Abstract
IntroductionHepatitis B is a potentially life-threatening liver infection caused by hepatitis B virus (HBV) and China has the largest disease burden. We aim to understand the ethnic disparities in HBV infection among the married reproductive-age couples planning for pregnancy in Yunnan, a multiethnic province in Southwest China, to increase the health equities within the hepatitis response in China.MethodsA population-based cross-sectional study was performed. Couples aged 20–49 years in rural Yunnan were enrolled through the National Free Preconception Health Examination Project from Jan 2014 to Dec 2019. HBsAg-positive couples were defined as couples in which one or both were HBsAg-positive, and HBsAg- and HBeAg-positive couples were defined as couples in which one or both were HBsAg- and HBeAg-positive. The HBV prevalence of positive couples was estimated by ethnicity. Multivariate logistic regression analyses were used to assess the association between ethnicity and HBsAg status.ResultsOverall, 63,513 of 1,060,643 couples (5.99%, 95% CI, 5.94%−6.03%) were HBsAg-positive, and 15,898 of 63,513 HBsAg-positive couples (25.03%, 95% CI 24.69%−25.37%) were HBsAg- and HBeAg-positive couples in rural Yunnan. The highest prevalence of HBsAg-positive couples was in the Miao and Miao ethnicity (12.04%) and Zhuang and Zhuang ethnicity (9.76%), and the risk of HBV infection of wives/husbands in these ethnic groups was significantly higher than that in the Han and Han ethnicity. Additionally, the HBsAg prevalence in wives/husbands has increased with the positive status of HBsAg and HBeAg of their spouses.ConclusionThe HBV prevalence in reproductive-age couples was intermediate (6% of 1 million couples) in rural Yunnan, China, with the highest in the Miao and Zhuang ethnicities. There are still large ethnic disparities in HBV infection in China. Therefore, China should make great efforts, especially giving priority to ethnic minorities and taking positive couples as an important unit of care, to equitably eliminate the HBV intrafamilial transmission.
Highlights
Hepatitis B is a potentially life-threatening liver infection caused by hepatitis B virus (HBV) and China has the largest disease burden
Our results indicated that the hepatitis B surface antigen (HBsAg) prevalence of either wives or husbands rose with positive statuses for HBsAg and hepatitis B e antigen (HBeAg) of the spouse, and these associations remained stable after adjustment for other possible confounders
The HBV prevalence in reproductive-age couples was intermediate in rural Yunnan, China
Summary
Hepatitis B is a potentially life-threatening liver infection caused by hepatitis B virus (HBV) and China has the largest disease burden. Hepatitis B is a potentially life-threatening liver infection caused by the hepatitis B virus (HBV) [1]. It accounts for a major global public health threat and high mortality from cirrhosis and liver cancer [1]. China has the largest disease burden of hepatitis B [3], with an estimated 70 million people living with HBV infection and 162,000 deaths related to hepatitis B in 2019 [4, 5]. Studies focusing on the HBV prevalence among married couples as a unit are necessary for China
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