Abstract
BackgroundData on hepatitis B virus (HBV) prevalence are limited in developing countries. There is also limited information of consistent condom use efficacy for reducing HBV transmission at the population level. The study goal was to evaluate the prevalence and factors associated with HBV infection in Peru, and the relationship between anti-HBc positivity and consistent condom use.Methods and FindingsData from two different surveys performed in 28 mid-sized Peruvian cities were analyzed. Participants aged 18–29 years were selected using a multistage cluster sampling. Information was collected through a validated two-part questionnaire. The first part (face-to-face) concerned demographic data, while the second part (self-administered using handheld computers) concerned sexual behavior. Hepatitis B core antibody (anti-HBc) was tested in 7,000 blood samples. Prevalences and associations were adjusted for sample strata, primary sampling units and population weights. Anti-HBc prevalence was 5.0% (95%CI 4.1%–5.9%), with the highest prevalence among jungle cities: 16.3% (95%CI 13.8%–19.1%). In the multivariable analysis, Anti-HBc positivity was directly associated with geographic region (highlands OR = 2.05; 95%CI 1.28–3.27, and jungle OR = 4.86; 95%CI 3.05–7.74; compared to coastal region); and inversely associated with age at sexual debut (OR = 0.90; 95%CI 0.85–0.97). Consistent condom use, evaluated in about 40% of participants, was associated with reduced prevalence (OR = 0.34; 95%CI 0.15–0.79) after adjusting for gender, geographic region, education level, lifetime number of sex partners, age at sexual debut and year of survey.ConclusionResidence in highlands or jungle cities is associated with higher anti-HBc prevalences, whereas increasing age at sexual debut were associated with lower prevalences. Consistent condom use was associated with decreased risk of anti-HBc. Findings from this study emphasize the need of primary prevention programs (vaccination) especially in the jungle population, and imply that condom use promotion might be a potential strategy to prevent HBV infection.
Highlights
Approximately 400 million people have chronic Hepatitis B virus (HBV) infection, the cause of more than 500,000 deaths worldwide annually [1]
Residence in highlands or jungle cities is associated with higher anti-HBc prevalences, whereas increasing age at sexual debut were associated with lower prevalences
Findings from this study emphasize the need of primary prevention programs especially in the jungle population, and imply that condom use promotion might be a potential strategy to prevent hepatitis B virus (HBV) infection
Summary
Approximately 400 million people have chronic Hepatitis B virus (HBV) infection, the cause of more than 500,000 deaths worldwide annually [1]. HBV is transmitted through percutaneous or mucosal exposure to infectious blood or other body fluids [3]. HBV transmission is associated primarily with sexual experience and injection drug use (IDU) [5]. Many general population surveys are based on the prevalence of surface antigen (HBsAg) [10], whereas studies of high-risk populations including sexually transmitted diseases (STD) clinic patients, MSM and IDUs have more often assessed antibody against hepatitis B core (anti-HBc) and antibody against surface antigen (anti-HBsAg) [7,8,9]. There is limited information of consistent condom use efficacy for reducing HBV transmission at the population level. The study goal was to evaluate the prevalence and factors associated with HBV infection in Peru, and the relationship between anti-HBc positivity and consistent condom use
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