Prevalence of hepatitis B immunity and infection in home self-sampling HIV service users

Rachel Roche*, Ruth Simmons, Louise Logan, Juan Ledesma Moreno, Caroline Sabin, Samreen Ijaz, Sema Mandal

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Objectives: Although hepatitis B virus (HBV) vaccination for high-risk groups including gay, bisexual and other men who have sex with men (MSM) is recommended in the UK, data on HBV immunisation coverage are limited. This study aimed to understand the prevalence of HBV infection, susceptibility and immunity due to immunisation among a high-risk population of MSM and heterosexuals who are less likely to attend sexual health services. 

Methods: Residual HIV-negative serology samples archived from a national HIV self-sampling service in 2016 were tested for HBV markers using an unlinked anonymous approach. Prevalence of HBV infection, evidence of immunisation and susceptibility were calculated and stratified by individuals' characteristics. Multinomial logistic regression was used to estimate relative risk ratios (RRRs) associated with covariates. 

Results: Of 2172 samples tested, 1497 (68.9%) were from MSM and 657 (30.2%) were from heterosexuals. Susceptibility to HBV infection was 66.1% among MSM and 77.0% among heterosexuals. Only 29.9% of MSM and 17.4% of heterosexuals had serological evidence of immunisation. Current infection was 1.1% in heterosexuals and 0.2% in MSM. Adjusted analysis showed evidence of immunisation was lower among heterosexuals (RRR 0.66, 95% CI 0.50 to 0.86) and those with no previous HIV test (RRR 0.41, 95% CI 0.31 to 0.54), and higher in those of other white or other ethnicity. 

Conclusions: Among MSM and heterosexual users of a self-sampling HIV service, evidence of immunisation to HBV infection was low and susceptibility to infection was comparatively high, suggesting suboptimal delivery of HBV immunisation in sexual health services.

Original languageEnglish
Pages (from-to)286-292
Number of pages7
JournalSexually Transmitted Infections
Issue number4
Early online date30 Jun 2021
Publication statusPublished - 17 May 2022

Bibliographical note

Funding Information: The research was funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at UCL in partnership with PHE and in collaboration with the London School of Hygiene and Tropical Medicine. The views expressed are those of the authors and not necessarily those of the NIHR, the Department of Health and Social Care or Public Health England. The funders had no role in study design, data collection and analysis, or preparation of the manuscript. The final draft was circulated with the NIHR HPRU steering group prior to submission.

Open Access: This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

Publisher Copyright: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Citation: Roche R, Simmons R, Logan L, et al. Prevalence of hepatitis B immunity and infection in home self-sampling HIV service users. Sexually Transmitted Infections 2022;98:286-292.



  • Communicable diseases
  • Epidemiology
  • Hepatitis B
  • Serology
  • Sexual health


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