A meta-analysis of HBsAg-positive rate among general Chinese populations aged 1--59 years

The third nationwide hepatitis B virus (HBV) sero-epidemiological survey conducted in China in 2006 showed a hepatitis B surface antigen (HBsAg)-positive rate of 7.18% and the number of carriers to be 93 million. To compensate for the lack of data on the national prevalence of hepatitis B from 2006 onwards, we performed a meta-analysis to investigate HBsAg-positive rates among the general Chinese population aged 1-59 years.

We systemically reviewed published studies (January 2007 to September 2013) from full-text databases such as VIP, Chinese National Knowledge Infrastructure, and PubMed and assessed HBsAg-positive rates using a random effects regression model with comprehensive meta-analysis software.

After evaluation of the quality of the papers, 36 were finally included, with a total sample size of 314 103 individuals. The meta-analysis showed that the combined HBsAg-positive rate was 6.1% (95% confidence interval (CI), 5.4-6.8%) among general Chinese populations aged 1-59, with a higher HBsAg-positive rate in males (6.6%; 95% CI, 5.7-7.7%) than in females (5.1%; 95% CI, 4.4-5.9%). Our data also showed a higher HBsAg-positive rate of 6.9% in mid-western China (95% CI, 5.2-9.1%) against 5.6% in eastern China (95% CI, 4.9-6.4%).

This meta-analysis suggested that the positive rates of HBsAg in China are reducing compared with previous 2006 sero-survey results, and China has changed from a high endemic area for HBV to an intermediate endemic area. However, owing to the large population, there remain an estimated 80 million HBsAg carriers in China. Thus, the prevention and control of hepatitis B represent a serious challenge, particularly in mid-western China.