Research and analysis

Hepatitis B in Yorkshire and Humber: 2025 report

Published 14 May 2026

Applies to England

Introduction

Hepatitis B virus (HBV) is a blood-borne virus that can cause an acute or chronic infection of the liver. Chronic infection can lead to liver cirrhosis, liver cancer, and even death.

Prevention and treatment efforts have been combined to combat HBV infection and progress towards elimination of HBV as a public health threat by 2030 (set out in the World Health Organization (WHO) Global Health Sector Strategy on Viral Hepatitis). The National Strategic Group on Viral Hepatitis, a cross-agency expert advisory body supported by the UK Health Security Agency (UKHSA) provides strategic guidance on viral hepatitis in England, and supports progress toward achieving the WHO goal of HBV elimination.

The UKHSA publishes a national report on the scale of HBV infection and related disease in England (the latest report for Hepatitis B in England), presenting disease surveillance and programme data to support monitoring of England’s progress towards WHO HBV elimination targets.

This report complements the UKHSA Hepatitis B in England report and presents further information on HBV disease surveillance, trends in HBV diagnosis and testing and related diseases in Yorkshire and Humber UKHSA region with data up to end of 2024. Although this report uses national data sources, regional figures may differ from the national figures for a given metric. For further details about data sources see information on data sources.

Summary

Trends in HBV testing and diagnosis in the general population and risk groups

Main trends are:

• 886 new laboratory reports of hepatitis B in residents of Yorkshire and Humber, representing a rate of 15.6 reports per 100,000 population in 2024 
• the number of new laboratory reports has increased by 10.2% between 2023 and 2024, and increased by 2.5% over the past 10 years 
• in 2024, the number of new laboratory reports in males was 599 (67.6%) and in females was 267 (30.1%) 
• in 2024, the highest number of new laboratory reports was in males aged 35 to 44 and females aged 25 to 34 
• in 2024, the number of new positive laboratory reports by upper tier local authority of residence ranged from 7 in North Lincolnshire to 244 in Leeds; rates were highest in York at 48.7 new laboratory reports per 100,000 population and lowest in North Lincolnshire with 4.1 per 100,000 population 
• the estimated incidence of acute (or probable acute) infection was 0.4 per 100,000 population. This was lower than the England average of 0.5 per 100,000 
• there have been 48,357 individuals tested for hepatitis B surface antigens (HBsAg) in sentinel laboratories in Yorkshire and Humber UKHSA region in 2024, of which 0.6% tested positive - the proportion positive was higher for tests referred through GP (General Practice) surgeries (1.1%), higher for tests through sexual health services (SHS) (0.7%), lower for tests through drug services (0.3%) and lower for tests through emergency departments (ED) (0.2%); the total number of tests conducted in the region may have increased since 2024 partially as a result of a new ‘opt-out’ blood-borne virus testing programme at some EDs.

Monitoring HBV-related morbidity

Main trends are:

• there have been 890 hospital admissions for individuals with a diagnosis code for acute or chronic hepatitis B in Yorkshire and Humber UKHSA region in 2024 which was higher than in 2023 
• the number of hospital admissions with a diagnosis code for hepatitis B-related end-stage liver disease (HBV-related ESLD) and hepatitis B-related hepatocellular carcinoma (HBV-related HCC) was 40 and 10 respectively in 2024 

Prevention of infection by immunisation

Main trends are:

• routine hepatitis B vaccine coverage of 3 doses at 24 months in Yorkshire and Humber UKHSA region was 94.3% for financial year (FY) 2024 to 2025 , continuing to exceed the WHO threshold
• vaccine coverage of 3 doses at 24 months has increased by 0.2 percentage points  between financial years 2023 to 2024 and 2024 to 2025
• reported level of hepatitis B vaccine uptake among people who inject drugs (PWID) in Yorkshire and Humber UKHSA region was 54.4% for 2023 (the most recently reported data)
• reported level of hepatitis B vaccine uptake among PWID has increased by 5.8 percentage points  between 2022 and 2023

Trends in HBV testing and diagnosis in the general population and risk groups

Estimated prevalence of HBV

Table 1. Estimated hepatitis B prevalence and number of people living with chronic hepatitis B, UKHSA regions and England, 2024

Region	Estimated number of individuals with chronic hepatitis B, (95% confidence interval (CI))	Estimated HBsAg prevalence (%), (95% CI)	Estimated SSBBV coverage (%)
England	268,767 (227,896 to 314,004)	0.58 (0.50 to 0.68)	45
East of England	19,584 (6,282 to 48,679)	0.38 (0.12 to 0.95)	40
East Midlands	7,584 (3,633 to 15,369)	0.19 (0.09 to 0.38)	64
London	99,067 (78,415 to 120,263)	1.39 (1.10 to 1.69)	75
North East	7,950 (2,700 to 20,289)	0.36 (0.12 to 0.93)	32
North West	25,406 (17,060 to 37,303)	0.42 (0.28 to 0.62)	43
South East	25,678 (12,326 to 53,207)	0.34 (0.16 to 0.70)	34
South West	15,978 (8,336 to 32,977)	0.34 (0.18 to 0.70)	30
West Midlands	24,756 (14,343 to 41,647)	0.52 (0.30 to 0.87)	35
Yorkshire and Humber	16,720 (9,012 to 29,921)	0.37 (0.20 to 0.67)	39

New laboratory-confirmed diagnoses of HBV

Figure 1. Number of new laboratory reports of hepatitis B (acute and chronic), residents of Yorkshire and Humber UKHSA region, 2015 to 2024

Data source: Second Generation Surveillance System (SGSS). For further information, see information on data sources.

In 2022, a new bloodborne virus (BBV) testing programme was introduced in selected ED sites in areas of high HIV diagnosed prevalence across England. This ‘opt-out’ programme may have led to increases in new diagnoses, however since the start of the ED opt-out programme, only approximately 11% of new hepatitis B diagnoses nationally where testing location is known have been made in ED.

The number of new laboratory reports rose to 886 in 2024, exceeding pre‑pandemic levels and a 10.2% increase from the previous year. [HH1] Reports have now exceeded the number reported prior to the COVID-19 pandemic in 2015 to 2019. This likely reflects both true increases in testing opportunities (for example, ED opt‑out) and ongoing service recovery across primary care and SHS.

Figure 2. New laboratory reports of hepatitis B (acute and chronic) rate per 100,000 population [note 1], residents of Yorkshire and Humber UKHSA region and England, 2015 to 2024

Data sources: SGSS and ONS MYE. For further information, see information on data sources.

Note 1: the error bands represent 95% confidence intervals.

In 2024, Yorkshire and Humber’s rate (15.6/100,000) was lower than England (21.4/100,000). Regional rates have been below the England average throughout most of the last 10 years. Rates of new laboratory reports have increased since 2020.

Since 2022, nationally funded ED opt-out programmes have become an important additional route to diagnosis in England and has contributed substantially to BBV testing and newly identified HBV infections nationally. Two trusts in Yorkshire and Humber were enrolled in this scheme towards the end of 2024.

Table 2. Number of new laboratory reports of hepatitis B (acute and chronic) by UKHSA region of residence, 2015 to 2024

Area	2015	2016	2017	2018	2019	2020	2021	2022	2023	2024
East Midlands	281	407	574	590	535	339	426	556	675	675
East of England	636	674	616	513	616	495	511	650	721	809
London	5,581	6,666	4,875	2,851	3,302	2,531	2,703	3,830	5,291	5,359
North East	155	192	228	199	206	112	144	205	271	275
North West	780	761	715	830	1,123	750	794	771	1,137	1,736
South East	712	684	830	726	966	533	734	978	1,072	1,077
South West	385	431	569	445	371	348	547	697	590	656
West Midlands	858	889	890	850	868	557	627	860	1,188	1,081
Yorkshire and Humber	864	699	683	755	764	451	548	731	804	886
England [note 2]	10,252	11,406	9,991	7,829	8,806	6,149	7,107	9,427	11,910	12,566

Data source: SGSS. For further information, see information on data sources.

Note 2: sum of all regional cases may not equal the number of England cases as some cases may not have been able to be assigned to a region.

Table 3. Rate per 100,000 population of new laboratory reports of hepatitis B (acute and chronic) by UKHSA region of residence, 2015 to 2024

Area	2015	2016	2017	2018	2019	2020	2021	2022	2023	2024
East Midlands	6.0	8.6	12.0	12.3	11.0	7.0	8.7	11.3	13.5	13.3
East of England	10.0	10.5	9.5	7.9	9.4	7.5	7.7	9.7	10.6	11.8
London	64.4	76.2	55.5	32.3	37.1	28.5	30.7	43.2	58.8	59.0
North East	5.9	7.3	8.7	7.6	7.8	4.2	5.4	7.6	9.9	10.0
North West	10.9	10.5	9.8	11.3	15.3	10.2	10.7	10.2	14.9	22.4
South East	8.2	7.8	9.4	8.2	10.8	6.0	8.1	10.7	11.6	11.5
South West	7.0	7.8	10.2	7.9	6.6	6.1	9.6	12.1	10.1	11.1
West Midlands	14.9	15.3	15.2	14.4	14.7	9.4	10.5	14.3	19.5	17.5
Yorkshire and Humber	16.1	12.9	12.6	13.9	14.0	8.2	10.0	13.2	14.3	15.6
England	18.7	20.6	18.0	14.0	15.7	10.9	12.6	16.5	20.6	21.4

Data sources: SGSS and ONS MYE. For further information, see information on data sources.

In 2024, the Yorkshire and Humber region had the fourth highest rate of new laboratory-confirmed reports of hepatitis B (acute and chronic) (886 reports and rate of 15.6 reports per 100,000 population) (Table 2 and 3). London reports (59.0 reports per 100,00 population) accounted for 43% of all reports in England and continues to be significantly higher than the rate for all other regions.

Figure 3. Age group and sex of new laboratory reports of hepatitis B (acute and chronic) [note 3], residents of Yorkshire and Humber UKHSA region, 2024

Data source: SGSS. For further information, see information on data sources.

Note 3: cases reported in children under one year old have been removed. 20 Hepatitis B cases in Yorkshire and Humber region in 2024 had no age and/or sex data and have not been included in this age-sex pyramid.

Age and sex were recorded for 866 of 886 (97.7%) new laboratory‑confirmed hepatitis B reports among Yorkshire and Humber residents in 2024. Of those with known sex, 599 (69.2%) were male and 267 (30.8%) were female. The highest numbers occurred in men aged 35 to 44 (n=170) and women aged 25 to 34 (n=103). In 2024, men accounted for a higher proportion of reports in every age group, including those 65 years and over.

Figure 4. Ethnicity distribution of new laboratory reports of new diagnoses of HBV [note 4], residents of Yorkshire and Humber UKHSA region, 2015 to 2024

Data source: SGSS. For further information, see information on data sources.

Note 4: this figure excludes cases of unknown ethnicity.

Figure 4 shows the proportion of laboratory-confirmed reports of new diagnoses of HBV in Yorkshire and Humber residents over the past 10 years by ethnicity. Ethnicity was recorded for 275 of 886 (31%) reports. This represents a substantial decline in completeness compared with previous years and should be considered when interpreting trends. In 2024, the White British and Black or Black British groups each accounted for around one‑quarter of reports where ethnicity was recorded (White British 26.6%, n=73; Black or Black British 26.2%, n=72).

Table 4. Number of new laboratory reports of hepatitis B (acute and chronic) by upper tier local authority of residence [note 5], Yorkshire and Humber UKHSA region, 2015 to 2024

Upper tier local authority	2015	2016	2017	2018	2019	2020	2021	2022	2023	2024
Barnsley	12	17	25	21	12	10	21	17	12	11
Bradford	111	64	46	65	80	48	57	85	94	89
Calderdale	6	14	9	14	13	4	6	14	13	15
Doncaster	21	15	20	23	26	20	15	23	19	25
East Riding of Yorkshire	3	11	12	13	20	16	14	15	17	21
Kingston upon Hull	1	7	8	23	32	17	33	48	47	39
Kirklees	51	40	42	52	42	24	39	42	45	43
Leeds	176	123	198	248	233	106	105	163	213	244
North East Lincolnshire	5	8	4	10	4	6	9	7	12	8
North Lincolnshire	9	8	8	12	14	14	10	11	10	7
North Yorkshire	49	57	71	71	53	42	49	70	70	99
Rotherham	19	20	7	14	28	8	16	23	33	13
Sheffield	95	80	99	89	121	62	95	132	124	140
Wakefield	28	13	20	21	25	21	16	18	25	30
York	42	78	83	78	60	53	61	62	69	102

Data source: SGSS. For further information, see information on data sources.

Note 5: this table excludes cases where upper tier local authority was unknown.

Table 5. Rate per 100,000 population of new laboratory reports of hepatitis B (acute and chronic) by upper tier local authority of residence [note 6], Yorkshire and Humber UKHSA region, 2015 to 2024

Upper tier local authority	2015	2016	2017	2018	2019	2020	2021	2022	2023	2024
Barnsley	5.0	7.1	10.4	8.7	4.9	4.1	8.6	6.9	4.8	4.4
Bradford	20.8	11.9	8.5	12.0	14.7	8.8	10.4	15.4	16.8	15.8
Calderdale	2.9	6.7	4.3	6.8	6.3	1.9	2.9	6.7	6.2	7.1
Doncaster	6.9	4.9	6.5	7.5	8.4	6.5	4.9	7.4	6.0	7.8
East Riding of Yorkshire	0.9	3.3	3.6	3.9	5.9	4.7	4.1	4.3	4.8	5.9
Kingston upon Hull	0.4	2.6	3.0	8.6	11.9	6.4	12.4	17.9	17.2	14.2
Kirklees	11.8	9.2	9.7	12.0	9.7	5.5	9.0	9.6	10.1	9.6
Leeds	22.6	15.6	25.0	31.1	29.0	13.1	13.0	19.9	25.6	28.9
North East Lincolnshire	3.1	5.0	2.5	6.3	2.5	3.8	5.7	4.4	7.6	5.0
North Lincolnshire	5.3	4.7	4.7	7.0	8.2	8.2	5.9	6.5	5.9	4.1
North Yorkshire	8.1	9.4	11.7	11.7	8.7	6.9	7.9	11.2	11.1	15.6
Rotherham	7.3	7.6	2.6	5.3	10.5	3.0	6.0	8.6	12.1	4.7
Sheffield	17.1	14.4	17.8	16.0	21.7	11.2	17.1	23.3	21.5	24.0
Wakefield	8.4	3.9	5.9	6.1	7.2	6.0	4.5	5.0	6.9	8.2
York	20.7	38.4	40.8	38.3	29.4	26.2	30.2	30.3	33.4	48.7

Data sources: SGSS and ONS MYE. For further information, see information on data sources.

Note 6: this table excludes cases where upper tier local authority was unknown.

Counts and rates continue to vary significantly among local authorities across the Yorkshire and Humber region, the number of new laboratory-confirmed reports of hepatitis B (acute and chronic) ranged from 7 in North Lincolnshire to 244 in Leeds in 2024 (Table 4). The corresponding rates ranged from 4.1 per 100,000 in North Lincolnshire to 48.7 per 100,000 in York (Table 5).

Figure 5. Test location of new laboratory reports of hepatitis B (acute and chronic), residents of Yorkshire and Humber UKHSA region, 2024

Data sources: SGSS. For further information, see information on data sources.

Diagnoses arise from multiple settings (primary care, SHS, EDs   and others). In 2024, most reports arose from testing at general practice (37.4%) or hospital (45.7%).

Since 2022, the ED opt‑out programme has become an important additional route to diagnosis in England and has contributed substantially to BBV testing and newly identified HBV infections nationally. Although no trusts in Yorkshire and Humber were included in the first round of the initiative, 2 trusts began opt-out BBV testing, including HBV, towards the end of 2024.

Acute or probable acute diagnoses of HBV

Figure 6. Estimated incidence of acute or probable acute hepatitis B per 100,000 population by UKHSA region [note 7], 2024

Data sources: SGSS, UKHSA Case and Incident Management System (CIMS) and ONS MYE. For further information, see information on data sources.

Note 7: UKHSA transitioned to a new case management system for notifiable diseases in 2024 which has impacted the identification of people with acute hepatitis B and likely resulted in underreporting.

In 2024, the Yorkshire and Humber region had the fifth lowest estimated incidence of acute or probable acute hepatitis B (0.4 per 100,000 population) of all UKHSA regions and was lower than the England average of 0.5 per 100,000 (Figure 6). It is possible incidence of acute cases is an underestimate in all regions nationally (see note 8, below).

Figure 7. Estimated incidence of acute or probable acute hepatitis B per 100,000 population [note 8], Yorkshire and Humber UKHSA region and England, 2015 to 2024

Data sources: SGSS, CIMS and ONS MYE. For further information, see information on data sources.

Note 8: UKHSA transitioned to a new case management system for notifiable diseases in 2024 which has impacted the identification of people with acute hepatitis B and likely resulted in underreporting.

In line with the England trend, the estimated incidence of acute or probable acute hepatitis B shows a general downward trajectory in Yorkshire and Humber. From a peak of 0.9 in 2018 to approximately 0.3 in 2022 and 2023. In 2024 the rate rose to 0.4 which is comparable to 2019 and remains below pre‑2019 levels, although it represents a slight increase compared with 2023. The markedly lower rates in 2021 were likely due to the impact of pandemic restrictions and disruption in services, with data for England showing a similar pattern.

HBV testing in the wider population

Figure 8. Number of individuals tested for HBsAg by year (excluding antenatal testing) and proportion positive in sentinel laboratories [note 9] in Yorkshire and Humber UKHSA region, 2015 to 2024

Data source: SSBBV Testing. For further information, see information on data sources.

Note 9: the error band represents 95% confidence intervals.

Sentinel surveillance data is from 2 laboratories in the Yorkshire and Humber. The number of individuals tested for HBsAg in sentinel laboratories in Yorkshire and Humber region increased by 37% in 2024 (48,357) compared to 2023 (35,192), this may in part reflect increased testing through the opt-out ED testing programme (Figure 8 and Figure 12). However, participating Yorkshire and Humber hospitals were included in the programme in the latter part of 2024. Testing volumes remain below the pre‑pandemic peak in 2019 (55,982). Of those tested in 2024, 0.6% were positive (95% CI 0.6 to 0.7).

Numbers tested and positivity rates according to service-type are presented in Figures 9 to 12. However, 36,0% of diagnoses were made in ‘other’ services in Yorkshire and Humber. The ‘other’ category includes prisons, hospitals (excluding EDs), mental health services, community healthcare, occupational health services, care or residential homes, university, and fertility clinics.

The SHS positivity was 0.7% (95% CI 0.5 to 0.9), very similar to all‑site regional positivity of 0.6% (95% CI 0.6 to 0.7) (Figure 8). General practice continued to show a higher positivity (1.1%, 95% CI 0.9 to 1.3), reflecting more risk‑proximal testing. Whereas drug services (0.3%, 95% CI 0.1 to 0.8) and EDs (0.2%, 95% CI 0.1 to 0.3) had lower positivity. However, EDs accounted for approximately 22% of all HBsAg tests in 2024, possibly supporting case‑finding among people who may not otherwise be tested.

Figure 9. Number of individuals tested for HBsAg by year (excluding antenatal testing) and proportion positive, through GP surgeries in sentinel laboratories [note 9] in Yorkshire and Humber UKHSA region, 2015 to 2024

Data source: SSBBV Testing. For further information, see information on data sources.

Note 9: the error band represents 95% confidence intervals.

Of the 48,357 individuals tested for HBsAg in Yorkshire and Humber in 2024, 14,571 (30%) were referred through GP surgeries submitting samples to sentinel laboratories (Figure 9). The proportion positive was higher for tests referred through these GP surgeries (1.1% (95% CI 0.9 to 1.3) compared to the all‑site regional positivity, possibly reflecting more risk‑proximal testing (Figure 9).

Testing and diagnoses in sexual health services (SHS)

Figure 10. Number of individuals tested for HBsAg by year (excluding antenatal testing) and proportion positive, through sexual health services in sentinel laboratories [note 9] in Yorkshire and Humber UKHSA region, 2015 to 2024

Data source: Sentinel Surveillance of Bloodborne Virus Testing. For further information, see information on data sources.

Note 9: the error band represents 95% confidence intervals.

Of the 48,357 individuals tested for HBsAg in Yorkshire and Humber in 2024, 4,153 (8.6%) were tested via SHS (Figure 10). The SHS positivity was 0.7% (95% CI 0.5 to 0.9), very similar to the all‑site regional positivity of 0.6% (95% CI 0.6 to 0.7) (Figure 8).

Testing and diagnoses in people who inject drugs and/or attend drug services

Figure 11. Number of individuals tested for HBsAg by year (excluding antenatal testing) and proportion positive, through drug services in sentinel laboratories [note 9] [note 10] in Yorkshire and Humber UKHSA region, 2015 to 2024

Data source: Sentinel Surveillance of Bloodborne Virus Testing. For further information, see information on data sources.

Note 9: the error band represents 95% confidence intervals.

Note 10: Between 2023 and 2024, there was underreporting of hepatitis testing data from a sentinel laboratory which undertakes a large proportion of testing for drug treatment services, making it difficult to monitor trends in drug treatment services over this period.

Of the 48,357 individuals tested for HBsAg in Yorkshire and Humber in 2024, approximately equal to 2.8% (1,359) were tests undertaken among PWID and/or attend drug services (Figure 11). The positivity in drug services was 0.3% (95% CI 0.1 to 0.8), lower than the all‑site regional positivity of 0.6% (95% CI 0.6 to 0.7). The number of individuals tested through drug services in Yorkshire and Humber has increased substantially over the last 10 years. From 489 tests in 2015 to 4,926 in 2022, before declining in 2023 to 2024.

Testing and diagnoses in people attending emergency departments

Figure 12. Number of individuals tested for HBsAg by year and proportion positive, through emergency departments in sentinel laboratories [note 9] in Yorkshire and Humber UKHSA region, 2015 to 2024

Data source: Sentinel Surveillance of Bloodborne Virus Testing. For further information, see information on data sources.

Note 9: the error band represents 95% confidence intervals.

The opt-out ED BBV testing programme was scaled-up to include 2 trusts in Yorkshire and Humber towards the end of 2024. Samples from Leeds are tested at a sentinel laboratory and are included here.

ED testing in the region increased to 10,847 tests in 2024, accounting for approximately 22.4% of all HBsAg tests performed in sentinel laboratories that year (10,847 out of 48,357). ED positivity in 2024 was 0.2% (95% CI 0.1 to 0.3), compared with an all‑site average of 0.6% (95% CI 0.6 to 0.7), consistent with EDs reaching a broader cross‑section of attendees rather than predominantly high‑risk groups.

Coverage of maternal hepatitis B surface antigen (HBsAg) testing

Figure 13. Coverage of hepatitis B antenatal screening by NHS region - Screening Standard IDPS-S02, NHS North East and Yorkshire region, financial years 2021/2022 to 2023/2024

Data source: Infectious Disease in Pregnancy Screening (IDPS) (for further information, see information on data sources).

The Infectious Disease in Pregnancy Screening (IDPS) programme changed its regional reporting structure in 2021, so data is only available from FY 2021 to 2022 onward. NHS regions differ from UKHSA regions; the region used here is the NHS North East and Yorkshire area.

In the FY 2023 to 2024, 82,982 women were eligible for hepatitis B antenatal screening in this NHS region, with 99.8% tested - surpassing the WHO 2030 target of 90% or above (Figure 13).

Monitoring HBV-related morbidity

Hospital admissions with HBV

Figure 14. Number of hospital admissions [note 11] and admission rate per 100,000 population [note 12] for individuals with a diagnosis code for acute or chronic hepatitis B [note 13], residents of Yorkshire and Humber UKHSA region [note 14], 2015 to 2024

Data source: Hospital Episode Statistics (HES), NHS England. Produced by the UK Health Security Agency. Copyright © 2025, re-used with the permission of NHS England. All rights reserved. For further information, see information on data sources.

Note 11: data has been suppressed in accordance with NHS disclosure control guidance for sub-national breakdowns. Numbers between 1 and 7 (inclusive) are suppressed and (where appropriate) represented in the figure by asterisks (*). All other numbers are rounded to the nearest 5. Zeroes are unchanged. Due to data quality issues around HES identifiers, data has been omitted for 2017 and 2018 (grey box).

Note 12: rates have been calculated using ONS mid-year population estimates.

Note 13: hepatitis B is defined by ‘International Statistical Classification of Diseases and Related Health Problems 10th Revision’ (ICD-10) codes B16.0, B16.1, B16.2, B16.9, B18.0 and B18.1.

Note 14: there is a high proportion of data missingness in the HES data for the geographies of residence for people admitted to hospital with acute and chronic hepatitis B (approximately 25% for 2024 admissions). This means that the regional admission counts and rates are likely an underestimate of the true number.

There were 890 (rounded to nearest 5) hospital admissions for individuals with a diagnosis code for acute or chronic hepatitis B among Yorkshire and Humber residents in 2024, up from 765 in 2023. The admission rate rose from 13.6 per 100,000 in 2023 to 15.7 per 100,000 in 2024 which mirrors the national trend (Figure 14). Rates in Yorkshire and Humber remain lower than England overall, where the 2024 rate was 20.0 per 100,000 (11,695 admissions).

Figure 15. Number of hospital admissions [note 15] for individuals with a diagnosis code for hepatitis B-related end-stage liver disease (HBV-related ESLD) or hepatitis B-related hepatocellular carcinoma (HBV-related HCC) [note 16] [note 17], residents of Yorkshire and Humber UKHSA region [note 18], 2015 to 2024

Data source: Hospital Episode Statistics (HES), NHS England. Produced by the UK Health Security Agency. Copyright © 2025, re-used with the permission of the NHS England. All rights reserved. For further information, see information on data sources. 

Note 15: data has been suppressed in accordance with NHS disclosure control guidance for sub-national breakdowns. Numbers between 1 and 7 (inclusive) are suppressed and (where appropriate) represented in the figure by asterisks (*). All other numbers are rounded to the nearest 5. Zeroes are unchanged. Due to data quality issues around HES identifiers, data has been omitted for 2017 and 2018 (grey box).

Note 16: end-stage liver disease (ESLD) is defined by ICD-10 codes for ascites (R18), bleeding oesophageal varices (I85.0 and I98.3), hepato-renal syndrome (K76.7), hepatic encephalopathy (K72.9) or hepatic failure (K72.0, K72.1 and K70.4). Hepatocellular carcinoma (HCC) is defined by ICD-10 code for hepatocellular carcinoma (C22.0).

Note 17: the methodology used to calculate hepatitis B-related ESLD and HCC admissions has been updated for this report, as the previous method of only using HES data may under report hepatitis B as it relies on a diagnosis of hepatitis B being recorded in HES. The updated methodology, which follows the ‘upper bound’ methodology outlined in Hepatitis B in England 2025 report, links HES data to laboratory diagnoses of hepatitis B from SGSS and SSBBV from any year.

Note 18: there is a high proportion of data missingness in the HES data for the geographies of residence for people admitted to hospital with ESLD and/or HCC (approximately 23% for ESLD admissions in 2024 and approximately 26% for HCC admissions in 2024). This means that the regional admission counts are likely an underestimate of the true number.

As shown in Figure 15, HES identified 40 presentations (rounded to nearest 5) ESLD in Yorkshire and Humber in 2024, up from 35 in 2023 and similar to 2022 (40). HBV‑related HCC admissions were 10 in 2024, down from 20 in 2023 and 15 in 2022.

Monitoring HBV-related mortality

Figure 16. Rate of deaths with ESLD [note 19] or HCC in those with HBV mentioned on their death certificate [note 20] by UKHSA region, 2020 to 2024

Data sources: ONS Mortality and ONS MYE. For further information, see information on data sources.

Note 19: ESLD is defined by codes or text entries for ascites, bleeding oesophageal varices, hepato-renal syndrome, hepatic encephalopathy or hepatic failure. Patients were identified via ICD-10 codes and text searching.

Note 20: the methodology used to calculate hepatitis B-related mortality has been updated for this report, as the previous method of only counting deaths where ESLD and/or HCC and hepatitis B were reported in ONS death registrations may lead to underreporting. The updated methodology, which follows the ‘upper estimate’ methodology outlined in Hepatitis B in England 2025 report, links ONS deaths registrations data to HES hospital admissions data and laboratory diagnoses of hepatitis B from SGSS and SSBBV from any year to yield a maximum number of deaths attributable to hepatitis B-related ESLD and/or HCC.

Between 2020 and 2024, the rate of deaths with ESLD or HCC in which hepatitis B was mentioned on the death certificate was 0.3 per 100,000 in Yorkshire and Humber, which is similar to the England rate of 0.3 per 100,000 (Figure 16).

Prevention of infection by immunisation

Coverage of hepatitis B vaccine 3 doses (HepB3) in universal programme

Figure 17. Routine hepatitis B vaccine coverage of 3 doses of the hexavalent vaccine at 12 months, Yorkshire and Humber UKHSA region and England, financial years 2019/2020 to 2024/2025

Data source: NHS Childhood Vaccination Coverage Statistics (COVER). For further information, see information on data sources.

Yorkshire and Humber has consistently maintained over 90% coverage for 3 doses of HepB3 by 12 months in previous years. Coverage in FY 2024 to 2025 (92.8%) was similar to that in the preceding year (92.8%). However, as observed across other infant immunisation programmes in the UK, coverage has been gradually declining both regionally and nationally, falling from 94.2% in FY 2019 to 2020 in Yorkshire and Humber.

Figure 18. Routine hepatitis B vaccine coverage of 3 doses of the hexavalent vaccine at 24 months, Yorkshire and Humber UKHSA region and England, financial years 2020/2021 to 2024/2025

Data source: NHS COVER. For further information, see information on data sources.

Coverage of children receiving 3 doses of HepB3 vaccine improved by 24 months of age compared to coverage at 12 months and ranged from 95.5% in FY 2020 to 2021 and 94.3% in FY 2024 to 2025 (Figure 18). Despite a small increase compared to last year, there continues to be a general downward trend over time during this period.

Coverage of hepatitis B vaccine 3 doses (HepB3) in selective programme

Table 6. Children born to mothers positive for hepatitis B vaccinated against hepatitis B by their first birthday by upper tier local authority: vaccine coverage (5 doses routine and selective combined [note 21]) and eligible population, Yorkshire and Humber UKHSA region, FY 2024 to 2025

Local authority	Eligible population	Number vaccinated	Percentage covered (%)
Barnsley	6	6	100.00%
Bradford	12	11	91.70%
Calderdale	[note 22]	[note 22]	70% to 100%
Doncaster	9	9	100.00%
East Riding of Yorkshire	[note 22]	[note 22]	70% to 100%
Kingston upon Hull	17	17	100.00%
Kirklees	8	7	87.50%
Leeds	27	23	85.20%
North East Lincolnshire	[note 22]	[note 22]	70% to 100%
North Lincolnshire	[note 22]	[note 22]	70% to 100%
North Yorkshire	[note 22]	[note 22]	70% to 100%
Rotherham	[note 22]	[note 22]	70% to 100%
Sheffield	16	16	100.00%
Wakefield	16	14	87.50%
York	[note 22]	[note 22]	70% to 100%

Data source: NHS COVER. For further information, see information on data sources.

Note 21: babies received 2 monovalent vaccines (at birth and at 4 weeks), and 3 doses of hexavalent vaccines (at 8, 12 and 16 weeks).

Note 22: denotes that data is suppressed due to potential disclosure issues associated with small numbers.

Coverage of children in the high-risk selective programme receiving 3 doses of HepB3 vaccine by their first birthday varied across local authorities in Yorkshire and Humber in FY 2024 to 2025, ranging from 85.2% in Leeds to 100% in Barnsley, Doncaster, Kingston upon Hull and Sheffield. Overall numbers of eligible children in this selective programme are very low at upper tier local authority level, therefore numbers should be treated with caution.

Table 7. Children born to mothers positive for hepatitis B vaccinated against hepatitis B by their second birthday by upper tier local authority: vaccine coverage (6 doses routine and selective combined [note 23]) and eligible population, Yorkshire and Humber UKHSA region, FY 2024 to 2025

Local authority	Eligible population	Number vaccinated	Percentage covered (%)
Barnsley	6	6	100.00%
Bradford	13	13	100.00%
Calderdale	[note 24]	[note 24]	70% to 100%
Doncaster	[note 24]	[note 24]	70% to 100%
East Riding of Yorkshire	[note 24]	[note 24]	70% to 100%
Kingston upon Hull	14	9	64.30%
Kirklees	11	10	90.90%
Leeds	37	20	54.10%
North East Lincolnshire	[note 24]	[note 24]	70% to 100%
North Lincolnshire	0	0	Not applicable
North Yorkshire	6	5	83.30%
Rotherham	[note 24]	[note 24]	35% to 69%
Sheffield	18	17	94.40%
Wakefield	7	6	85.70%
York	[note 24]	[note 24]	70% to 100%

Data source: NHS COVER. For further information, see information on data sources.

Note 23: babies received 3 monovalent vaccines (at birth, 4 weeks and 12 months), and 3 doses of hexavalent vaccines (at 8, 12 and 16 weeks).

Note 24: denotes that data is suppressed due to potential disclosure issues associated with small numbers.

Coverage of children in the high risk selective programme receiving 3 doses of HepB3 vaccine by their second birthday was lowest in Leeds (54.1%; 20 out of 37) and the highest in Barnsley (100%; 6 out of 6) and Bradford (100%; 13 out of 13).

Vaccine uptake in people who inject drugs

Figure 19. Reported level of hepatitis B vaccine uptake among people who inject drugs (PWID), Yorkshire and Humber UKHSA region, 2014 to 2023

Data source: Unlinked Anonymous Monitoring (UAM) survey. For further information, see information on data sources.

Hepatitis B vaccine uptake in PWID has decreased in Yorkshire and Humber from 80.1% in 2018 to 48.5% in 2022, with a sharp drop between 2021 (71.8%) and 2022; there was a partial recovery to 54.4% in 2023, but uptake remained below England in the same year (62.2%)

Prevention of infection by harm reduction

Figure 20. Reported level of direct sharing of needles and/or syringes among people who inject drugs (PWID) in the preceding 4 weeks, Yorkshire and Humber UKHSA region and England, 2014 to 2023

Data source: UAM survey. For further information, see information on data sources.

The proportion of PWID in Yorkshire and Humber reporting direct sharing of needles and/or syringes in the previous 4 weeks increased from 10.0% in 2021 to 20.8% in 2022, similar to 2019 (20.1%) and close to the England average in 2022 (19.6%); in 2023, sharing rose further to 28.7% in Yorkshire and Humber compared with 25.2% in England (Figure 20).

Figure 21. Reported level of direct and indirect sharing of injecting equipment among people who inject drugs (PWID) in the preceding 4 weeks, Yorkshire and Humber UKHSA region and England, 2014 to 2023

Data source: UAM survey. For further information, see information on data sources.

The proportion of PWID in Yorkshire and Humber reporting direct and indirect sharing of injecting equipment in the past 4 weeks rose from 41.4% in 2021 to 45.8% in 2022, exceeding the England average in 2022 (39.1%); in 2023, the regional figure fell to 37.2% (Figure 21).

Information on data sources

Second Generation Surveillance System (SGSS)

Brief description

SGSS captures routine laboratory surveillance data on infectious diseases and antimicrobial resistance from laboratories within England. Along with a number of other organisms, hepatitis B is notifiable under the Health Protection (Notifications) Regulations (2010).

Technical notes

Data extracted from Sentinel Surveillance of Blood Borne Virus testing (SSBBV) and SGSS will vary for several reasons and should not be compared: the 2 systems have collected data over different historical periods, with data reported to SGSS and predecessor systems since 1995, whereas SSBBV has been running since 2002. Data reported to SSBBV reflects the timeframe from when the laboratory joined the surveillance system, with laboratories joining more recently having less data available than laboratories who have been reporting since 2002. Furthermore, whilst SGSS collects national level data, SSBBV collects data from a subset of laboratories. There are 35 laboratories which report to SSBBV with an estimated 45% coverage testing in the GP registered population in England.

Data completeness for ethnicity within this dataset declines over time, due to changes in methodology. ONOMAP, an ethnicity estimator which classifies ethnicity based on name is no longer used. Ethnicity is assigned using data reported through the test request form and through linkage to healthcare datasets and represents ethnicity that is assigned rather than estimated. Data will improve over time as additional information is reported, older records are more likely to be more complete.

Laboratory reports of new diagnoses of HBV include positive test results for HBV surface antigen (HBsAg) and are submitted to UKHSA or predecessor organisations via SGSS/CoSurv.

Data includes laboratory reports for both acute and chronic hepatitis B infections and therefore cannot be used to estimate incidence.

Data is assigned to local authority and UKHSA region by patient postcode where present, if patient postcode is unknown, data is assigned to local authority and UKHSA region of registered general practice; where both patient postcode and registered general practice are unknown data is assigned to local authority and UKHSA region of laboratory.

Dates are assigned based on earliest positive specimen date.

Patient identifiable data submitted by NHS laboratories is variable, particularly from sexual health and drug and alcohol services, which limits the ability to deduplicate.

Laboratory reports for children under one year of age are excluded from the analyses to rule out detecting maternal antibody.

Rates per 100,000 have been calculated using mid-year population estimates supplied by the Office for National Statistics (ONS).

Caveat: SGSS data in this report may differ from data shown in the Hepatitis B in England report and from data reported in other surveillance outputs at a different point in time. This is due to the SGSS dataset being a live system and a number of cleaning, deduplication, remapping and other operational processes being routinely applied to the data to improve data quality.

HPZone/CIMS

Brief description

HPZone was a case and outbreak management system used by the health protection teams (HPTs) in UKHSA until mid-2024, when it was replaced by a new Case and Incident Management System (CIMS). Details related to cases of hepatitis A, B, C and E are stored on this system in addition to details of other infections reported to the HPTs. 

HPZone and CIMS are secure systems. Where acute hepatitis B cases are reported, HPTS used HPZone historically and CIMS currently to capture data about these cases and relevant risk factors to inform public health action. As a result of the transition from HPZone to CIMS in mid-2024, there is a known issue that has likely impacted the identification of people with acute hepatitis B and likely resulted in the underreporting of cases. 

Hepatitis B case definitions using SGSS and HPZone/CIMS data

The definition for acute hepatitis B is ‘HBsAg positive and anti-HBc IgM positive and abnormal liver function tests with a pattern consistent with acute viral hepatitis’. As information on liver function is not usually available to UKHSA, for the purpose of this analysis the following case definitions were used:

• cases classified as acute viral hepatitis B by the local UKHSA region or the laboratory and/or with a documented positive anti-HBc IgM were classified as acute cases
• cases classified as acute viral hepatitis B by the local UKHSA region but without an anti-HBc IgM test result or not classified but a positive anti-HBc IgM reported were assumed to be probable acute hepatitis B cases
• cases initially classified as acute by the local UKHSA region but with contradictory laboratory evidence were reclassified as chronic infections
• cases classified as chronic infections or those not classified where anti-HBc IgM was negative or equivocal or missing were assumed to be chronic infections

The case definitions were derived using the following methodology: cases reported to UKHSA regions via HPZone/CIMS were extracted from 1 January 2015 to 31 December 2024 and matched using identifiers to SGSS data. The SGSS data was used to determine final classification of any cases reported from the UKHSA region via HPZone/CIMS. A final reconciled data set including cases classified as acute or probable acute was used for this report. 

Technical notes

UKHSA transitioned to a new case management system for notifiable diseases in 2024 which has impacted the identification of people with acute hepatitis B and likely resulted in underreporting.

Sentinel Surveillance of bloodborne viruses (BBVs)

Brief description

The sentinel surveillance study of hepatitis, HIV and HTLV began in 2002 and provides information on testing, individual risk exposures and clinical symptoms. The study collects information on blood borne virus testing carried out in participating sentinel laboratories regardless of result. In 2022 there were 24 participating laboratories and at the time this report was produced there were 28 participating laboratories, some of the new laboratories have provided legacy data if they were able to. 

Technical notes

See first technical note for SGSS

Excludes dried blood spot, oral fluid, reference testing and testing from hospitals referring all samples. Data is de-duplicated subject to availability of date of birth, Soundex and first initial.

Individuals under one year old are excluded from the analysis. 

Regional and England data is aggregated data for all organisations who provided complete data for all 4 quarters. Data is assigned to UKHSA region by the location of the requesting testing site.

Infectious Diseases in Pregnancy Screening (IDPS)

Brief description

NHSE’s IDPS Programme has commissioned the Integrated Screening Outcomes Surveillance Service (ISOSS). ISOSS monitors pregnancies where the mother is screen positive or is already known to have hepatitis B. Monitoring is also conducted for HIV, syphilis as well as continuing monitoring cases of congenital rubella syndrome

Technical notes

Published data can be found at Antenatal screening standards: data report 2020 to 2021.

Hospital Episode Statistics (HES)

Brief description

HES is a database containing details of all admissions, A&E attendances and outpatient appointments at NHS hospitals in England. This data is used to calculate the number of individuals per year that have a hospital admission related to hepatitis B associated end stage liver disease (ESLD) or hepatocellular carcinoma (HCC). It is also used to calculate incidence of HBV related ESLD and HCC. 

Technical notes

Hospital Episode Statistics (HES), NHS England. Produced by the UK Health Security Agency. Copyright © 2025, re-used with the permission of the NHS England. All rights reserved. 

Data is based on Hospital Episode Statistics as at October 2025. 

Patients who have had more than one hospital episode with a diagnosis of HBV in any one year and who have moved residence within that year have been grouped into the UKHSA region of their latest hospital episode in that year. 

Hepatocellular carcinoma (HCC) is defined by ICD-10 code for hepatocellular carcinoma (C22.0). End-stage liver disease (ESLD) is defined by ICD-10 codes for ascites (R18), bleeding oesophageal varices (I85.0 and I98.3), hepato-renal syndrome (K76.7), hepatic encephalopathy (K72.9) or hepatic failure (K72.0, K72.1 and K70.4). 

Data for 2017 and 2018 has been omitted. This is due an interrupt in the supply of identifiers in the HES year April 2017 to March 2018 making it impossible to distinguish repeat hospital episodes for the same person within the same year, and thus determine the number of prevalent cases of HBV and HBV-related HCC/ESLD in 2017 and 2018.

Office for National Statistics (ONS) Mortality data

Brief description

Data from the Mortality and Birth Information System is used to calculate the number of deaths from end stage liver disease (ESLD) or hepatocellular carcinoma (HCC) with hepatitis B mentioned on the death certificate. 

Technical notes

Published data about deaths can be found on the ONS website. 

Data on the number of deaths from ESLD and HCC in this report was identified by searching the ONS Mortality dataset using a combination of 2 methodologies described below, deaths that met either of these criteria were included in this report: 

• searching for all causes of mortality using the following ICD-10 codes - ‘C220’, ‘R18’, ‘K767’, ‘K729’, ‘K720’, ‘K721’, ‘K704’, ‘I850’, ‘I983’
• searching all free-text variables for the following terms - “hepatocellular c%”, “primary liver c%”, “hcc”, “ascites”, “encephal%”, “liver failure”, “hepatorenal syndrome”, “hepatic failure”, “hepatic coma”, “bleeding o%”, “ruptured oesoph%”, “haemorrhage from oesoph%”, where ICD-10 codes ‘B160’, ‘B161’, ‘B162’, ‘B169’, ‘B181’, ‘B180’ were also reported on the death certificate

There has been no additional clinical review stage, as may be conducted on other UKHSA reporting for ESLD/HCC mortality, and therefore numbers may vary slightly from other reports.

Cover of Vaccination Evaluated Rapidly (COVER)

Brief description

The COVER programme is a quarterly data collection that started in 1987 with the aim of providing timely data. COVER data is extracted from Child Health Information Systems at the local authority level for children aged one, 2 and 5 years of age. Babies born to mothers with hepatitis B have been offered the hepatitis B vaccine from birth since the late 1980s. During autumn 2017 hepatitis B became part of the routine childhood immunisation schedule for all babies in a 6-in-1 vaccine.

Technical notes

Data from the Universal Programme:

• in FY 2019 to 2020, all children in the 12 month cohort were eligible for the DtaP/IPV/Hib/HepB (6-in-1) vaccination, which replaced the 5-in-1 vaccination
• this is the first year coverage is fully reported against the 6-in-1 vaccine for the 12 month cohort
• the DTaP/IPV/Hib (5-in-1) vaccine was replaced by the DTaP/IPV/Hib/HepB (6-in-1) vaccine in August 2017; therefore the 24 month age cohort in FY 2019 to 2020 (born in FY 2017 to 2018), will have received either the 5-in-1 or the 6-in-1 vaccination, depending on when in the year they were vaccinated
• from FY 2020 to 2021 onwards, all children in the 12 month cohort and 24 month cohort were eligible for the DtaP/IPV/Hib/HepB (6-in-1) vaccination, which replaced the 5-in-1 vaccination in 2017
• the DTaP/IPV/Hib (5-in-1) vaccine was replaced by the DTaP/IPV/Hib/HepB (6-in-1) vaccine in August 2017; therefore the 5 year age cohort in FY 2022 to 2023 (born in FY 2017 to 2018), will have received either the 5-in-1 or the 6-in-1 vaccination, depending on when in the year they were vaccinated
• all babies born on or after 1 January 2020 received their first dose of PCV at 12 weeks of age
• prior to this, PCV primary at 12 months was 2 doses administered at 8 and 16 weeks - FY 2021 to 2022 is the first year that coverage reported is based on the single dose primary course

Data from the Selective Programme:

• the ‘eligible population’ is the total number of children reaching their first birthday during the specified evaluation period with maternal Hep B positive status
• the ‘number of children vaccinated’ by their first birthday is total number of children from the eligible population receiving 2 monovalent HepB vaccines (at birth and one month) and 3 doses of hexavalent vaccine (at 8, 12 and 16 weeks) before their first birthday
• the ‘number of children vaccinated’ by their second birthday is total number of children from the eligible population receiving 3 monovalent HepB vaccines at birth, 4 weeks and 12 months, and 3 doses of hexavalent vaccine (at 8, 12 and 16 weeks) before their 2nd birthday
• small number suppression is carried out on data in this table, adhering to the following methodology; suppress all data (that is, eligible population, number vaccinated and coverage) where the eligible population is 1 or 2, and where the eligible population is greater than 2 and the number of children vaccinated is 0 or 1, suppress the number of children vaccinated and the coverage

Due to small number suppression, some local authorities had to be combined, therefore:

• Leicestershire also contains data for Rutland
• Hackney also contains data for City of London
• Cornwall also contains data for Isles of Scilly

More information can be found at Childhood Vaccination Coverage Statistics, England, 2022 to 2023.

Unlinked Anonymous Monitoring (UAM) Survey

Brief description

The voluntary UAM survey recruits people who have ever injected psychoactive drugs through specialist services (such as needle and syringe programmes and addiction treatment centres) across England, Wales and Northern Ireland. Those who agree to take part complete a questionnaire and provide a biological specimen that is tested anonymously for HIV, hepatitis B and hepatitis C.

Technical notes

Regional level data from the UAM survey should be interpreted cautiously as the survey recruits participants through a nationally reflective sample of the services provided to people who inject drugs. 

Published regional-level data and more information can be found at People who inject drugs: HIV and viral hepatitis monitoring.

Acknowledgements

We would like to thank the following: 

• local laboratories for supplying the hepatitis data 
• the UKHSA Blood Safety, Hepatitis, STI and HIV Division for collection, analysis and distribution of data 
• the UKHSA Epidemiology Data Science unit (part of the Regions Data Science team) for producing the charts and figures contained in this report
• the Office for National Statistics (ONS carried out the original collection and collation of the data but bears no responsibility for their future analysis or interpretation) 
• the Hospital Episode Statistics (HES), NHS England, produced by UKHSA

About Field Services

Field Services is a Division within UKHSA that provides a national service comprising geographically dispersed multi-disciplinary teams integrating expertise in Field Epidemiology, Public Health Microbiology, Rapid Investigation, Real-time Syndromic Surveillance, and Field Epidemiology Training to strengthen the surveillance, epidemiological intelligence and response functions of UKHSA.

You can contact your local Field Services team at YHREU@ukhsa.gov.uk

If you have any comments or feedback regarding this report or the Field Services, please contact FS.Central@ukhsa.gov.uk