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Objective: A cross-sectional community prevalence survey was conducted to investigate the sero-epidemiological features of hepatitis B virus (HBV) infection among children aged 1-14 years in Guangdong Province in 2013, and to provide baseline data for the evaluation of HBV disease burden and the impacts of HBV control., Methods: A total of 2765 children aged 1-14 years from 16 villages/streets of eight cities in Guangdong Province were recruited as subjects. A blood sample was obtained from each subject. A chemiluminescence microparticle immunoassay (CMIA) was used to detect hepatitis B surface antigen (HBsAg), antibody to hepatitis B surface antigen (HBsAb), and antibody to hepatitis B core antigen (HBcAb)., Results: The prevalence rates of HBsAg, HBsAb, and HBcAb among children aged 1-14 years were 1.16%, 61.63%, and 2.35%, respectively. The prevalence of HBsAg and HBcAb increased with increasing age, and the prevalence was lowest in the 1-4 years age group (0.97% for HBsAg and 1.45% for HBcAb). In contrast, the prevalence of HBsAb decreased with increasing age; however the prevalence was also highest in the 1-4 years age group (76.48%). Eastern Guangdong had the highest prevalence of HBsAg and HBcAb, and the lowest prevalence of HBsAb. The prevalence of HBsAg was under 1% in the Pearl River Delta and western Guangdong regions. Children who had received three or more doses of vaccine had a lower prevalence of HBsAg and HBcAb and a higher prevalence of HBsAb compared to those who had received fewer than three doses of vaccine., Conclusions: The prevalence of HBsAg among children aged 1-14 years in Guangdong in 2013 was 1.2%, showing a dramatic decrease compared to the 1992 provincial-level cross-sectional survey (19.9%). Children aged 1-4 years and children from the Pearl River Delta had the lowest prevalence of HBsAg positivity. High vaccination coverage among children and timely vaccination of newborns has played an important role in reducing the prevalence of HBsAg., (Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objective: To estimate the disease burden and financial burden attributed to hepatitis B virus (HBV) infection in Guangdong Province., Methods: Based on the data of incidence, mortality and healthcare cost of HBV-related diseases and other socio-economic data in Guangdong Province, we estimated deaths, disability-adjusted life-years (DALYs) and economic cost for the three HBV-related diseases-hepatitis B, liver cirrhosis and liver cancer-in Guangdong following the procedures developed for the global burden of disease study. Then disease burden and economic cost attributed to HBV infection was estimated., Results: HBV infection was estimated to have caused 33,600 (95% confidence interval (CI): 29,300-37,800) premature deaths and the loss of 583,200 (95% CI: 495,200-671,100) DALYs in Guangdong in 2005. The greatest loss of deaths and DALYs were from liver cancer. The 45-59 years age group had the greatest burden attributable to HBV infection. The estimated total annual cost of HBV-related diseases in Guangdong was RMB 10.8 (95% CI: 8.7-13.0) billion, the direct and indirect cost were RMB 2.6 (95% CI: 2.1-3.2) and 8.2 (95% CI: 6.6-9.8) billion., Conclusions: HBV infection is a great medical challenge as well as a significant economic burden to Guangdong Province. The results suggest that substantial health benefits could be gained by extending effective public health and clinical interventions to reduce HBV infection in Guangdong Province.

Objective: To investigate the epidemic status of Hepatitis B in children aged 1-14 in 3 counties of Guangdong province in 2013, and to evaluate the effect of hepatitis control in children aged 1-14 after hepatitis B vaccine was integrated into the national immunization program in 2002 and catch-up vaccination was conducted from 2009 to 2011., Methods: A multi-stage stratified random sampling was designed to survey 1 621 children aged 1-14 in rural area of Nanxiong county, Haifeng county and Xinxing county by questionnaires including general information, medical history and risk factors. The samples were tested with chemiluminescence method to detect hepatitis B virus (HBV) surface antigen (HBsAg), antibody to HbsAg (anti-HBs) and antibody to HBV core antigen (anti-HBc). Chi-square test was used to compare the positive rate of HBV serum markers in different age groups, vaccine histories, birth weight and HBV infection status of mother., Results: Among the children aged 1-14 in 3 counties rural regions of Guangdong province, the positive rate of HBsAg, anti-HBs, and anti-HBc was 1.11% (18/1 621), 60.69% (982/1 618) and 1.92% (31/1 617), respectively. The HBsAg positive rate of vaccinated children (0.84%, 13/1 547) was lower than that of unvaccinated children (1/13) or children with unknown vaccination status (6.56%, 4/61) (χ² = 22.64, P < 0.001). The HBsAg positive rate (0.45%, 5/1 118) of the children with birth-dose given within 24 hours was lower than those that of children given beyond 24 hours (2.63%, 61/190) (χ² = 10.21, P < 0.001). The HBsAg positive rate (5/18) of children with birth weight under 2 kilogram was higher than that of children with birth weight above 2 kilogram (0.78%, 12/1 548) (χ² = 120.8, P < 0.001). The HBsAg positive rate of children born to HBsAg-positive mothers (2.80%, 3/107) was higher than that of children born to HBsAg-negative mothers (0.21%, 1/470) (χ² = 8.50, P = 0.004). With the age increasing, the coverage and timely birth-dose coverage of Hepatitis B vaccine (HepB) decreased, and the positive rate of anti-HBs gradually decreased., Conclusion: After the catch-up vaccination was conducted in unvaccinated children aged 1-14 years from 2009 to 2011, the HBsAg and anti-HBc positive rate decreased, while the anti-HBs positive rate increased significantly.

Background: Guangdong province of China is HBV high endemicity and 1.6 million neonates are administrated 5 μg yeast recombinant anti-HBV vaccine each year. But few studies are performed to evaluate the immunogenicity and revaccination effect on non- and low- responders., Methods: 2,199 children were administered intramuscularly with 5 μg vaccine at 0, 1 and 6 mo after birth. A 3 ml blood sample was drawn from each infant 1 mo after the third dose for determination of anti-HBs level. Three additional doses (10 μg each) were given to non- and low- responders., Results: Of 1,814 subjects, 3.1% were non-responders (anti-HBs titer < 10 mIUml (-1) ) and 28.9% were low-responders (anti-HBs ≥ 10 mIUml (-1) and < 100 mIUml (-1) ). Low birth weight (LBW) was a risk factor for non- and low- responders (RR = 1.6, 95%CI = 1.2-2.0). After revaccination, of the 34 non-responders, 14.7% became low-responders and 85.3% became responders. Of the 74 low-responders, 21.6% remained at the same level and 78.4% shifted into responder category., Conclusions: Based on the lower responding rate after the primary immunization cycle and the higher responding rate after the additional cycle, measurement of anti-HBs level should be considered for people who had been immunized with three-dose 5 μg HB vaccine in Guangdong, especially for specific populations including LBW infants, healthcare workers, and patients with immunodeficiency disorders. An amount of 10 μg vaccine should be revaccinated to any non- and low- responders to provide adequate seroprotection.

Objective: To evaluate the impact of the universal infant hepatitis B vaccination program on hepatitis B virus (HBV) infection in Guangdong Province, China., Methods: In 2006, a serosurvey was conducted in Guangdong Province among children aged <15 years, 14 years after the introduction of universal infant hepatitis B vaccination. The participants were selected by stratified, multi-stage random sampling. Demographic characteristics and hepatitis B vaccination history were collected by a questionnaire and a review of the vaccination records, and serum specimens were tested for hepatitis B surface antigen (HBsAg), antibody to hepatitis B core antigen (anti-HBc), and antibody to hepatitis B surface antigen (anti-HBs) by ELISA. The prevalence rate of HBV serological markers and the rate of immunization coverage in this survey were compared with those of the 1992 and 2002 surveys., Results: A total of 1967 children aged <15 years participated in 2006. The prevalence rate of HBsAg decreased from 19.86% in the 1992 survey to 4.91% in the 2006 survey. The rates of three-dose and timely birth dose coverage of hepatitis B vaccine were 92.40% and 70.84%, respectively, among children born during the period 2002-2005. The prevalence of HBsAg was significantly lower among fully immunized children (1.99%) than among unvaccinated children (5.56%)., Conclusions: Guangdong Province has successfully integrated the hepatitis B vaccine into routine immunization programs and this has had a very significant impact on decreasing the HBsAg carrier rate among children., (Copyright © 2012 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)