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Prevalence of hepatitis B virus infection among black children in Soweto
Insights
Hepatitis B virus (HBV) infection is less common in urban Soweto children (0.97% HBsAg carriers) compared to rural areas. This urban advantage warrants further investigation into protective environmental factors for hepatitis B prevention.
Area of Science:
- Hepatology
- Infectious Diseases
- Pediatrics
- Public Health
Background:
- Hepatitis B virus (HBV) infection poses a significant public health challenge, with approximately 15% of black children in rural Southern Africa being carriers.
- Understanding the prevalence of chronic HBV infection in different environments is crucial for developing targeted prevention strategies.
Purpose of the Study:
- To determine the prevalence of chronic hepatitis B virus infection among urban black children in Soweto.
- To compare HBV infection rates between different socioeconomic classes and sexes.
- To investigate the influence of age on HBV marker prevalence.
Main Methods:
- A cross-sectional study involving 2364 black children (aged 3-19 years) from Soweto, representing upper and lower socioeconomic strata.
- Serum samples were analyzed for hepatitis B virus surface antigen (HBsAg), antibodies to hepatitis B core antigen (anti-HBc), and antibodies to hepatitis B surface antigen (anti-HBs).
- Hepatitis A virus IgG antibody was also tested to assess prior exposure.
Main Results:
- The overall prevalence of HBsAg (active infection) was 0.97% (23/2364).
- Combined anti-HBc and anti-HBs (past infection with immunity) was found in 6.6% (155/2364), while anti-HBc alone (past infection without immunity) was 0.7% (17/2364), and anti-HBs alone (vaccination or resolved infection) was 3% (72/2364).
- Hepatitis B virus markers were more prevalent in boys than girls and increased with age. No significant difference was observed between socioeconomic classes. Hepatitis A virus IgG was highly prevalent (97%).
Conclusions:
- The prevalence of hepatitis B virus infection in urban Soweto children is significantly lower than reported in rural Southern Africa.
- The urban environment appears to have a protective effect against HBV infection, suggesting potential for reduced transmission.
- Further research is needed to identify the specific factors within the urban setting that contribute to this lower prevalence for effective public health interventions.
Abstract:
Roughly 15% of black children in rural areas of southern Africa are carriers of the hepatitis B virus. The purpose of the present study was to determine the prevalence of chronic hepatitis B virus infection among urban black children born and growing up in Soweto. A total of 2364 children were studied, ranging in age from 3 to 19 years, and of these, 1319 (56%) were girls. The children were drawn from the highest and the lowest socioeconomic classes. Serum samples were tested for all hepatitis B virus markers as well as IgG antibody against hepatitis A virus. HBsAg was detected in 23 (0.97%) of the children, anti-HBc and anti-HBs together in 155 (6.6%), anti-HBc alone in 17 (0.7%), and anti-HBs alone in 72 (3%). Of the 2364 children, 2097 (88.5%) were negative for all hepatitis B virus markers. IgG antibody to hepatitis A virus was present in 175 (97%) of a sample of 179 children. There was no difference in prevalence of hepatitis B virus markers between children from the upper and lower socioeconomic classes. HBsAg was more common in boys (16 out of 1043 (1.5%) than girls (seven out of 1321 (0.57%), and the prevalence of all hepatitis B virus markers increased with age. The youngest carrier of hepatitis B virus was 7 years old. The remarkable difference in the hepatitis B virus carrier rate between urban and rural black children offers a unique opportunity to investigate the favourable influences operating in an urban environment to limit the prevalence of hepatitis B virus infection.