Community-Based Screening for Hepatitis B and C Infectivity Using Two Quantitative Antigens to Identify Endemic Townships.

Wei-Cheng Huang,Kwong-Ming Kee,Sheng-Nan Lu,Po-Ju Chen,Wen-Hua Chao,Te-Sheng Chang,Chia-Ling Tu,Nien-Tzu Hsu,Chao-Hung Hung,Yu-Chen Lin

doi:10.3390/v14020304

Abstract

Screening and linkage to care are essential to achieve viral hepatitis elimination before 2030. The accurate identification of endemic areas is important for controlling diseases with geographic aggregation. Viral activity drives prognosis of chronic hepatitis B and hepatitis C virus infection. This screening was conducted in Chiayi County from 2018–2019. All residents aged 30 years or older were invited to participate in quantitative HBsAg (qHBsAg) and HCV Ag screening. Among the 4010 participants (male:female = 1630:2380), the prevalence of qHBsAg and HCV Ag was 9.9% (396/4010) and 4.1% (163/4010), respectively. High-prevalence townships were identified, three for qHBsAg > 15% and two for HCV Ag > 10%. The age-specific prevalence of qHBsAg was distributed in an inverse U-shape with a peak (16.0%, 68/424) for subjects in their 40 s; for HCV, prevalence increased with age. Concentrations of qHBsAg < 200 IU/mL were found in 54% (214/396) of carriers. The rate of oral antiviral treatment for HCV was 75.5% (114/151), with subjects younger than 75 years tending to undergo treatment (85.6% vs. 57.4%, p < 0.001). QHBsAg and HCV Ag core antigens can reflect the concentration of the viral load, which serves as a feasible screening tool. Using quantitative antigen screening for hepatitis B and C in community-based screening, two hyperendemic townships were identified from an endemic county.

Highlights

Chronic viral hepatitis infection, including Chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, is a major disease worldwide
In Taiwan, HBV infection is endemic in a non-vaccinated cohort
A unique epidemiological characteristic of HCV infection is the geographic aggregation of people born before 1960 [3]

Summary

Introduction

Chronic viral hepatitis infection, including Chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, is a major disease worldwide. In Taiwan, HBV infection is endemic in a non-vaccinated cohort. Successful universal vaccination has been introduced, chronic HBV infection remains a health problem in the non-vaccinated cohort of those born before 1984 [2]. A unique epidemiological characteristic of HCV infection is the geographic aggregation of people born before 1960 [3]. Since the national screening project for HBV and HCV was launched in late 2020, the map has used seven nationwide hepatitis-related surrogates rather than the prevalence of antiHCV. A precise hepatitis C prevalence map is urgently required, a nationwide township-specific map of liver disease risk was published in 2018 [4]

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