Status of HBsAg seroprevalence in 15 million rural couples in China: a cross-sectional study

Abstract

A cross-sectional analysis of prevalence of hepatitis B virus infection (HBV) among rural couples was conducted between 2010 and 2014. Serologic HBV markers, including hepatitis B surface antigen (HBsAg) and e antigen (HBeAg), were tested. Primary outcome of interest comprised HBsAg positivity in couples (both positive: F+M+, only wife positive: F+M-, only husband positive: F-M+), and secondary outcome consisted of prevalence and risk factors of HBsAg positivity among husbands or wives. Of 14,816,300 couples included, 0.7% were F+M+; 6.3% were F-M+; 4.4% were F+M-, resulting in the overall seroprevalence of 11.4%. Individually, 6.1% were HBsAg positive with a higher rate seen in husbands (7.0%) than in wives (5.2%). Wife's HBeAg(+)/HBsAg (+) (AOR = 2.61), HBeAg(-)/HBsAg (+) (AOR = 2.23), positivity of syphilis (AOR = 1.50), living in a high-risk region (AOR = 1.46) were significantly predictors of HBsAg positivity in husbands. Prevalence and predictors of HBsAg positivity in wives had similar results. Our data show a high burden and discordant pattern of HBV infection in rural couples, and partner's double positivity of HBeAg and HBsAg was the most significant factor of HBV infection in couples. A comprehensive strategy that emphasizes vaccination and education is needed.

Figure 1. Flowchart of Study Population.

Figure 2. Prevalence of HBsAg Positivity among Individuals by Partner’s HBV Serostatus.

Figure 3. Multivariate Logistic Regression for HBsAg Positivity among Individuals.

Individual (husband or wife)’s status of HBsAg positivity was modelled and their partner’s characteristics were analyzed as covariates. Blue bars refer to husband’s HBsAg positivity, and green bars refer to wife’s HBsAg positivity. Partner’s characteristics are displayed along with x-axis.