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. doi:10.1017/S0950268800001497 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, Engineering and Medicine > 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
Official Date:	October 1996
Dates:	Date Event October 1996 Published
Volume:	Vol.117
Number:	No.2
Page Range:	pp. 313-325
DOI:	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)

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