Knowledge and Perceptions of Hepatitis B in Immigrant Populations: A Systematic Review and Thematic Synthesis of Qualitative Research.

An estimated 254 million people live with hepatitis B worldwide, with only 13% of people diagnosed and 3% receiving antiviral treatment. Without timely treatment, people with hepatitis B risk developing liver damage and liver cancer. In countries like Australia, where most people with hepatitis B are born in countries with higher prevalence, it is important that the knowledge and perceptions of hepatitis B in immigrant populations are explored to improve engagement in care. This review sought to systematically identify and synthesise qualitative research findings describing the knowledge and perceptions of hepatitis B in immigrant communities. An Ovid database search for English language publications for the years 2000-2024 was performed. 34 studies were selected for review. These were analysed using thematic synthesis and categorised using an modified version of the socio-ecological model. Ten analytic themes were identified: (1) knowledge of hepatitis B and misconceptions about transmission, (2) knowledge and familiarity with hepatitis B varies between communities, (3) culturally informed perceptions of health and illness, (4) alternative aetiologies of hepatitis B infection, (5) barriers and facilitators to engagement in healthcare, (6) sources of information, (7) stigma and family dynamics, (8) gender differences, (9) fear and anxieties of engaging with the healthcare system, (10) fear of health outcomes related to hepatitis B. These themes can be used to frame the development of culturally appropriate health promotion materials and interventions to improve knowledge and engagement in care among people living with hepatitis B.