Epidemiological serosurvey of hepatitis B in China--declining HBV prevalence due to hepatitis B vaccination.
OBJECTIVE
To determine the prevalence of hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), and hepatitis B core anti-body (anti-HBc) in a representative population in China 14 years after introduction of hepatitis B vaccination of infants.


METHODS
National serosurvey, with participants selected by multi-stage random sampling. Demographics and hepatitis B vaccination history collected by questionnaire and review of vaccination records, and serum tested for HBsAg, antibody to anti-HBc and anti-HBs by ELISA.


RESULTS
The weighted prevalences of HBsAg, anti-HBs and anti-HBc for Chinese population aged 1-59 years were 7.2%, 50.1%, 34.1%, respectively. HBsAg prevalence was greatly diminished among those age <15 years compared to that found in the 1992 national serosurvey, and among children age <5 years was only 1.0% (90% reduction). Reduced HBsAg prevalence was strongly associated with vaccination among all age groups. HBsAg risk in adults was associated with male sex, Western region, and certain ethnic groups and occupations while risk in children included birth at home or smaller hospitals, older age, and certain ethnic groups (Zhuang and other).


CONCLUSIONS
China has already reached the national goal of reducing HBsAg prevalence to less than 1% among children under 5 years and has prevented an estimated 16-20 million HBV carriers through hepatitis B vaccination of infants. Immunization program should be further strengthened to reach those remaining at highest risk.
Liang
Xiaofeng
X
Chinese Center for Disease Control and Prevention, Beijing, China.
Bi
Shengli
S
Yang
Weizhong
W
Wang
Longde
L
Cui
Gang
G
Cui
Fuqiang
F
Zhang
Yong
Y
Liu
Jianhua
J
Gong
Xiaohong
X
Chen
Yuansheng
Y
Wang
Fuzhen
F
Zheng
Hui
H
Wang
Feng
F
Guo
Jing
J
Jia
Zhiyuan
Z
Ma
Jingchen
J
Wang
Huaqing
H
Luo
Huiming
H
Li
Li
L
Jin
Shuigao
S
Hadler
Stephen C
SC
Wang
Yu
Y
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology* / Q000517:prevention & control; D006512:Hepatitis B Core Antigens / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D017325:Hepatitis B Vaccines / Q000008:administration & dosage*; D006801:Humans; D017589:Immunization Programs; D007223:Infant; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D016036:Seroepidemiologic Studies; D055815:Young Adult
D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines