Hepatitis B seroprevalence and knowledge awareness among spouses of reported Hepatitis B cases in Quzhou city: A cross-sectional study

This study investigated Hepatitis B virus (HBV) infection prevalence and disease-related knowledge among spouses of reported HBV cases in Quzhou City to support family-based interventions reducing intra-familial transmission. In 2024, a cross-sectional survey was conducted in three randomly selected counties. Spouses (≥18y) of cases reported from Jan 2023 to Sep 2024 were interviewed with a structured questionnaire and tested for serological markers. Among 344 valid respondents, 161 provided blood samples. The HBsAg positivity rate was 11.80%. The rates for anti-HBs, anti-HBe, and anti-HBc were 60.87%, 23.60%, and 77.02%, respectively. No participant tested positive for HBeAg. Based on serological patterns, 12.42% were classified as susceptible, 9.94% had immunity from vaccination, and 50.93% had evidence of past infection. Overall HBV knowledge awareness rate was 36.69% with a pass rate of 22.09%. The awareness rates for the 10 specific knowledge items ranged from 6.40% to 62.21%. Multivariate logistic regression analysis showed that older age (≥60y: OR = 0.102, 95%CI:0.040 - 0.261), farmers/workers(OR = 0.335, 95%CI:0.155 - 0.723), and unawareness of personal infection status(OR = 0.364, 95%CI:0.159 - 0.833) were independently associated with lower knowledge. Most respondents preferred obtaining information through "hospitals/medical staff"(61.63%) and "online platforms/WeChat official accounts"(38.95%). Spouses have high HBsAg prevalence and poor HBV knowledge, indicating a substantial risk of intra-family transmission. Targeted health education, especially for the elderly, farmers/workers, and those unaware of their status, should be delivered through medical institutions to promote vaccination and regular testing, thereby reducing family‑clustered transmission.