Abstract
The hepatitis B prevalence rate in adults is still at a high to intermediate level in China. Our purpose was to explore the incidence rate and protective immune barrier against hepatitis B in adults in China. A sample of 317961 participants was multi-screened for hepatitis B surface antigens (HBsAg) in a large-scale cohort of the National Hepatitis B Demonstration Project. A total of 5401 persons were newly-infected, representing an incidence rate of 0.81 (95% CI: 0.77–0.85) per 100 person-years after adjusted by gender and age. History of acquired immune deficiency syndrome, birth prior to 1992, coastal residence, family history of HBV, and migrant worker status were significantly associated with higher incidence, while HBV vaccination and greater exercise with lower incidence. The hepatitis B surface antibody (HBsAb) positive rate was negatively correlated with the incidence rate of hepatitis B (r = −0.826). Linear fitting yielded an incidence rate of 1.23 plus 0.02 multiplied by HBsAb positive rate. The study firstly identified the HBsAg incidence rate, which was reduced to 0.1 per 100 person-years after vaccination coverage of about 64%. The protective immune barrier against hepatitis B needs to be established in individuals born prior to the advent of infant HBV vaccination.
Highlights
IntroductionIn contrast to the plethora of data on prevalence, studies exploring the incidence rate are limited[4,14]
Of the effectiveness of hepatitis B vaccination in this population
HBsAg prevalence rate of the group aged 0–4 years was the lowest, with a rate of 0.26%, and the highest in the age group of 35–39 years, with a rate of 9.33%.The HBsAg prevalence rate in the whole population was standardized by gender and age, with an adjusted rate of 6.22%
Summary
In contrast to the plethora of data on prevalence, studies exploring the incidence rate are limited[4,14]. 12 demonstration zones in Zhejiang, China were selected for a comprehensive hepatitis B prevention and control program. Though other published studies have reported factors that are associated with prevalence rates in China[16], no evidence exists to examine factors that are associated with newly incident infection risk. Understanding risk factors may help to tailor vaccination programs at those with greater risk profiles and we undertook this work to fill this important gap and identify which characteristics are associated with higher risk of becoming infected. Based on data collected from the project in the past 6 years, we have analyzed the incidence rate of hepatitis B virus and its risk factors for the first time. The objective of this study was to evaluate the role of immune barrier against hepatitis B in adults, and its implications for accelerated control of hepatitis B infection
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