The Epidemiology of Hepatitis B Virus Among Family Members in the Middle East

Abstract

In 1985, the authors studied the epidemiology of hepatitis B virus (HBV) in a healthy Middle Eastern population. Residents of three remote villages and urban areas of Jordan were assessed for seroprevalence of hepatitis B surface antigen (HBsAg) and HBV infection. Infection was defined as the presence of antibody to hepatitis B core antigen (total) and/or antibody to hepatitis B surface antigen, with or without HBsAg. The overall HBsAg prevalence was 9.9% and was not age-related, although significant differences were noted between the villages (range, 5.7%-12.8%). The prevalence of HBV infection was 36% and increased with age. In addition, there were differences between the villages in patterns of age-specific infection. A newly constructed socioeconomic index showed greater HBsAg prevalence in lower (14.4%) than in upper (2.4%) socioeconomic groups. A history of contact with a jaundiced person and socioeconomic status were independent risk factors for HBsAg-positive status, while contact with a jaundiced person, rural background, and age were independently related to HBV infection. There was evidence of familial clustering of HBV in two of the villages, with HBV carriers and infected children particularly aggregating around HBsAg-positive siblings. There was also a trend toward an association of HBsAg-positive children with HbsAg-positive mothers. HBV carrier prevalence correlated with family size, and HBV infection in the household increased proportionately with the number of carriers in the family. Hepatitis B e antigen was detected most frequently in children and antibody to hepatitis B e antigen in adults. Postnatal early childhood transmission through contact among children of poorer and larger families probably accounts for the high endemicity of HBV in this region.

Prevalence of chronic hepatitis B virus infection after implementation of a hepatitis B vaccination program among children in three provinces in Cambodia

“…We assessed only a few risk factors for low vaccine coverage and for acquiring chronic HBV infection. Other important factors such as low socioeconomic status and household crowding were not assessed [29][30][31][32][33]. Additionally, small numbers of HBsAg positive children limited stratification by receiving a birth dose and limited evaluation of the impact of ≥3 dose hepatitis B coverage.…”

Epidemiological Findings of Hepatitis B Infection Based on 1998 National Health and Nutrition Survey in Korea

“…Other countries (8)(9)(10)(11)(12) have also reported geographical variations of HBsAg seropositivity within their countries. Among them, the study from China (8) showed a higher positivity of HBsAg in coast areas, comparable with ones from Korea.…”

Epidemiological patterns of hepatitis B virus (HBV) in highly endemic areasr

“…This decline in the risk of developing the carrier state with increasing age at infection is highly nonlinear and appears to be remarkably consistent for a wide range of communities and geographical settings [18]. Childhood [19,20]. This paper reviews the patterns of HBV infection in highly endemic countries and attempts to define the epidemiological relationships between the routes of infection, the age at infection and the prevalence of carriers.…”