Seroprevalence of hepatitis B among the general population in Shandong Province, Eastern China, an update 30 years after the implementation of the neonatal vaccination program

Abstract

Background

In 1992, Hepatitis B vaccine was first recommended for routine neonatal immunization in China. This study aimed to estimate the prevalence of hepatitis B virus (HBV) infection in Shandong Province, eastern China (updating our previous study in 2014), and to help guide the efforts of hepatitis B elimination.

Methods

We determined prevalence of HBV infection from the remaining serum samples collected through a population-based survey, which was originally intended for a seroepidemiological survey of anti-SARS-CoV-2 antibodies conducted in 2023. The samples (n = 5000) were obtained from individuals all-aged over 1 year residing in ten counties of Shandong Province. The chemiluminescence microparticle immunoassay was used to detect serological markers of HBV.

Results

In total, 4999 samples were eligible for the test of hepatitis B. The overall prevalence of HBsAg, anti-HBs, and anti-HBc in the 2023 survey was 2.25% (95%CI:1.64–2.87), 46.21% (95%CI:44.05–48.38), and 25.17% (95%CI:23.46–26.88), respectively. The HBsAg prevalence has dropped to 0.28% among individuals younger than 30 years, particularly with less than 0.1% among children aged 1–14 (considerably below the 8% prevalence recorded in 1992). The peak prevalence of HBsAg was observed in individuals aged 40–49 years (5.63%), followed by those aged 30–39 (3.11%).

Conclusion

The Shandong Province has achieved substantial success in controlling HBV infection among the younger generation through the newborn routine vaccination program. To accelerate progress towards the goal of eliminating hepatitis B in the province, additional strategies should also be adopted in parallel, including increasing diagnostic coverage, expanding antiviral treatment, and enhancing hepatitis B vaccine coverage for HBV-susceptible adults.