Abstract

BackgroundAmong the Chinese population of 1.3 billion, there are an estimated 93 million carriers of hepatitis B virus (HBV). Men who have sex with men (MSM) are at increased risk for HBV infection; however, the prevalence of HBV immunization and infection among Chinese MSM remains undetermined.MethodsA cross-sectional survey of 1,114 eligible participants was conducted in Beijing, China. Multiple methods were used to recruit study participants. Demographic information and potential correlated factors were collected by questionnaire. Additionally, blood specimens were collected and tested for sexually transmitted infections and serologic markers of hepatitis B immunization and infection.ResultsLaboratory data were available for 1,111 participants (99.7%), the prevalence of hepatitis B immunization was 38.9%, and 26.5% had serologic markers of HBV infection. Multivariate analyses indicated that higher education level, smaller number of male sex partners in the past 12 months, reported diagnosis of sexually transmitted disease (STD), and history of blood donation were independently associated with HBV immunization. Absence of steady male sex partner(s) in the past 12 months, and reported diagnosis of STD were shown to be independently associated with HBV infection. MSM positive for HBV infection were more likely to have past or current syphilis infection.ConclusionsLow prevalence of HBV immunization and high prevalence of HBV infection among Chinese MSM and a correlation between sexual risk factors and hepatitis B infection indicate that comprehensive preventative measures for HBV among MSM, including blood donor and HIV-STD clinic vaccination programs as well as targeted health education campaigns should be developed in China.

Highlights

  • Hepatitis B virus (HBV) infection is a major global health concern due to the high morbidity and mortality associated with cirrhosis and primary liver cancer

  • 300,000 deaths are attributed to chronic hepatitis B, including deaths associated with liver cirrhosis and hepatocellular carcinoma (HCC) [2]

  • The current study aims to: (1) assess the prevalence of hepatitis B virus (HBV) infection among men who have sex with men (MSM) in Beijing, China; (2) explore risk factors associated with HBV infection and the association of HBV infection with other sexually transmitted infection (STI) (HIV, syphilis) and hepatitis C virus (HCV) infection; and (3) assess hepatitis B immunization rate and explore factors associated with immunization among MSM in Beijing, China

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Summary

Introduction

Hepatitis B virus (HBV) infection is a major global health concern due to the high morbidity and mortality associated with cirrhosis and primary liver cancer. In the Chinese population of 1.3 billion individuals, there are estimated to be 93 million HBV carriers. For individuals engaging in high-risk sexual behavior, such as unprotected anal intercourse, men who have sex with men (MSM) are at an increased risk of infection with HBV, HIV, syphilis, and other STIs. To control hepatitis B, the Chinese government has implemented infant vaccination with hepatitis B vaccine as the highest priority, thereby, hepatitis B vaccine coverage (3 doses) increased from 30.0% for children born in 1992 to 93.4% for children born in 2005 [4], and hepatitis B vaccine catch-up immunization has been extended to adolescents under 15 years of age in year 2009 [5]. Among the Chinese population of 1.3 billion, there are an estimated 93 million carriers of hepatitis B virus (HBV). Men who have sex with men (MSM) are at increased risk for HBV infection; the prevalence of HBV immunization and infection among Chinese MSM remains undetermined

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