Observational Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 7, 2015; 21(25): 7842-7850
Published online Jul 7, 2015. doi: 10.3748/wjg.v21.i25.7842
Seroepidemiology of hepatitis B virus infection and impact of vaccination
Peng Huang, Li-Guo Zhu, Ye-Fei Zhu, Ming Yue, Jing Su, Feng-Cai Zhu, Hai-Tao Yang, Yun Zhang, Hong-Bing Shen, Rong-Bin Yu, Xiang-Jun Zhai, Zhi-Hang Peng
Peng Huang, Jing Su, Hong-Bing Shen, Rong-Bin Yu, Zhi-Hang Peng, Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, Jiangsu Province, China
Li-Guo Zhu, Ye-Fei Zhu, Feng-Cai Zhu, Hai-Tao Yang, Xiang-Jun Zhai, Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing 210009, Jiangsu Province, China
Ming Yue, Department of Infectious Disease, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Yun Zhang, Department of Epidemiology, Medical Institute of Nanjing Army, Nanjing 210002, Jiangsu Province, China
Author contributions: Zhu FC, Yang HT, Shen HB, Yu RB, Zhai XJ and Peng ZH designed the research, provided the funding support and supervised the study; Zhu LG, Zhai XJ and Zhu YF analyzed the data; Su J, Zhang Y and Yue M contributed reagents/materials/analysis tools; and Huang P interpreted the results and wrote the manuscript.
Supported by National S and T Major Project Foundation of China, No. 2011ZX10004-902; Priority Academic Program Development of Jiangsu Higher Education Institutions, Jiangsu Province Health Development Project with Science and Education, No. ZX201109; and Research and Innovation Project for College Graduates of Jiangsu Province of China, No. KYZZ_0265.
Ethics approval: The study was reviewed and approved by the Nanjing Medical University Institutional Review Board.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have nothing to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is 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 and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Zhi-Hang Peng, PhD, Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, No. 140 Hanzhong Road, Nanjing 211166, Jiangsu Province, China. zhihangpeng@njmu.edu.cn
Telephone: +86-25-86868436 Fax: +86-25-86868499
Received: December 31, 2014
Peer-review started: January 2, 2015
First decision: January 22, 2015
Revised: February 9, 2015
Accepted: March 27, 2015
Article in press: March 27, 2015
Published online: July 7, 2015

AIM: To investigate hepatitis B virus (HBV) prevalence in the general population in China.

METHODS: A total of 148931 individuals were investigated by multistage random sampling in Eastern China. Data were collected on demographics and hepatitis B vaccination history, and serum was tested for hepatitis B surface antigen (HBsAg) by ELISA.

RESULTS: A total of 11469 participants (7.70%, 95%CI: 7.57%-7.84%) were positive for HBsAg. HBsAg prevalence was 0.77% among children < 5 years old but increased progressively from adolescents (1.40%-2.55%) to adults (5.69%-11.22%). A decrease in HBsAg prevalence was strongly associated with vaccination and familial history of HBV among both children and adult groups. Meanwhile, HBsAg risk in adults was associated with invasive testing and sharing needles. The HBV immunization rate among participants aged < 20 years was 93.30% (95%CI: 93.01%-93.58%). Significant difference in HBsAg prevalence appeared between vaccinated and unvaccinated participants (3.59% vs 10.22%).

CONCLUSION: Although the national goal of HBsAg prevalence < 1% among children < 5 years old has been reached, immunization programs should be maintained to prevent resurgence.

Keywords: Epidemiological study, Familial history, Hepatitis B surface antigen, Immunization, General population

Core tip: A total of 148931 individuals were investigated in Eastern China to evaluate the impact of hepatitis B vaccination since 1992. 7.70% were positive for hepatitis B surface antigen (HBsAg) which has not achieved the national goal for the whole population in decreasing the prevalence of HBsAg to < 7%. Prevalence was 0.77% among children aged < 5 years and the rate of hepatitis B virus immunization among teenagers aged < 20 years was 93.30%, which have reached the national goals of < 1% and > 90%, respectively.