Comparison between two population-based hepatitis B serosurveys with an 8-year interval in Shandong Province, China

- The prevalence rates of hepatitis B surface antigen (HBsAg) and antibody against hepatitis B core antigen (anti-HBc) showed sustained decreases from 2006 to 2014 in Shandong Province, China.
- The emerging peak of HBsAg prevalence in those aged 20-29 years seen in the 2014 survey should be taken seriously.
- Students and farmers may become the high-risk populations for HBV infection, and sexual transmission may be the main route of transmission in students.
- Extending the hepatitis B vaccination program to students and farmers might be the priority intervention for HBV infection in future in Shandong Province, China.

BackgroundTremendous progress has been made in hepatitis B virus (HBV) prevention and control in the last 30 years in China, but it continues to be a major public health problem. The most recently reported population-based seroepidemiological survey on HBV in Shandong Province in China was published in 2006, and an updated baseline for HBV prevalence was badly needed in the province to identify the change in HBV epidemiology in the last decade.MethodsTwo population-based cross-sectional serosurveys were performed among the population aged 1-59 years in the same sample areas in Shandong Province, China in 2006 and 2014, respectively. Data on demographic characteristics were collected. A blood sample was obtained from each person and was tested for hepatitis B surface antigen (HBsAg), antibody against HBsAg (anti-HBs), and antibody against hepatitis B core antigen (anti-HBc).ResultsOverall, the prevalence rates of HBsAg, anti-HBs, and anti-HBc were 3.39% (95% confidence interval (CI) 2.51-4.26), 44.96% (95% CI 41.34-48.57), and 24.45% (95% CI 22.19-26.71), respectively, among the population aged 1-59 years in the 2006 serovsurvey; the corresponding prevalence rates were 2.49% (95% CI 1.81-3.17), 48.27% (95% CI 45.63-50.92), and 22.56% (95% CI 20.14-24.97), respectively, in 2014. The prevalence rates of HBsAg and anti-HBc were lower in 2014 than in 2006. Conversely, the prevalence of anti-HBs showed an increase. However, none of these differences were statistically significant (all p > 0.05). The prevalence of HBsAg showed an increase among persons aged 20-24 years in 2014 (3.83%) compared with 2006 (2.98%) (t = 0.45, p = 0.67). Among all occupation groups, the prevalence of HBsAg was lower in 2014 than in 2006, while the prevalence of anti-HBc showed moderate increases in students and farmers (all p > 0.05). The prevalence of HBsAg decreased more obviously in urban areas (65.49%) than rural areas (7.07%) from 2006 to 2014.ConclusionsThe epidemiology of HBV infection has changed in Shandong Province, China over the last decade. More attention should be paid to HBV infection among students and farmers.