Abstract
The residents of Baisha, a county of Hainan Island, mainly composed of Li ethnic population and relatively closed living environment with its unique geographical location. Our previous study showed that Li ethnic population of Baisha is an endemic center for hepatitis C virus, with significantly higher rates than in other parts of China. However, the epidemiology of HBV in this region remains unclear. Therefore, we conducted a comprehensive epidemiological survey of HBV in Baisha County, including 1,682 Li ethnic residents. The total seropositive rate for HBsAg was 10.2% and was higher than other parts of China. HBV-positive status was associated with the 20–40-year-old group (OR = 1.27, 95%CI 1.04–1.39, P < 0.01) and alcohol consumption (OR = 2.17, 95%CI 1.58–2.99, P < 0.01). Phylogenetic analysis showed that HBV subgenotype D3 was predominant in Baisha County which was first discovered in China, followed by C5, C1, B2, and undetermined subgenotypes which were significantly different from other geographical distribution of main genotypes in China. The most recent common ancestor (tMRCA) of the HBV genotype C in the Li ethnic of Baisha County was 1846 (95%CI: 1739–1932), and Baisha-C5 was earlier than Baisha-C1 and Baisha-C2. Most Baisha-D3 sequences were concentrated in one bundle and unrelated to those D3 genome sequences elsewhere in the world. According to the phylogenetic tree, D3 was introduced into Baisha County in 1884 (95%CI: 1816–1993) and became a local endemic virus. In conclusion, HBV infection in the Li ethnic group is characterized by a high prevalence rate in 20–40-year-old individuals and a unique genotype distribution which were significantly different from other geographical distribution of main genotypes in China, and subgenotype D3 was first discovered in China.
Highlights
Hepatitis B virus (HBV) infection is a significant public health challenge, especially in developing countries with high prevalence
The current study revealed that the seropositive rate for hepatitis B surface antigen (HBsAg) was 10.2% among Li ethnic population in Baisha County, Hainan Island
The most prevalent HBV subgenotype D3 was first discovered in China, followed by C5, C1, B2 and undetermined subgenotypes
Summary
Hepatitis B virus (HBV) infection is a significant public health challenge, especially in developing countries with high prevalence. Our recent study showed that Baisha County is an endemic center for HCV infection, where the rate of anti-HCV was significantly higher than other areas in China (Xu et al, 2019). Some reports have shown that the prevalence of HBV was higher in rural areas than in urban areas (Zhang et al, 2013; Liu et al, 2017; Wang et al, 2019). Two studies reported that the seroprevalence of HBV infection was higher in Hainan Province than in other parts of China (Li et al, 2008; Sun et al, 2008). Conducting an epidemiological investigation of HBV in this special region is vital to understand the burden of HBV infection and to predict the future prevalence of HBV in the Hainan Li ethnic population, and helpful to understand the cause of the distinctive HBV epidemiology in this area
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