Edmunds, W. John , Medley, Graham, Nokes, D. James, O'Callaghan, C. J., Whittle, H. C. and Hall, A. J. (Andrew James). (1996) Epidemiological patterns of hepatitis B virus (HBV) in highly endemic areas. Epidemiology and Infection, Vol.117 (No.2). pp. 313-325. ISSN 0950-2688

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Abstract

This paper uses meta-analysis of published data and a deterministic mathematical model of hepatitis B virus (HBV) transmission to describe the patterns of HBV infection in high endemicity areas. We describe the association between the prevalence of carriers and a simple measure of the rate of infection, the age at which half the population have been infected (A50), and assess the contribution of horizontal and perinatal transmission to this association. We found that the two main hyper-endemic areas of sub-Saharan Africa and east Asia have similar prevalences of carriers and values of A50, and that there is a negative nonlinear relationship between A50 and the prevalence of carriers in high endemicity areas (Spearman's Rank, P = 0·0086). We quantified the risk of perinatal transmission and the age-dependent rate of infection to allow a comparison between the main hyper-endemic areas. East Asia was found to have higher prevalences of HBeAg positive mothers and a greater risk of perinatal transmission from HBeAg positive mothers than sub-Saharan Africa, though the differences were not statistically significant. However, the two areas have similar magnitudes and age-dependent rates of horizontal transmission. Results of a simple compartmental model suggest that similar rates of horizontal transmission are sufficient to generate the similar patterns between A50 and the prevalences of carriers. Interrupting horizontal transmission by mass immunization is expected to have a significant, nonlinear impact on the rate of acquisition of new carriers.

Item Type:	Journal Article
Subjects:	Q Science > QR Microbiology > QR355 Virology R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions:	Faculty of Science > Life Sciences (2010- ) > Biological Sciences ( -2010)
Library of Congress Subject Headings (LCSH):	Hepatitis B virus, Communicable diseases -- Transmission -- Mathematical models, Epidemiology -- Research, Vaccination
Journal or Publication Title:	Epidemiology and Infection
Publisher:	Cambridge University Press
ISSN:	0950-2688
Date:	October 1996
Volume:	Vol.117
Number:	No.2
Page Range:	pp. 313-325
Identification Number:	10.1017/S0950268800001497
Status:	Peer Reviewed
Access rights to Published version:	Restricted or Subscription Access
Funder:	Royal Society (Great Britain), Medical Research Council (Great Britain) (MRC), Wellcome Trust (London, England), Royal Society (Great Britain) , Medical Research Council (Canada) (MRC)
References:	1. Maynard JE. Hepatitis B: global importance and need for control. Vaccine 1990; 8 (suppl): s 18-s20. 2. Ghendon Y. WHO strategy for the global elimination of new cases of hepatitis B. Vacine 1990; 8 (suppl): s129-s133. 3. Beasley RP, Hwang L-Y, Lin C-C, Chien C-S. Hepatocellular carcinoma and hepatitis B virus A prospective study of 22707 men in Taiwan. Lancet 1981;ii: 1129-33. 4. Maynard JE, Kane MA, Hadler SC. Global controls of hepatitis B through vaccination: role of hepatitis B vaccine in the expanded programmes on immunization. Rev Infect Dis 1989; 11 (suppl 3): s574-s578. 5. Andre FE. Overview of a 5-year clinical experience with a yeast-derived hepatitis B vaccine. Vaccine 1980; 8 (suppl): s74-s78. 6. Coursaget P, Yvonnet B, Chotard J, et al. Seven-year study of hepatitis B vaccine efficacy in infants from an endemic area (Senegal). Lancet 1986; ii: 1143-5. 7. Coursaget P, Yvonnet B, Gilks WR, et al. Scheduling of revaccination against hepatitis B virus. Lancet 1991; 337: 1180-3. 8. Whittle HC, Inskip H, Hall AJ, Mendy M, Downes R, Hoare S. Vaccination against hepatitis B and protection against chronic viral carriage in The Gambia. Lancet 1991; 337: 747-50. 9. Pearce N, Milne A. Hepatitis B virus: the importance of age at infection. NZ Med J 1988; 101: 788-90. 10. McMahon BJ, Alward WLM, Hall DB, et al. Acute hepatitis B virus infection: Relation of age to the clinical expression of disease and subsequent development of the carrier state. J Infect Dis 1985; 151: 599-603. 11. Coursaget P, Yvonnet B, Chotard J, et al. Age- and sexrelated study of hepatitis B virus chronic carrier state in infants from an endemic area (Senegal). J Med Virol 1987; 22: 1-5. 12. Beasley RP, Hwang L-Y, Lin C-C, et al. Hepatitis B immune globulin (HBIg) efficacy in the interuption of perinatal transmission of hepatitis B virus carrier state. Lancet 1981; ii: 388-93. 13. Stevens CE, Beasley RP, Tsui J, Lee W-C. Vertical transmission of hepatitis B antigen in Taiwan. New Engl J Med 1975; 292: 771-4. 14. Stevens CE, Neurath RA, Beasley RP, Szmuness W. HBeAg and anti-HBe detection by radioimmunoassay: correlation with vertical transmission of hepatitis B virus in Taiwan. J Med Virol 1979; 3: 237-41. 15. Iwarson S, Hermodsson S. Hepatitis associated antigen (HAA) in acute viral hepatitis. Scand J Infect Dis 1971; 3: 93-101. 16. Tassopoulos NC, Papaevangelou GJ, Sjogren MH, Roumeliotou-Karayannis A, Gerin JL, Purcell RH. Natural history of acute hepatitis B surface antigenpositive hepatitis in Greek adults. Gastroenterol 1987; 92: 1844-50. 17. Nielsen JO, Dietrichson 0, Elling P, Christoffersen P. Incidence and meaning of persistence of Australia antigen in patients with acute viral hepatitis: Development of chronic hepatitis. New Engl J Med 1971; 285: 1157-60. 18. Edmunds WJ, Medley GF, Nokes DJ, Hall AJ, Whittle HC. The influence of age on the development of the hepatitis B virus (HBV) carrier state. Proc Roy Soc (Lond) Series B 1993; 253: 197-201. 19. Khashiwagi S, Hayashi J, Ikematsu H, et al. Transmission of hepatitis B virus among siblings. Am J Epidemiol 1984; 120: 617-25. 20. Toukan AU, Sharaiha ZK, Abu-El-Rub OA, et al. The epidemiology of hepatitis B virus among family members in the Middle East. Am J Epidemiol 1990; 132: 220-32. 21. Overby LR, Ling C-M, Decker RH, Mushahwar IK, Chau K. Serodiagnostic profiles of viral hepatitis. In: Szmuness W, Alter MJ, Maynard JE, eds. Viral hepatitis. Philadelphia: Franklin Institute Press, 1982: 169-82. 22. Prince AM. An antigen detected in the blood during the incubation period of serum hepatitis. Proc Natl Acad Sci USA 1968; 60: 814-21. 23. Hadler SC, Margolis HS. Viral hepatitis. In: Evans AS, ed. Viral infections of humans. Epidemiology and control, 3rd ed. New York: Plenum, 1991: 351-91. 24. McMahon BJ, Parkinson AJ, Helminiak C, et al. Response to hepatitis B vaccine of persons positive for antibody to hepatitis B core antigen. Gastroenterol 1992; 103: 590-4. 25. Deinhardt F. Predictive value of markers of hepatitis virus infection. J infect Dis 1980; 141: 299-305. 26. Whittle H, Inskip H, Bradley AK, et al. The pattern of childhood hepatitis B infection in two Gambian villages. J Infect Dis 1990; 161: 1112-5. 27. Tabor E, Bayley AC, Cairns J, Pelleu, Gerety RJ. Horizontal transmission of hepatitis B virus among children and adults in five rural villages in Zambia. J Med Virol 1985; 15: 113-20. 28. Bowry TR. Seroepidemiology of hepatitis B in an urban population of Nairobi, Kenya. J Infect Dis 1983; 148: 1122. 29. Hyams KC, Al-Arabi MA, Al-Tagani AA, Messiter JF, Al-Gaali AA, George JF. Epidemiology of hepatitis B in the Gezira Region of Sudan. Am J Trop Med Hyg 1989; 40: 200-6. 30. Feret E, Larouze B, Diop B, Sow M, London WT, Blumberg BS. Epidemiology of hepatitis B infection in the rural community of Tip, Senegal. Am J Epidemiol 1987; 125: 140-9. 31. Prozesky OW, Szmuness W, Stevens CE, et al. Baseline epidemiological studies for a hepatitis B vaccine trial in Kangwane. S Afr Med J 1983; 64: 891-3. 32. Chung D-C, Ko Y-C, Chen C-J, et al. Seroepidemiological studies on hepatitis B and D viruses infection among five ethnic groups in Southern Taiwan. J Med Virol 1988; 26: 411-8. 33. Lingao AL, Domingo EO, West S, et al. Seroepidemiology of hepatitis B in the Philippines. Am J Epidemiol 1986; 123: 473-80. 34. Hu M, Schenzle D, Deinhardt F, Scheid R. Prevalence of markers of hepatitis A and B in the Shanghai Area. J. Infect Dis 1983; 147: 360. 35. Mazzur S, Bastiaans MJS, Nath N. Hepatitis B virus (HBV) infection among children and adults in the Soloman Islands. Am J Epidemiol 1981; 113: 510-9. 36. Boutin J-P, Flye Sainte Marie F, Cartel J-L, Cardines R, Girard M, Roux J. Prevalence of hepatitis B virus infection in the Austral archipelago, French Polynesia: identification of transmission patterns for the formulation of immunization strategies. Trans R Soc Trop Med Hyg 1990; 84: 283-7. 37. Torres JR, Mondolfi A. Protracted outbreak of severe delta hepatitis: Experience in an isolated Amerindian population of the Upper Orinoco Basin. Rev Infect Dis 1991; 13: 52-5. 38. Swenson PD. Hepatitis viruses. In: Balows A, Hausler WJ, Jr., Herrmann KL, Isenberg HD, Shadomy HJ, eds. Manual of clinical microbiology, 5th ed. Washington D.C.: American Society for Microbiology, 1991: 959-83. 39. Schweitzer IL. Vertical transmission of the hepatitis B surface antigen. Am J Med Sci 1975; 270: 287-91. 40. Sokal RR, Rohlf FJ. Biometry. San Francisco: W. H. Freeman and Company, 1969. 41. Anderson RM, May RM. Infectious diseases of humans. Oxford: Oxford University Press, 1991. 42. Anderson RM, May RM. Vaccination against rubella and measles: quantitative investigations of different policies. J Hyg 1983; 90: 259-325. 43. Grenfell BT, Anderson RM. The estimation of agerelated rates of infection from case notifications and serological data. J Hyg 1985; 95: 419-36. 44. Margolis HS. Prevention of chronic liver disease through immunization: Hepatitis B and beyond. J Infect Dis 1993; 168: 9-14. 45. Gebreselassie L. Prevalance of specific markers of viral hepatitis A and B among an Ethiopian population. Bull WHO 1983; 61: 991-6. 46. Milne A, Allwood GK, Moyes CD, Pearce NE, Lucas CR. Prevalence of hepatitis B infections in a multiracial New Zealand community. NZ Med J 1985; 98: 529-32. 47. Sobeslavsky 0. Prevalence of markers of hepatitis B virus infection in various countries: a WHO collaborative study. Bull WHO 1980; 58: 621-8. 48. Beasley RP, Trepo C, Stevens CE, Szmuness W. The e antigen and vertical transmission of hepatitis B surface antigen. Am J Epidemiol 1977; 105: 94-8. 49. Beasley RP, Hwang L-Y, Lee GC-Y, et al. Prevention of perinatally transmitted hepatitis B virus infections with hepatitis B immune globulin and hepatitis B vaccine. Lancet 1983; ii: 1099-102. 50. Bortolotti F, Cadrobbi P, Crivellaro C, Bertaggia A, Alberti A, Realdi G. Chronic hepatitis type B in childhood: longitudinal study of 35 cases. Gut 1981; 22: 499-504. 51. Alward WLM, McMahon BJ, Hall DB, Heyward WL, Francis DP, Bender TR. The long term serological course of asymptomatic B virus carriers and the development of primary hepatocellular carcinoma. J Infect Dis 1985; 151: 604-9. 52. McMahon BJ, Alberts SR, Wainwright RB, Bulkow L, Lanier AP. Hepatitis B-related sequelae. Prospective study in 1400 hepatitis B surface antigen-positive Alaska native carriers. Arch Intern Med 1990; 150: 1051-4. 53. Bortolotti F, Cadrobbi P, Crivellaro C, et al. Long-term outcome of chronic type B hepatitis in patients who acquire hepatitis B virus infection in childhood. Gastroenterol 1990; 99: 805-10. 54. Tong MJ, Thursby MW, Lin J-H, Weissman JY, McPeak CM. Studies on the maternal-infant transmission of the hepatitis B virus and HBV infection within families. Prog Med Virol 1981; 274 137-47. 55. Schweitzer IL, Mosley JW, Ashcavai M, Edwards VM, Overby LB. Factors influencing neonatal infection by hepatitis B virus. Gastroenterol 1973; 65: 277-83. 56. Shiraki K, Yoshihara N, Kawana T, Yasui H, Sakurai M. Hepatitis B Surface Antigen and Chronic Hepatitis in Infants born to Asymptomatic Carrier Mothers. Am J Dis Child 1977; 131: 644-647. 57. Okada K, Yamada T, Miyakawa Y, Mayumi M. Hepatitis B Surface Antigen in the Serum of Infants After Delivery from Asymptomatic Carrier Mothers. J Pediatric 1975; 87: 360-363. 58. Greenfield C, Osidiana V, Karayiannis P, Galpin S, Musoke R, Jowett TP, et al. Perinatal Transmission of Hepatitis B Virus Transmission in Kenya: Its Relation to the Level of Serum HBV-DNA and Anti-HBe in the Mother. J Med Virol 1986; 19: 135-142. 59. Lau Y-L, Chow C-B, Leung T-H. Changing epidemiology of measles in Hong Kong from 1961 to 1990 - Impact of measles vaccination program. J Infec Dis 1991; 165: 1111-1115. 60. Marinier E, Barrois V, Larouze B, London WT, Cofer A, Diakhate L, et al. Lack of Perinatal Transmission of Hepatitis B Virus Infection in Senegal, West Africa. J Pediatric 1985; 106: 843-849. 61. Barin F, Perrin J, Chotard J, Denis F, N'Doye R, Mar ID, et al. Cross-sectional and longitudinal epidemiology of hepatitis B in Senegal. Prog Med Virol 1981; 27: 148-162. 62. Tsega E, Tsega M, Mengesha B, Nordenfelt E, Hansson B-G, Lindberg J. Transmission of Hepatitis B virus Infection in Ethiopia with Emphasis on the Importance of Vertical Transmission. Int J Epidemiol 1988; 17: 874-879. 63. Botha JF, Ritchie MJJ, Dushieko GM, Mouton HWK, Kew MC. Hepatitis B Virus Carrier State in Black Children in Ovamboland: Role of Perinatal and Horizontal Infection. Lancet 1984; 1: 1210-1212. 64. Haukenes G, Shao JF, Mbena E, Rustad S. Hepatitis B markers in the population of Dar es Salaam, Tanzania. J Infect 1987; 15: 183-8. 65. Wong VCW, Lee AKY, Ip MMH. Transmission of hepatitis B antigen from symptom free carrier mothers to the fetus and the infant. Br J Obstet Gynecol 1980; 87: 958-65. 66. Wong VCW, Ip HMH, Reesink HW, et al. Prevention of the HBsAg carrier state in newborn infants of mothers who are chronic carriers of HBsAg and HBeAg by administration of hepatitis-B vaccine and hepatitis- B immunoglobulin. Lancet 1984; 8: 921-6. 67. Okada K, Yamada T, Miyakawa Y, Mayumi M. Hepatitis B surface antigen in the serum of infants after delivery from asymptomatic carrier mothers. J Pediatric 1975; 87: 360-3. 68. Pongpipat D, Suvatte V, Assateerawatts A. Vertical transmission of the hepatitis B surface antigen in Thailand. Southeast Asian J Trop Med Pub Hlth 1980; 11: 582-7. 69. Nayak NC, Panda SK, Zuckerman AJ, Bhan MK, Guha DK. Dynamics and impact of perinatal transmission of hepatitis B virus in North India. J Med Virol 1987; 21: 137-45. 70. Biswas SC, Gupta I, Ganguly NK, Chawla Y, Dilawari JB. Prevalence of hepatitis B surface antigen in pregnant mothers and its perinatal transmission. Trans R Soc Trop Med Hyg 1989; 83: 698-700. 71. Hyams KC, Osman NM, Khaled EM, et al. Maternalinfant transmission of hepatitis B in Egypt. J Med Virol 1988; 24: 191-7. 72. Reniers J, Vrancks R, Ngantung W, Sugita E, Meheus A. Prevalence and determinants of hepatitis B virus markers in pregnant women in West Java, Indonesia. J Trop Med Hyg 1987; 90: 249-53. 73. Al-Nakib B, El-Mekki A, Al-Kandari S, Nordenfelt E, Al-Nakib W. Hepatitis B virus perinatal transmission among arab women. Ann Trop Ped 1986; 6: 239-41. 74. Goudeau A, Yvonnet B, Lesage G, et al. Lack of anti- HBc IgM in neonates with HBsAg carrier mothers argues against transplacental transmission of hepatitis B virus infection. Lancet 1983; ii: 1103-4. 75. Chen D-S, Sung J-L, Lai M-Y, et al. Inadequacy of immunoglobulin M hepatitis B core antibody in detecting acute hepatitis B virus infection in infants of HBsAg carrier mothers. J Med Virol 1985; 16: 309-14. 76. Shiraki K, Yoshihara N, Sakurai M, Eto T, Kawana T. Acute hepatitis B in infants born to carrier mothers with the antibody to hepatitis B e antigen. J Pediatric 1980; 97: 768-72. 77. Hwang L-Y, Roggendorf M, Beasley RP, Deinhardt F. Perinatal transmission of hepatitis B virus: role of maternal HBeAg and anti-HBc IgM. J Med Virol 1985; 15: 265-9. 78. Lee AKY, Ip HMH, Wong VCW. Mechanisms of maternal-fetal transmission of hepatitis B virus. J Infect Dis 1978; 138: 668-71. 79. Panda SK, Gupta A, Datta R, Nayak NC. Transplacental transmission of hepatitis B virus. Lancet 1986; ii: 919-20. 80. Panda SK, Bhan MK, Guha DK, et al. Significance of maternal and infant serum antibodies to hepatitis B core antigen in hepatitis B virus infection in infancy. J Med Virol 1988; 24: 343-9. 81. Derso A, Boxall EH, Tarlow MJ, Flewett TH. Transmission of HBsAg from mother to infant four ethnic groups. BMJ 1978; I: 949-52. 82. De Virgiliis S, Frau F, Sanna G, et al. Perinatal hepatitis B virus detection by hepatitis B virus-DNA analysis. Arch Dis Child 1985; 60: 56-60.
URI:	http://wrap.warwick.ac.uk/id/eprint/2675

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