General epidemiological parameters of viral hepatitis A, B, C, and E in six regions of China: a cross-sectional study in 2007

Jian Lu, Yongdong Zhou, Xiaojing Lin, Yongzhen Jiang, Ruiguang Tian, Yonghui Zhang, Jia Wu, Fengwei Zhang, Yong Zhang, Yue Wang, Shengli Bi, Jian Lu, Yongdong Zhou, Xiaojing Lin, Yongzhen Jiang, Ruiguang Tian, Yonghui Zhang, Jia Wu, Fengwei Zhang, Yong Zhang, Yue Wang, Shengli Bi

Abstract

Background: Viral hepatitis is a serious health burden worldwide. To date, few reports have addressed the prevalence of hepatitis A, B, C, and E in China. Therefore, the general epidemiological parameters of viral hepatitis remain unknown.

Principal findings: In this cross-sectional study, we performed a serological prevalence analysis of viral hepatitis A, B, C, and E in 8,762 randomly selected Chinese subjects, which represented six areas of China. The overall prevalence of anti-Hepatitis C virus antibody (anti-HCV) was 0.58%, which was much lower than was estimated by WHO. The prevalences of Hepatitis B virus surface antigen (HBsAg), anti-Hepatitis B virus surface protein antibody (HBsAb), and anti-Hepatitis B virus core protein antibody (HBcAb) were 5.84%, 41.31%, and 35.92%, respectively, whereas in the group of subjects less than 5 years old, these prevalences were 1.16%, 46.77%, and 8.69% respectively, which suggests that the Hepatitis B virus (HBV)-carrier population is decreasing, and the nationwide HBV vaccine program has contributed to the lowered HBV prevalence in the younger generation in China. Meanwhile, a large deficit remains in coverage provided by the national HBV immune program. In addition, our data suggested the possibility that HBsAb may not last long enough to protect people from HBV infection throughout life. The overall prevalence of anti-Hepatitis A virus antibody (anti-HAV) and anti-Hepatitis E virus antibody (anti-HEV) were as high as 72.87% and 17.66%, respectively. The indices increased with age, which suggests that a large proportion of Chinese adults are protected by latent infection. Furthermore, the pattern of HEV infection was significantly different among ethnic groups in China.

Conclusions: Our study provided much important information concerning hepatitis A, B, C, and E prevalence in China and will contribute to worldwide oversight of viral hepatitis.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Serological features of anti-HCV prevalence…
Figure 1. Serological features of anti-HCV prevalence in China.
Bars represent the number of subjects in each group indicated by left vertical axis, and the points represent the prevalence in each group indicated by right vertical axis. The horizontal axis represents the age ranges. A, Overall characterization of anti-HCV by age group. B, Overall characterization of anti-HCV by gender, M, male, F, female. C, Regional characterization of anti-HCV by age group.
Figure 2. Prevalence of HBV serologic markers…
Figure 2. Prevalence of HBV serologic markers in China.
Bars represent the number of subjects in each group indicated by left vertical axis, and the points represent the prevalence in each group indicated by right vertical axis. The horizontal axis represents the age ranges. A, Overall characterization of HBV serologic markers by age range group. B, Overall characterization of HBV serologic markers by gender, M, male, F, female. C, Regional characterization of HBV serologic markers by age group.
Figure 3. Serological features of anti-HAV prevalence…
Figure 3. Serological features of anti-HAV prevalence in China.
Bars represent the number of subjects in each group indicated by left vertical axis, and the points represent the prevalence in each group indicated by right vertical axis. The horizontal axis represents the age ranges. A, Overall characterization of anti-HAV by age group. B, Overall characterization of anti-HAV by gender, M, male, F, female. C, Regional characterization of anti-HAV by age group.
Figure 4. Serological features of anti-HEV prevalence…
Figure 4. Serological features of anti-HEV prevalence in China.
Bars represent the number of subjects in each group indicated by left vertical axis, and the points represent the prevalence in each group indicated by right vertical axis. The horizontal axis represents the age ranges. A, Overall characterization of anti-HEV by age group. B, Overall characterization of anti-HEV by gender, M, male, F, female. C, Regional characterization of anti-HEV by age group.
Figure 5. Location of the six study…
Figure 5. Location of the six study areas in China.
“n” represents the number of subjects in each area. Statistical data on the population of each area are from National Bureau of Statistics of China, updated in 2007 when samples were collected.

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