To determine the prevalence of hepatitis B surface antigen (HBsAg), hepatitis B surface
antibody (anti-HBs), and hepatitis B core anti-body (anti-HBc) in a representative
population in China 14 years after introduction of hepatitis B vaccination of infants.
National serosurvey, with participants selected by multi-stage random sampling. Demographics
and hepatitis B vaccination history collected by questionnaire and review of vaccination
records, and serum tested for HBsAg, antibody to anti-HBc and anti-HBs by ELISA.
The weighted prevalences of HBsAg, anti-HBs and anti-HBc for Chinese population aged
1-59 years were 7.2%, 50.1%, 34.1%, respectively. HBsAg prevalence was greatly diminished
among those age <15 years compared to that found in the 1992 national serosurvey,
and among children age <5 years was only 1.0% (90% reduction). Reduced HBsAg prevalence
was strongly associated with vaccination among all age groups. HBsAg risk in adults
was associated with male sex, Western region, and certain ethnic groups and occupations
while risk in children included birth at home or smaller hospitals, older age, and
certain ethnic groups (Zhuang and other).
China has already reached the national goal of reducing HBsAg prevalence to less than
1% among children under 5 years and has prevented an estimated 16-20 million HBV carriers
through hepatitis B vaccination of infants. Immunization program should be further
strengthened to reach those remaining at highest risk.