Seroepidemiology of hepatitis B virus infection and impact of vaccination

Table 1 Characteristics of the study population n (%)

Variables		Value
Age (yr)	1-4	1175 (0.79)
	5-19	28046 (18.83)
	≥ 20	119710 (80.38)
Sex	Male	67319 (45.20)
	Female	81612 (54.80)
Marital status (≥ 20 yr)	Unmarried	6614 (5.53)
	Married	106395 (88.88)
	Divorced	6264 (5.23)
	Unknown	437 (0.37)
Education (≥ 20 yr)	Illiterate or primary school	68552 (57.27)
	Middle school	43460 (36.31)
	College school	7097 (5.93)
	Unknown	599 (0.50)
Occupation (≥ 20 yr)	Agricultural worker	40363 (33.72)
	Worker	40530 (33.86)
	Student	1248 (1.04)
	Civil servant	5129 (4.28)
	Public service worker	5222 (4.36)
	Unemployed	21763 (18.18)
	Others	4883 (4.08)
	Unknown	572 (0.48)
Smoking status (≥ 20 yr)	Never	87144 (72.80)
	Current	27024 (22.57)
	Past	2731 (2.28)
	Unknown	2811 (2.35)
Drinking status (≥ 20 yr)	Never	95470 (79.75)
	Frequently	5900 (4.93)
	Every day	2132 (1.78)
	Unknown	16208 (13.54)
BMI (kg/m2) (≥ 20 yr)	< 18.5	4238 (3.54)
	18.5-24	59117 (49.38)
	24-28	41559 (34.72)
	≥ 28	14796 (12.36)
History of hypertension (≥ 20 yr)	No	99327 (82.97)
	Yes	20383 (17.03)
History of diabetes (≥ 20 yr)	No	116701 (97.49)
	Yes	3009 (2.51)
Familial history of HBV	No	132997 (91.06)
	Yes	12016 (8.23)
	Unknown	1034 (0.71)
Immunization history of HBV	No	75868 (51.77)
	Yes	50233 (34.28)
	Unknown	20444 (13.95)

BMI: Body mass index.

Table 2 Prevalence of hepatitis B surface antigen by other demographic and selected variables in Eastern China

Variables	HBsAg negative (n = 137462)	HBsAg positive (n = 11469)	Prevalence (%, 95%CI)	P value
Marital status (≥ 20 yr)				< 0.001
Unmarried	6127	487	7.36 (6.75-8.02)
Married	96383	10012	9.41 (9.24-9.59)
Divorced	5808	456	7.28 (6.65-7.95)
Education (≥ 20 yr)				< 0.001
Illiterate or primary school	61819	6733	9.82 (9.60-10.05)
Middle school	39830	3630	8.35 (8.09-8.62)
College school	6526	571	8.05 (7.42-8.70)
Occupation (≥ 20 yr)				< 0.001
Agricultural worker	36186	4177	10.35 (10.05-10.65)
Worker	36717	3813	9.41 (9.13-9.70)
Student	1163	85	6.81 (5.48-8.35)
Civil servant	4672	457	8.91 (8.14-9.72)
Public service worker	4749	473	9.06 (8.29-9.87)
Unemployed	20297	1466	6.74 (6.41-7.08)
Others	4411	472	9.67 (8.85-10.53)
Immunization history of HBV				< 0.001
No	68111	7757	10.22 (10.01-10.44)
Yes	48430	1803	3.59 (3.43-3.76)
Familial history of HBV
No	123472	9525	7.16 (7.02-7.30)	< 0.001
Yes	10319	1697	14.12 (13.50-14.76)

HBsAg: Hepatitis B surface antigen.

Table 3 Risk factors associated with hepatitis B surface antigen positivity among population aged 1-19 years

Variables	uaj. OR (95%CI)	P value	aj. OR (95%CI)	P value
Age group (yr)
5-9 vs 1-4	0.91 (0.45-1.86)	0.805	1.14 (0.52-2.54)	0.740
10-14 vs 1-4	1.84 (0.93-3.63)	0.078	1.18 (0.86-3.21)	0.095
15-19 vs 1-4	3.39 (1.74-6.60)	< 0.001	4.12 (1.93-8.75)	< 0.001
Sex (female vs male)	0.89 (0.74-1.07)	0.218	-	-
Immunization history of HBV (yes vs no)	0.50 (0.35-0.70)	< 0.001	0.71 (0.49-0.98)	0.028
Familial history of HBV (yes vs no)	2.52 (1.83-3.49)	< 0.001	2.00 (1.88-2.13)	< 0.001

aj. OR: Logistic regression analyses adjusted for age group, familial history of HBV, and immunization history of HBV; uaj.: Unadjusted.

Table 4 Risk factors associated with hepatitis B surface antigen positivity among population aged > 19 years

Variables	uaj. OR (95%CI)	P value	aj. OR (95%CI)	P value
Age group (yr)
30-39 vs 20-29	1.52 (1.41-1.65)	< 0.001	1.18 (1.08-1.30)	< 0.001
40-49 vs 20-29	1.35 (1.25-1.45)	< 0.001	0.97 (0.88-1.06)	0.494
50-59 vs 20-29	1.32 (1.22-1.42)	< 0.001	0.87 (0.79-1.02)	0.108
60-69 vs 20-29	1.04 (0.96-1.13)	0.339	0.84 (0.57-1.02)	0.212
≥ 70 vs 20-29	0.92 (0.85-1.10)	0.962	0.81 (0.69-1.02)	0.478
Sex (female vs male)	0.74 (0.71-0.77)	< 0.001	0.72 (0.69-0.75)	< 0.001
Familial history of HBV (yes vs no)	1.90 (1.80-2.01)	< 0.001	1.93 (1.83-2.05)	< 0.001
Immunization history of HBV (yes vs no)	0.56 (0.53-0.59)	< 0.001	0.52 (0.49-0.56)	< 0.001
Hospitalization (yes vs no)	0.95 (0.92-1.04)	0.227	-	-
Surgery (yes vs no)	0.92 (0.85-1.03)	0.312	-	-
Blood transfusion (yes vs no)	1.00 (0.88-1.13)	0.966	-	-
Blood donation (yes vs no)	0.88 (0.75-1.12)	0.215	-	-
Invasive testing (yes vs no)	1.44 (1.36-1.53)	< 0.001	1.18 (1.11-1.26)	< 0.001
Hemodialysis (yes vs no)	0.56 (0.20-1.53)	0.255	-	-
Acupuncture (yes vs no)	0.94 (0.87-1.09)	0.612	-	-
Dental therapy (yes vs no)	0.88 (0.82-1.01)	0.061	-	-
Tattoos (yes vs no)	1.24 (0.84-1.82)	0.280	-	-
Piercing (yes vs no)	0.97 (0.92-1.03)	0.388	-	-
Sharing needles (yes vs no)	1.40 (1.09-1.80)	0.008	1.44 (1.12-1.86)	0.005
Sharing razors (yes vs no)	0.90 (0.81-1.02)	0.478	-	-
Sharing toothbrush (yes vs no)	1.04 (0.76-1.41)	0.814	-	-

aj. OR: Logistic regression analyses adjusted for age group, sex, familial history of HBV, immunization history of HBV, invasive testing, and sharing needles.

Table 5 Cumulative effects of familial history of hepatitis B virus on hepatitis B virus infection

Variables	HBsAg negative	HBsAg positive	OR (95%CI)	P value
Mother	1031	317	3.57 (3.12-4.08)	< 0.001
Father	2488	432	1.95 (1.75-2.17)	< 0.001
Spouse (≥ 20 yr)	3363	531	1.02 (1.00-1.04)	0.041
Offspring (≥ 20 yr)	1817	283	1.61 (1.41-1.83)	< 0.001
Siblings	1059	353	3.10 (2.73-3.51)	< 0.001
Other families	1061	130	1.57 (1.30-1.89)	< 0.001
Combined familial history of HBV and HBV infection
0	123472 (92.29)	9525 (84.88)	1	-
1	9838 (7.36)	1562 (13.95)	1.93 (1.82-2.05)	< 0.001
2	462 (0.34)	121 (1.05)	3.19 (2.60-3.92)	< 0.001
3-6	19 (0.01)	14 (0.12)	9.82 (4.80-20.11)	< 0.001
Trend				< 0.0011
0	123472 (92.29)	9525 (84.88)	1	-
1-6	10319 (7.71)	1697 (15.12)	2.00 (1.89-2.12)	< 0.001

¹The P value of Cochran-Armitage’s trend test. Logistic regression analyses adjusted for age, sex, and immunization history of HBV.