Seroprevalence and Risk Factors for Hepatitis B in an Adult Population: The First Report from Birjand, South Khorasan, Iran.
BACKGROUND
Infection with the hepatitis B virus (HBV) is an important global health problem. Knowledge of the geographic distribution pattern of HBV infection can help to control the spread of the disease.


OBJECTIVE
To determine the prevalence of HBV infections and risk factors for the disease for the first time in Birjand, Southeastern Iran.


METHODS
This was an analytical cross-sectional study conducted in 2013 - 2014 of 5235 HBV cases in Birjand, South Khorasan Iran. Subjects aged 15 - 70 y were selected using the cluster sampling method. Blood samples were taken and tested at a reference laboratory for the hepatitis B core antibody (anti-HBc). Seropositive specimens were tested for the hepatitis B surface antigen (HBsAg).


RESULTS
The mean age (± SD) was 39.07 (± 14.04) y, and 786 (15%) subjects were anti-HBc positive. The prevalence of HBsAg was 1.6% (n = 85). The prevalence of anti-HBc seropositivity was significantly higher in subjects with a lower level of education (P = 0.09), older subjects (P = 0.001), intravenous (IV) drug users (P<0.05), subjects with piercings (P < 0.001), and subjects with a positive history of familial HBV or HCV infection (P < 0.05). It was also significantly higher in those who drank alcohol (P = 0.09) or had a history of blood transfusions (P = 0.001), cupping (P = 0.004), hospital admission (P = 0.03), or endoscopy (P = 0.002). The rate of HBsAg positivity was significantly higher in subjects with a history of cupping (P=0.03), a positive history of familial HBV or HCV infection (P < 0.05), and older subjects (P = 0.015).


CONCLUSIONS
Although the frequency of HBsAg seropositivity in the present study was close to that observed in the overall Iranian population, the seroprevalence of anti-HBc was higher, possibly due to the exposure of the elderly to more risk factors. The risk factors were similar. These included a history of blood transfusions, cupping, hospital admission, endoscopy, or familial HBV/HCV infection, in addition to piercings and drug abuse.
Hepatitis Research Center, Birjand University of Medical Sciences, Birjand, IR Iran.
Masood
M
Ziaee
Hepatitis Research Center, Birjand University of Medical Sciences, Birjand, IR Iran.
Azadeh
A
Ebrahimzadeh
Hepatitis Research Center, Birjand University of Medical Sciences, Birjand, IR Iran.
Zohreh
Z
Azarkar
Hepatitis Research Center, Birjand University of Medical Sciences, Birjand, IR Iran.
Mohammad Hasan
MH
Namaei
Birjand Atherosclerosis and Coronary Artery Research Center, Birjand University of Medical Sciences, Birjand, IR Iran; Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
Amin
A
Saburi
Asthma, Allergy and Immunology Research Center, Birjand University of Medical Sciences, Birjand, IR Iran.
Mohammad
M
Fereidouni
Hepatitis Research Center, Birjand University of Medical Sciences, Birjand, IR Iran.
Bita
B
Bijari
Hepatitis Research Center, Birjand University of Medical Sciences, Birjand, IR Iran.
Mehdi
M
Karamian
Hepatitis Research Center, Birjand University of Medical Sciences, Birjand, IR Iran.
Gholamreza
G
Sharifzadeh
Epidemiology; Hepatitis B; Hepatitis B Surface Antigen; Risk Factor, Iran