Abstract
Background: Hepatitis B surface antigen (HBsAg) is widely used in hepatitis B screening, and HBsAg seroclearance indicates hepatitis B eradication. Few studies have explored the incidence of and determinants for spontaneous seroclearance using a long-term follow-up cohort study. Our research aimed to examine the incidence of and influencing factors for hepatitis B virus infection and spontaneous clearance of HBsAg from a large-scale cohort in China.Methods: A total of 151,926 resident individuals in Tongxiang underwent HBsAg screening at least thrice in a 7-year period. Serum samples collected at baseline and follow-up examinations were tested for HBsAg. Cox proportional hazard models were used to analyze determinants of HBsAg seroclearance and persistent HBsAg presence.Results: Among the 151,926 participants, new hepatitis B infections occurred in 4,497 participants, yielding an incidence rate of 571.38 per 100,000 person-years. The incidence rate for males was higher than that for females. In the multivariate Cox regression analysis, female gender, alcohol drinking history, hepatitis family history and middle-age group were predictors for persistent positive HBsAg status.Conclusions: The incidence rate of new hepatitis B infections was 571.38 per 100,000 person-years. Male and aged people in this community cohort have a higher infection rate. Alcohol drinking and hepatitis family history were risk factor leading to chronic infection. Female and middle-aged people were prone to persistent positive HBsAg status.
Highlights
Hepatitis B is an infectious disease induced by hepatitis B virus (HBV) that mainly invades the liver and can induce a variety of liver diseases, such as acute or chronic hepatitis, hepatic failure, liver cirrhosis and hepatic carcinoma [1, 2]
After infection with HBV, 1–2% of cases evolve into fulminant hepatic failure, and 5–10% of adult cases evolve into chronic infection [1]
Hepatitis B surface antigen (HBsAg) is positive in serological testing in acute and chronic hepatitis B infections [8] and indicates a current HBV infection
Summary
Hepatitis B is an infectious disease induced by hepatitis B virus (HBV) that mainly invades the liver and can induce a variety of liver diseases, such as acute or chronic hepatitis, hepatic failure, liver cirrhosis and hepatic carcinoma [1, 2]. Most of them were adults who had no hepatitis B vaccine immunization in infancy Since its discovery in the 1960s, hepatitis B surface antigen (HBsAg, commonly known as Australia antigen) has become an important serological marker for screening for HBV infection [7]. HBsAg is positive in serological testing in acute and chronic hepatitis B infections [8] and indicates a current HBV infection. HBsAg spontaneously vanishes via seroconversion to anti-HBs antibodies (an antibody for the hepatitis B surface antigen) in a few months, indicating viral clearance.
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