Seroprevalence of hepatitis B among the general population in Shandong Province, Eastern China, an update 30 years after the implementation of the neonatal vaccination program

BACKGROUND: In 1992, Hepatitis B vaccine was first recommended for routine neonatal immunization in China. This study aimed to estimate the prevalence of hepatitis B virus (HBV) infection in Shandong Province, eastern China (updating our previous study in 2014), and to help guide the efforts of hepatitis B elimination. METHODS: We determined prevalence of HBV infection from the remaining serum samples collected through a population-based survey, which was originally intended for a seroepidemiological survey of anti-SARS-CoV-2 antibodies conducted in 2023. The samples (n = 5000) were obtained from individuals all-aged over 1 year residing in ten counties of Shandong Province. The chemiluminescence microparticle immunoassay was used to detect serological markers of HBV. RESULTS: In total, 4999 samples were eligible for the test of hepatitis B. The overall prevalence of HBsAg, anti-HBs, and anti-HBc in the 2023 survey was 2.25% (95%CI:1.64-2.87), 46.21% (95%CI:44.05-48.38), and 25.17% (95%CI:23.46-26.88), respectively. The HBsAg prevalence has dropped to 0.28% among individuals younger than 30 years, particularly with less than 0.1% among children aged 1-14 (considerably below the 8% prevalence recorded in 1992). The peak prevalence of HBsAg was observed in individuals aged 40-49 years (5.63%), followed by those aged 30-39 (3.11%). CONCLUSION: The Shandong Province has achieved substantial success in controlling HBV infection among the younger generation through the newborn routine vaccination program. To accelerate progress towards the goal of eliminating hepatitis B in the province, additional strategies should also be adopted in parallel, including increasing diagnostic coverage, expanding antiviral treatment, and enhancing hepatitis B vaccine coverage for HBV-susceptible adults.