Seroprevalence of Hepatitis B virus infection in a household-based representative sample of African men and women in KwaZulu-Natal, South Africa.
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Date
2018
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Abstract
Background: In South Africa, hepatitis B virus (HBV) infection remains a major cause of
morbidity and mortality, however, little is known about the prevalence and distribution of HBV
in some regions and populations.
Methods: This secondary analysis is based on 9791 participants (15-49 years old) enrolled in
the HIV incidence Provincial Surveillance System (HIPSS); a population-based household
study undertaken from June 2014 to June 2015 in the Vulindlela (rural) and Greater Edendale
(periurban) areas of the uMgungundlovu district, KwaZulu-Natal (KZN), South Africa.
Interviewer administered questionnaires were completed to obtain demographic, psychosocial,
behavioural and clinical information. Peripheral blood samples were collected and sera
were tested for hepatitis B surface antigen (HBsAg) and all samples testing positive were
further tested for hepatitis B e antigen (HBeAg) and hepatitis B e antibody (anti-HBe). The
estimated weighted seroprevalence of HBV markers was calculated and the association of
HBsAg with sociodemographic and behavioural factors measured.
Results: The overall HBsAg prevalence was 4.0% (95% confidence interval (CI) 3.4-4.5);
4.8% (95% CI 3.8- 5.8) in men and 3.2% (95% CI 2.5-3.9) in women, P=0.01. Among HBsAg
positive participants, 35.2% (95% CI 29.2-41.2) were HBeAg positive and 66.3% (95% CI
60.1-72.4) were anti-HBe positive. Among men 15-19 years old HBeAg seroprevalence was
92.2% (95% CI 75.8-100) compared to 4.4% (95% CI 0-13.7) in women in the same age group;
P <0.01. HBsAg prevalence was 6.4% (95% CI 5.3-7.5) among HIV positive participants
compared to 2.6% (95% CI 1.9-3.2) among HIV negative participants, (P<0.01) and was higher
among HIV positive men 8.7% (95% CI 6.3-11.2) compared to HIV positive women 5.0%
(95% CI 3.8-6.2), P<0.01.
Conclusion: HBV infection, particularly among HIV positive men remains an important public
health problem in rural and periurban communities in KwaZulu-Natal, South Africa. The
prevalence of HBsAg and HBeAg highlight the importance of surveillance and an important
missed opportunity for the scale up of programmes to achieve the goal of controlling HBV for
public health benefit.
Description
Masters Degree. University of KwaZulu-Natal, Durban.