The declining rates of hepatitis B carriage among adolescents and young people in the Eastern region of Saudi Arabia

OBJECTIVES: To study age specific rates of hepatitis B virus (HBV) carriage in the eastern region of Saudi Arabia following a 24 year immunization program. METHODS: Hepatitis B surveillance data between January 2004 and December 2013 were analyzed in a retrospective study, which included 24,504,914 patients. Seropositive cases of hepatitis B were reported by laboratory personnel as part of various investigations. Hepatitis B cases including acute and chronic carriers were identified upon serological positivity of hepatitis B surface antigen (HBsAg). RESULTS: The study shows that the overall prevalence rate decreased from 18.8 to 9.9/100,000 population between 2004 and 2013 (p=0.01). It was also found that the prevalence rate increased with age. For instance, the highest prevalence of hepatitis B was seen among patients >15 years of age and the lowest was seen among children <15 years of age. Over the period, the prevalence rate decreased in all age groups with the greatest decline among the age groups <4 years old. However, this was statistically insignificant (p>0.05). Another significant reduction in the prevalence rate occurred among age groups 5-14 years old (p=0.00). An insignificant decrease in the rate by 43% was also seen among older patients of 15-44 years old and 35% in >45 years old. The overall prevalence of hepatitis B is significantly higher in men than in women (p=0.00). CONCLUSION: There is a particular decreased trend in the prevalence of HBV infection in different age groups over a decade of surveillance following more than 20 years of the universal HBV vaccination program.