Abstract
In 1991, Peru launched the first vaccination program against hepatitis B in children aged under 5 years in the hyperendemic [hepatitis B virus (HBV) and hepatitis D virus (HDV)] province of Abancay. We conducted a cross-sectional study to determine the prevalence of HBV and HDV infections, 23 years after the launch of the vaccination program, as well as the post-vaccine response against hepatitis B in terms of prevalence of hepatitis B surface antibody (anti-HBs ≥10 mUI/ml). Among 3165 participants aged from 0 to 94 years, the prevalence rates of hepatitis B surface antigen (HBsAg), and hepatitis B core antibody (total anti-HBc) were 1.2% [95% confidence interval (CI) 0.85-1.64%], and 41.67% (95% CI 39.95-43.41%), respectively. The prevalence rate of anti-HBs at protective levels (≥10 mUI/ml) in individuals who HBsAg and anti-HBc negative was 66.36% (95% CI 64.15-68.51%). The prevalence rate of HBsAg in children aged <15 years was nil, and among adult HBsAg carriers, the prevalence of hepatitis D antibody (anti-HDV) was 5.26% (2/38; 95% CI 0.64-17.74). These findings showed that HBV prevalence has changed from high to low endemicity, 23 years following implementation of the vaccination program against hepatitis B, and HDV infection was not detected in those aged <30 years.
Highlights
Hepatitis B virus (HBV) infection remains a serious public health problem worldwide [1]
Since 1984, prevention programs against HBV infection have been implemented in various countries, including immunization using hepatitis B vaccine and use of immunoglobulin in infants born to hepatitis B surface antigen (HBsAg)-positive mothers [2,3], which have led to a substantial decline in the prevalence of HBV and hepatitis D virus (HDV) infections among children in hyperendemic countries such as China, Japan and Colombia [2,3,4,5,6]
Our findings showed that since the introduction of the first pilot vaccination program against HBV in Abancay, there has been a decrease in the HBsAg carrier rate over the past two decades, from high to low endemicity (9.8% in 1991 vs. 1.2% in 2014), compared with those reported in previous studies, especially in children (Fig 2) [11]
Summary
Hepatitis B virus (HBV) infection remains a serious public health problem worldwide [1]. Since 1984, prevention programs against HBV infection have been implemented in various countries, including immunization using hepatitis B vaccine and use of immunoglobulin in infants born to hepatitis B surface antigen (HBsAg)-positive mothers [2,3], which have led to a substantial decline in the prevalence of HBV and hepatitis D virus (HDV) infections among children in hyperendemic countries such as China, Japan and Colombia [2,3,4,5,6].
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