Change of the prevalence of hepatitis B and its related factors in Inner Mongolia between 2006 and 2020 (Preprint)

BACKGROUND The course of hepatitis B is prolonged and easy to turn into chronic hepatitis, cirrhosis and liver cancer as the second serious disease-causing human cancer.Hepatitis B not only affects the health of individuals, but also causes a heavy economic burden to the family society.In 2015, WHO launched a strategy to eliminate hepatitis as a public health threat by 2030; however, annual global deaths from HBV are projected to increase by 39% between 2015 and 2030 if the status quo is maintaine.Mortality from HBV-related liver diseases in China with the highest burden of HBV infection accounts for 30% of the global mortality from HBV infection. It’s important for China to achieve the WHO goal of global hepatitis eradication by 2030.In the past three decades, China has made timely vaccination of newborns and infants a top priority to prevent and control hepatitis B.The infection rate of HBV has decreased significantly, and our country is no longer a high-prevalence area.However, large differences in the burden of hepatitis B virus exist not only between countries and regions, but also within a country or region, varying by state or province, income, race or ethnicity, and other social and cultural factors. Inner Mongolia located in the north of China and life style has greater specificity. HBV vaccination has been carried out in Inner Mongolia for many years. However, few studies have been conducted to evaluate the actual effects of the vaccine after using. OBJECTIVE To compare the prevalence rate of hepatitis B virus serum markers in Inner Mongolia between 2020 and 2006, and understand the change of hepatitis B prevalence in the past 15 years, and provide scientific basis for the development of hepatitis B prevention and control plan. METHODS A stratified multi-stage cluster random sampling method was adopted in 12 areas of Inner Mongolia. The subjects aged 1-60 years old were selected to carry out questionnaire survey and sample collection and detect hepatitis B serum biomarkers, including HBV surface antigen (HBsAg), HBV surface antibody (HBsAb) and HBV core antibody (HBcAb). The prevalence of serum biomarkers of hepatitis B was analyzed and compared between 2020 and 2006 which were standardized by age and sex. RESULTS There were 6,500 subjects in 2020 and 6304 subjects in 2006. HBV infection rate was 22.69% (95%CI 21.67%-23.71%) and 30.06% after standardization. The positive rate of HBsAg was 2.06%, lower than 2.74% in 2006 (P=.012) with the decrease proportion of 24.82%. After the standardization using the population in the Inner Mongolia by age and sex, the prevalence of HBsAg was also lower in 2020 than in 2006 (2.75% vs. 4.11%, P<.001). Men and the subjects without the HBV vaccination were related with HBsAg prevalence. The same results were observed in the serum biomarker of HBsAb (44.65% vs. 47.76%, P<.001; standardized 41.40% vs. 42.14%, P=.39) and HBcAb (14.63% vs. 16.24%, P=.012; standardized 20.15% vs. 22.91%, P<.001). CONCLUSIONS The burden of HBV infection in Inner Mongolia has decreased significantly. The prevention and control of hepatitis B in Inner Mongolia should continue to strengthen, not only pay more attention to hepatitis B vaccination, but also emphasize the active treatment after HBV infection.