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Progress towards the comprehensive control of hepatitis B in Africa: a view from South Africa

M C Kew1

  • 1Department of Medicine, University of the Witwatersrand, Johannesburg, South Africa.

Gut
|January 1, 1996
PubMed

Insights

Hepatitis B virus (HBV) carriage in black Africans is high, primarily established in childhood. Vaccination and urbanization are expected to reduce new infections and carriers significantly within two decades.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Public Health

Background:

  • The carrier rate of hepatitis B virus (HBV) in black Africans averages 10.4%, with significant regional variations.
  • HBV carriage is mainly established in early childhood via horizontal transmission, with lower perinatal transmission compared to the Far East.
  • Hepatitis B e antigen (HBeAg) positivity rates are notably lower in childbearing-aged black Africans.

Purpose of the Study:

  • To analyze the epidemiology of hepatitis B virus carriage in black Africans.
  • To assess the impact of vaccination and urbanization on HBV prevalence.
  • To project future trends in HBV infection and its long-term sequelae.

Main Methods:

  • Epidemiological analysis of HBV carrier rates.
  • Review of transmission patterns (horizontal and perinatal).
  • Assessment of vaccination program impact and urbanization effects.

Main Results:

  • Universal infant HBV vaccination began in South Africa in 1995.
  • Urbanization shows a beneficial effect, with lower carrier rates in urban compared to rural areas.
  • A significant reduction in acute HBV infections and new carriers is projected within 20 years.

Conclusions:

  • While vaccination and urbanization will decrease acute HBV infections and new carriers, the long-term sequelae like cirrhosis and cancer will take longer to impact.
  • Ensuring effective integration and completion of vaccination doses is crucial.
  • Further research into lower HBeAg positivity rates in this population may be warranted.

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