Determining the characteristics of hepatitis B virus (HBV) infection in the healthy population and evaluating the effectiveness of detection strategies will facilitate the optimization of hepatitis B screening strategies in the community and accelerate the elimination of HBV infection in China by the end of 2030. Hepatitis B surface antigen (HBsAg)-electrochemiluminescence immunoassays (ECLIAs), HBsAg-rapid diagnostic tests (RDTs), and HBV DNA-nucleic acid tests (NATs) were performed on serum samples from 2721 community-based healthy participants in Guangdong Province. The screening performance of the RDT and NAT and the distribution characteristics of HBsAg and HBV DNA were evaluated. The prevalence rates of HBsAg-ECLIA, HBsAg-RDT and HBV DNA-NAT in Guangdong Province were 6.10% (95% CI: 5.26~7.06), 4.96% (95% CI: 4.21~5.84) and 6.55% (95% CI: 5.64~7.49), respectively, and the prevalence rates for the three methods for individuals aged over 30 years were 11.18%, 10.92% and 12.57%, respectively. When the ECLIA was used as the gold standard, the sensitivities of the RDT, NAT and RDT and NAT in parallel were 80.7% (95% CI: 73.9~86.4), 86.7% (95% CI: 80.6~91.5) and 93.4% (95% CI: 88.5~96.6), respectively, and the sensitivity of the RDT and NAT in parallel was greater than that of the RDT alone (p < 0.001). The parallel RDT and NAT revealed an additional cost–benefit ratio (ACBR) < 1 for males and individuals aged over 30 years, which indicated that switching from the RDT screening strategy to the RDT and NAT in parallel is more cost effective. Adults aged over 30 years are the main population with hepatitis B infection in Guangdong Province, China, whose prevalence of HBsAg-ECLIA was 11.18%. Single RDT screening is prone to miss individuals with low levels of HBsAg. It is recommended to implement an RDT and NAT in parallel for individuals older than 30 years.

Objectives Eliminating hepatitis B remains challenging, especially in Guangdong, the region with China's highest burden. Predicting incidence, optimizing vaccination, and reducing illness are essential to meet the WHO goal of a 90 % reduction by 2030. Methods Based on the HBV surveillance data from 2005 to 2022, disease clustering patterns, correlation between vaccination and incidence were determined. A six-compartment transmission model was established and validated by estimating infectivity using nonlinear least squares and polynomial fitting. Results From 2005 to 2022, acute HBV cases in Guangdong declined from 7509 to 2,097, while chronic cases in adults aged ≥15 rose from 38,595 to 146,658. High-risk clusters remained in Guangzhou, Foshan, and Shenzhen. Infant vaccination was linked to reduced acute infections but had limited effect on chronic cases. By 2030, acute HBV infectivity is projected to reach 1872 cases, with 100,354 new chronic infections expected in adults. To meet the WHO 2030 elimination target, average recovery time for chronic carriers must be reduced from 40 years to 7.7 years. For full elimination, it should be shortened to 1.85 years. Conclusions Infant vaccination curbed acute HBV in youth, but chronic cases in adults threaten elimination goals. Scaling therapies to accelerate chronic HBV recovery is urgent.

Objective: A cross-sectional community prevalence survey was conducted to investigate the sero-epidemiological features of hepatitis B virus (HBV) infection among children aged 1–14 years in Guangdong Province in 2013, and to provide baseline data for the evaluation of HBV disease burden and the impacts of HBV control. Methods: A total of 2765 children aged 1–14 years from 16 villages/streets of eight cities in Guangdong Province were recruited as subjects. A blood sample was obtained from each subject. A chemiluminescence microparticle immunoassay (CMIA) was used to detect hepatitis B surface antigen (HBsAg), antibody to hepatitis B surface antigen (HBsAb), and antibody to hepatitis B core antigen (HBcAb). Results: The prevalence rates of HBsAg, HBsAb, and HBcAb among children aged 1–14 years were 1.16%, 61.63%, and 2.35%, respectively. The prevalence of HBsAg and HBcAb increased with increasing age, and the prevalence was lowest in the 1–4 years age group (0.97% for HBsAg and 1.45% for HBcAb). In contrast, the prevalence of HBsAb decreased with increasing age; however the prevalence was also highest in the 1–4 years age group (76.48%). Eastern Guangdong had the highest prevalence of HBsAg and HBcAb, and the lowest prevalence of HBsAb. The prevalence of HBsAg was under 1% in the Pearl River Delta and western Guangdong regions. Children who had received three or more doses of vaccine had a lower prevalence of HBsAg and HBcAb and a higher prevalence of HBsAb compared to those who had received fewer than three doses of vaccine. Conclusions: The prevalence of HBsAg among children aged 1–14 years in Guangdong in 2013 was 1.2%, showing a dramatic decrease compared to the 1992 provincial-level cross-sectional survey (19.9%). Children aged 1–4 years and children from the Pearl River Delta had the lowest prevalence of HBsAg positivity. High vaccination coverage among children and timely vaccination of newborns has played an important role in reducing the prevalence of HBsAg.

OBJECTIVE:To investigate the epidemic status of Hepatitis B in children aged 1-14 in 3 counties of Guangdong province in 2013, and to evaluate the effect of hepatitis control in children aged 1-14 after hepatitis B vaccine was integrated into the national immunization program in 2002 and catch-up vaccination was conducted from 2009 to 2011.METHODS:A multi-stage stratified random sampling was designed to survey 1 621 children aged 1-14 in rural area of Nanxiong county, Haifeng county and Xinxing county by questionnaires including general information, medical history and risk factors. The samples were tested with chemiluminescence method to detect hepatitis B virus (HBV) surface antigen (HBsAg), antibody to HbsAg (anti-HBs) and antibody to HBV core antigen (anti-HBc). Chi-square test was used to compare the positive rate of HBV serum markers in different age groups, vaccine histories, birth weight and HBV infection status of mother.RESULTS:Among the children aged 1-14 in 3 counties rural regions of Guangdong province, the positive rate of HBsAg, anti-HBs, and anti-HBc was 1.11% (18/1 621), 60.69% (982/1 618) and 1.92% (31/1 617), respectively. The HBsAg positive rate of vaccinated children (0.84%, 13/1 547) was lower than that of unvaccinated children (1/13) or children with unknown vaccination status (6.56%, 4/61) (χ² = 22.64, P < 0.001). The HBsAg positive rate (0.45%, 5/1 118) of the children with birth-dose given within 24 hours was lower than those that of children given beyond 24 hours (2.63%, 61/190) (χ² = 10.21, P < 0.001). The HBsAg positive rate (5/18) of children with birth weight under 2 kilogram was higher than that of children with birth weight above 2 kilogram (0.78%, 12/1 548) (χ² = 120.8, P < 0.001). The HBsAg positive rate of children born to HBsAg-positive mothers (2.80%, 3/107) was higher than that of children born to HBsAg-negative mothers (0.21%, 1/470) (χ² = 8.50, P = 0.004). With the age increasing, the coverage and timely birth-dose coverage of Hepatitis B vaccine (HepB) decreased, and the positive rate of anti-HBs gradually decreased.CONCLUSION:After the catch-up vaccination was conducted in unvaccinated children aged 1-14 years from 2009 to 2011, the HBsAg and anti-HBc positive rate decreased, while the anti-HBs positive rate increased significantly.

Objective: To estimate the disease burden and financial burden attributed to hepatitis B virus (HBV) infection in Guangdong Province. Methods: Based on the data of incidence, mortality and healthcare cost of HBV-related diseases and other socio-economic data in Guangdong Province, we estimated deaths, disability-adjusted life-years (DALYs) and economic cost for the three HBV-related diseases—hepatitis B, liver cirrhosis and liver cancer—in Guangdong following the procedures developed for the global burden of disease study. Then disease burden and economic cost attributed to HBV infection was estimated. Results: HBV infection was estimated to have caused 33,600 (95% confidence interval (CI): 29,300–37,800) premature deaths and the loss of 583,200 (95% CI: 495,200–671,100) DALYs in Guangdong in 2005. The greatest loss of deaths and DALYs were from liver cancer. The 45–59 years age group had the greatest burden attributable to HBV infection. The estimated total annual cost of HBV-related diseases in Guangdong was RMB 10.8 (95% CI: 8.7–13.0) billion，the direct and indirect cost were RMB 2.6 (95% CI: 2.1–3.2) and 8.2 (95% CI: 6.6–9.8) billion. Conclusions: HBV infection is a great medical challenge as well as a significant economic burden to Guangdong Province. The results suggest that substantial health benefits could be gained by extending effective public health and clinical interventions to reduce HBV infection in Guangdong Province.

Objective To investigate the infection status of hepatitis B virus (HBV) among rural childbearing women in Wuhua county and provide the scientific basis for control and prevention of HBV. Methods 2 towns were sampled from 16 towns of Wuhua county by multiple-stage randomly sampling, and 3 administrative villages were selected randomly from the towns.15~49 years-old resident women of childbearing age in each village were randomly sampled. 5 ml venous blood were collected for the detection of HBsAg, anti-HBs antibody and anti-HBc antibody. HBsAg positive samples were further detected for HBeAg and anti-HBe antiboy. The infection status of HBV in 15~49 years-old women of childbearing age were analyzed. Results In 613 tested individuals, the HBV prevalence rate was 66.88%. In HBsAg positive women of childbearing age,the positive rates of HBeAg and anti-HBe antibody were 36.36%, and 59.09%, respectively. Conclusion The HBV infection rate among women of childbearing age in Wuhua county is relatively high,and the comprehensive measures for control and prevention of HBV should be strengthened.

Objective: To evaluate the impact of the universal infant hepatitis B vaccination program on hepatitis B virus (HBV) infection in Guangdong Province, China.Methods: In 2006, a serosurvey was conducted in Guangdong Province among children aged <15 years, 14 years after the introduction of universal infant hepatitis B vaccination. The participants were selected by stratified, multi-stage random sampling. Demographic characteristics and hepatitis B vaccination history were collected by a questionnaire and a review of the vaccination records, and serum specimens were tested for hepatitis B surface antigen (HBsAg), antibody to hepatitis B core antigen (anti-HBc), and antibody to hepatitis B surface antigen (anti-HBs) by ELISA. The prevalence rate of HBV serological markers and the rate of immunization coverage in this survey were compared with those of the 1992 and 2002 surveys.Results: A total of 1967 children aged <15 years participated in 2006. The prevalence rate of HBsAg decreased from 19.86% in the 1992 survey to 4.91% in the 2006 survey. The rates of three-dose and timely birth dose coverage of hepatitis B vaccine were 92.40% and 70.84%, respectively, among children born during the period 2002-2005. The prevalence of HBsAg was significantly lower among fully immunized children (1.99%) than among unvaccinated children (5.56%).Conclusions: Guangdong Province has successfully integrated the hepatitis B vaccine into routine immunization programs and this has had a very significant impact on decreasing the HBsAg carrier rate among children. (c) 2012 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.