Journal Article

Global epidemiology of hepatitis B virus infection: New estimates of age-specific HBsAg seroprevalence and endemicity

Groeger, J., Ott, J.J., Wiersma, S.T., Stevens, G.A.

2012

Overview

► Systematic review of global hepatitis B prevalence and modeling of data. ► HBsAg-positive persons increased from 223 million in 1990 to 240 million in 2005. ► HBsAg prevalence varied geographically with highest endemicity in sub-Saharan Africa. ► HBsAg prevalence decreased overall but global differences exist. ► Demographic changes call for targeted hepatitis B prevention. Chronic hepatitis B virus infection is one of the most serious infections and a major risk factor for deaths from cirrhosis and liver cancer. We estimate age-, sex- and region-specific prevalence of chronic HBV infection and calculate the absolute number of persons being chronically infected. A systematic review of the literature for studies reporting HBV infection was conducted and worldwide HBsAg seroprevalence data was collected over a 27-year period (1980–2007). Based on observed data, age-specific prevalence and endemicity were estimated on a global level and for all world regions for 1990 and 2005 using an empirical Bayesian hierarchical model. From 1990 to 2005, the prevalence of chronic HBV infection decreased in most regions. This was particularly evident in Central sub-Saharan Africa, Tropical and Central Latin America, South East Asia and Central Europe. Despite this decrease in prevalence, the absolute number of HBsAg positive persons increased from 223 million in 1990 to 240 million in 2005. Age-specific prevalence varied by geographical region with highest endemicity levels in sub-Saharan Africa and prevalence below 2% in regions such as Tropical and Central Latin America, North America and Western Europe. Asian regions showed distinct prevalence patterns with lower intermediate prevalence in South Asia, but up to 8.6% HBsAg prevalence in East Asia. Strong declines were seen in South East Asian children. Declines in HBV infection prevalence may be related to expanded immunization. The increasing overall number of individuals being chronically infected with HBV, and the widespread global differences in HBV prevalence call for targeted approaches to tackle HBV-related mortality and morbidity. HBV infection prevalence data are needed at country and sub-national level to estimate disease burden and guide health and vaccine policy.

• Publisher: Elsevier Ltd,Elsevier Limited
• Subject: Adolescent / Adult / Age / Age distribution / Age Factors / Aged / Aged, 80 and over / Allergy and Immunology / Antigens / Asians / Bayesian analysis / burden of disease / Cancer / Central European region / Child / Child, Preschool / Children / chronic hepatitis B / Chronic infection / Cirrhosis / Data processing / Disease / Epidemiology / Estimates / Fatalities / Female / Geography / Global Health / Hepatitis / Hepatitis B / hepatitis B antigens / Hepatitis B surface antigen / Hepatitis B surface antigen (HBsAg) / Hepatitis B Surface Antigens - blood / Hepatitis B virus / Hepatitis B, Chronic - epidemiology / Humans / Immunization / indigenous species / Infant / Infant, Newborn / Infection / Infections / issues and policy / Latin America / Literature reviews / Liver cancer / liver cirrhosis / liver neoplasms / Low income groups / Male / Mathematical models / Middle Aged / Modeling / Morbidity / Mortality / North America / Population / Prevalence / Reporting requirements / Reviews / Risk factors / Seroepidemiologic Studies / seroprevalence / Sex Factors / South Asia / South East Asia / Studies / Sub-Saharan Africa / Systematic review / tropics / Vaccines / Western European region / Young Adult