Distribution and persistence of hepatitis B surface antigen and antibody in a Melanesian population

The population of Graciosa Bay, Santa Cruz, British Solomon Islands Protectorate, was tested for HBsAg and anti-HBs in 1973 and 1974. Both the antigen and antibody occurred more often in males, presumably due to a higher exposure rate. None of 28 infants under one year of age had antigen and only one of 50 individuals under two years (2%) did. The prevalence of antigenemia was higher in older children and did not decline with increasing age. This pattern is contrasted to that found in other populations which is characterized by onset during the first year and a decrease in prevalence in older age groups. The ratio of antigenemia prevalence to that of antibody is significantly higher in the population under six years of age (p less than 0.01), indicating that younger infected people tend to be asymptomatic carriers while older individuals tend to have produced antibody. Three of 28 individuals with antigen detectable by immunodiffusion in 1973 had lower levels, detectable only by reversed passive hemagglutination after one year. The age specific prevalence of anti-HBs increases to a peak of 34% in the 15-19 year age group and declines thereafter.