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Chronic HBV prevalent among non-high-risk populations across world

In a new study, researchers found a prevalence of chronic hepatitis B virus infection across various non–high-risk populations across the world, indicating strategies of prevention and control are still needed to combat the infection, according to findings published in The Lancet.

“Chronic hepatitis B virus infection continues to be a major public health issue worldwide, despite the availability of an effective vaccine and potent antiviral treatments,” the researchers wrote. “[Currently] there are no up-to-date global systematic reviews reporting country-level chronic HBV prevalence [and] previous systematic reviews on HBV prevalence were limited in scope.”

To perform a pooled analysis and up-to-date systematic review, researchers analyzed data of 1,800 studies they extracted from the Medline, Embase, CAB Abstracts, Popline, and Web of Science databases that focused on the prevalence of chronic HBV infection published between January 1965 and October 2013. The studies included reports on hepatitis B surface antigen (HBsAg) serological marker of chronic HBV infection in non–high-risk groups across 161 countries.

“For each country, we calculated HBsAg prevalence estimates and 95% [confidence intervals] weighted by study size,” the researchers wrote. “We extrapolated prevalence estimates to population sizes in 2010 to obtain the number of individuals with chronic HBV infection.”

In the analysis, researchers found HBsAg seroprevalence was 3.61% worldwide with highest prevalence in countries among the African (8.83%) and Western Pacific region (5.26%).

"Within the WHO region of the Americas, prevalence ranged between 0.2% and 13.55%, with the lowest range being in Mexico (0.19%-0.21%) and the highest being in Haiti (9%-19.89%). Prevalence ranged between 0.48% and 22.38% in the African region, with the lowest being in the Seychelles (0.12%-1.9%) and the highest being South Sudan (20.1%-24.83%), according to the research.

Countries in the Western Pacific region had a high-intermediate prevalence of HBsAg (5%-7.99%), with most prevalence being found among Pacific Island states than large countries like China and Australia.

Overall, the highest number of people living with HBV lived in the Western Pacific region (95 million), then the African region (over 75 million). America had the least number of infected people (7 million). The highest population of people positive with HBsAg were China (74 million), India (17 million) and Nigeria (15 million), according to the research.

“We estimated that in 2010, globally, about 248 million individuals were HBsAg-positive,” the researchers wrote.

The researchers concluded: “The findings of this report indicate an unmet need for prevention and control of this infection, particularly in high-endemicity countries. Investments in comprehensive and effective strategies to interrupt the transmission of hepatitis B and reduce resultant morbidity and mortality are urgently required.

“Furthermore, the magnitude of this epidemic warrants investments in research and concerted efforts in developing epidemiological research capacity, particularly within resource-poor countries to accurately quantify the problem and assess the effect of interventions.” – by Melinda Stevens

Disclosures: The study was funded by the Word Health Organization. The researchers report no relevant financial disclosures.