Abstract
A cross-sectional analysis of prevalence of hepatitis B virus infection (HBV) among rural couples was conducted between 2010 and 2014. Serologic HBV markers, including hepatitis B surface antigen (HBsAg) and e antigen (HBeAg), were tested. Primary outcome of interest comprised HBsAg positivity in couples (both positive: F+M+, only wife positive: F+M−, only husband positive: F−M+), and secondary outcome consisted of prevalence and risk factors of HBsAg positivity among husbands or wives. Of 14,816,300 couples included, 0.7% were F+M+; 6.3% were F−M+; 4.4% were F+M−, resulting in the overall seroprevalence of 11.4%. Individually, 6.1% were HBsAg positive with a higher rate seen in husbands (7.0%) than in wives (5.2%). Wife’s HBeAg(+)/HBsAg (+) (AOR = 2.61), HBeAg(−)/HBsAg (+) (AOR = 2.23), positivity of syphilis (AOR = 1.50), living in a high-risk region (AOR = 1.46) were significantly predictors of HBsAg positivity in husbands. Prevalence and predictors of HBsAg positivity in wives had similar results. Our data show a high burden and discordant pattern of HBV infection in rural couples, and partner’s double positivity of HBeAg and HBsAg was the most significant factor of HBV infection in couples. A comprehensive strategy that emphasizes vaccination and education is needed.
Highlights
Hepatitis B virus (HBV) infection and its related complications remain a primary public health threat globally[1]
Our study demonstrates that 11.4% of rural couples who planned to conceive in China were affected by hepatitis B virus infection (HBV) infection and most of these infections were discordant, which may expose seronegative partner to a higher risk of infection
We found that people living with a HBV infected partner were more likely to have current HBV infection, to experience past or ongoing HBV infection, and to develop immune protection, suggesting closeness of married couples can risky for HBV transmission without appropriate preventive measures
Summary
Hepatitis B virus (HBV) infection and its related complications remain a primary public health threat globally[1]. Infections have been much controlled among young age groups, the number of reported HBV infections in adults aged >2 0 years increased by 22%, from 740 thousands in 2004 to 903 thousands in 20148. In China, adults at risk for HBV infection, such as susceptible heterosexual partners of people with HBV infection, have not been prioritized for intervention despite uprising reported HBV infections in adults. It is of importance to provide evidence of prevalence of HBV infection and evaluate its risks of transmission among adult population in order to inform HBV prevention policy in China, and to provide insight into global HBV control in adults. We aimed to report seroprevalence of HBsAg and to evaluate risks of prevalent HBV infection among rural couples, using data from the National Free-pregnancy Checkups (NFPC) program in China
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