The United Kingdom is one of the few developed countries that
have not implemented universal immunisation. Instead, it follows
a policy of selective immunisation of high-risk groups, and
screening all women attending antenatal clinics. But this
approach has come in for some criticism. So, is the British
selective programme effective and should the UK now adopt
universal immunisation against hepatitis B, ask the authors?
Although the UK has one of the lowest incidences of hepatitis B
infection worldwide, the Health Protection Agency estimated that
only 44% of infections are potentially preventable under the
current programme. Of particular importance is the average net
immigration of about 6,500 people with chronic hepatitis B
infection each year between 1996 and 2000, say the authors. This
total is cumulative, and therefore the pool is increasing. For
example, in Ireland, the incidence of hepatitis B infection
increased markedly between 1997 and 2003, in part reflecting
migration from countries with high rate