevalence and risk factors for key infectious diseases amongst migrants to the UK: a systematic review

Migrants are at increased risk of infections including HIV, tuberculosis and viral hepatitis, with poorer outcomes. Early diagnosis and management can reduce morbidity, mortality and onward transmission. This systematic review summarises prevalence of HIV, latent and active tuberculosis and hepatitis B and C among UK migrants and evaluates associated risk factors.

PubMed/Medline, EMBASE, Web of Science and the Cochrane Library were systematically searched from 2004 to 11 June 2025. The review was conducted using PRISMA guidelines and registered with PROSPERO (registration CRD42024521191). Quality assessment was performed using the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies. High heterogeneity (I² = 95.2%, 99.2%, 87.2%, 96.9% and 91.6% for IGRA, active TB, HIV, HBV and HCV yields, respectively) indicated that meta-analysis was not appropriate. The impact of risk factors on prevalence was explored through meta-regression and descriptive analysis.

Of 2033 identified records, 36 were included, reporting Interferon Gamma Release Assay (IGRA) (n = 13), active TB (n = 10), HIV (n = 12), HBV (n = 16) and HCV (n = 11) test yields. An additional two publications excluded from the main analysis for reporting duplicate study data were included in the risk factor analysis because they stratified prevalence by additional risk factors. Highest yield was for IGRA which, excluding one lower prevalence outlier (6.9% (n = 1617)), was 15.1%-22.1%. There was high heterogeneity in active TB prevalence: 62-1,484/100,000. HIV prevalence among larger studies (n > 200) was 0.18%-0.48%. HBV prevalence was 0.00%-8.93% (all studies) and 1.06%-4.75% for larger studies (n > 1000). HCV prevalence was lower: 0.00%-1.67%, with only two of 11 included estimates above 0.50%. There was considerable heterogeneity in risk factors analysed making comparisons difficult.

Despite heterogeneity, infection prevalence was generally high, particularly IGRA yield and HBV. This underscores the need to maintain effective monitoring, testing and treatment for key infections among migrant populations, especially given the rapidly evolving epidemiological and demographic landscape for this population.