Hepatitis B virus markers in children and staff in Northern Territory schools

To measure the prevalence of hepatitis B virus (HBV) infection in children and staff at Northern Territory schools.

Children in Years 5-7 in 24 selected primary schools were invited, with parental consent, to provide demographic and ethnic details, and a capillary blood sample for tests for hepatitis B surface antigen (HBsAg) and antibody to hepatitis B surface antigen (anti-HBs). School staff participated on a similar basis.

1104 children, comprising 556 from ethnic groups (originating from the United Kingdom, Ireland and northern Europe) previously reported as "low HBV prevalence", 439 Aboriginal Australians, and 109 from "other" ethnic groups (originating from Asia, the Pacific, the Middle East and southern Europe); and 209 school staff, comprising 180 from "low HBV prevalence" ethnic groups, and 29 from Aboriginal and other ethnic groups.

Prior HBV infection (i.e. serum positive for HBsAg or anti-HBs) was detected in 28.7% of children (46.9% of 439 Aborigines; 13.7% of the 556 children from the "low prevalence" groups and 32.1% of the 109 from the "other" groups). HBsAg was detected in 8.2% of Aboriginal children, in 0.36% of those from "low prevalence" groups, and in 1.8% of those from the "other" groups. Aboriginal children in rural schools had the highest prevalence of HBV: 5.4% were positive for both HBsAg and anti-HBs, and an additional 9.8% were positive for HBsAg alone. In urban schools, the prevalence was highest in the "other" ethnic groups. For school staff, the prevalence of HBV infection was 12.8% for those from "low prevalence" ethnic groups, and 37.9% for those from all remaining groups (including Aborigines).

In the Northern Territory the prevalence of past HBV infection is high in children and school staff from ethnic groups previously known to be at higher risk of HBV infection. For students and staff from ethnic backgrounds expected to be at low risk, HBV prevalence is greater than in individuals from similar backgrounds in other parts of Australia. HBV vaccination is now offered to all infants in the Northern Territory. These results also provide a rationale for the more widespread use of HBV vaccine in other situations where significant HBV transmission might occur.