Hepatitis B Markers in Isfahan, Central Iran: A Population-Based Study

Hepatitis B is the most frequent cause of chronic hepatitis and cirrhosis in Iran. To establish better preventive strategies, updating data on prevalence rates are needed. This study was conducted to determine the seroprevalence of hepatitis B virus (HBV) in Isfahan province, Central Iran, in 2006. In a cross-sectional study in 2006, 816 subjects over 6 years old were selected through a systematic multi-stage cluster sampling from 32 urban and 9 rural areas of Isfahan province. Demographic data, HBV risk factors and blood samples were collected and hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (HBsAb) and hepatitis B core antibody (HBcAb) were measured by enzyme-linked immunosorbent assay (ELISA) method. Chi-square test and Odds Ratio (95% CIs) and multistage logistic regression analysis were used for statistical analysis. A P<0.05 was considered statistically significant. The subjects of this study included 428 females (52.5%) and 388 males (47.5%). Of the 816 participants, 10 (1.3%) were positive for HBsAg, 98 (12.1%) for isolated HBsAb, 22 (2.9%) for isolated HBcAb and 11 (1.3%) for both HBsAb and HBcAb. The HBsAg seropositive rate ranged from 0 in 6-9-year-old to 1.9% in 40-49-year-old age groups. HBsAb and HBcAb were more frequently observed in 6-9-year-old and ≥50-year-old age groups, respectively. No subject vaccinated for HBV was found positive for HBsAg or HBcAb (age group 6-9 years old). According to the status of education, the highest HBcAb positivity rate was in non-educated group (P<0.001). There were no independent risk factors for any of HBV markers. Isfahan province seems to have a low prevalence of HBV infection. However, as low HBcAb and HBsAb prevalence rates were seen in non-vaccinated at-risk age groups, improving the coverage of vaccination for HBV seems necessary.