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  • Title: Seroepidemiology of hepatitis B, delta and human immunodeficiency virus infections in Hamadan province, Iran: a population based study.
    Author: Amini S, Mahmoodi MF, Andalibi S, Solati AA.
    Journal: J Trop Med Hyg; 1993 Oct; 96(5):277-87. PubMed ID: 8411302.
    Abstract:
    The epidemiologic features of HBV, HDV and HIV in the general population of Hamadan province of Iran were studied. A total of 4930 subjects (1649 males and 3281 females) constituted the study population. Seropositivity for any HBV marker was found in 25.72% of the subjects. Of these, 2.49% were carriers of HBsAg, 18.09% were positive for anti-HBs and 5.13% for anti-HBc alone. HBeAg, anti-HBC IgM, and anti-HDV were present in 13.8, 6.5 and 2.4% of HBSAg carriers, respectively. Antibody to HIV was detected in none of the 4930 sera tested. Prevalence of HBV infection was lowest in children and young adults < 19 years and highest in adults > 60 years. No significant difference was observed between the rates in males and females. Family size and prevalence of HBV infection were unrelated but an inverse relation was found between HBV infection and education. Unmarried men and women showed the lowest (18.26%) and widows and divorcees the highest (51.59%) rate of HBV infection. Our results suggest that horizontal transmission is likely to be the primary mode of acquisition of HBV infection in children and young adults. Also infection is partly transmitted before or soon after birth to babies of HBsAg-carrier mothers. Socioeconomic and demographic variables have a greater impact on the prevalence of HBV infection than blood or medical care variables in our population. The first national epidemiological survey of hepatitis B virus (HBV) infection rates in Iran using a well-defined general population and a single laboratory was carried out to determine prevalence, regional variations, and risk factors associated with the disease. The prevalence of hepatitis Delta virus (HDV) and HIV antibodies were also ascertained in the 4930 subjects (1649 males and 3281 females) from Hamadan province who were examined during the 4 weeks starting August 23, 1989. Each participant was apparently healthy. Demographic data and detailed histories of exposure to HBV were obtained. HBV seropositivity was found in 25.72% of the population, with 2.49% carriers of HBsAg, 18.09% positive for anti-HBs, and 5.13% positive for anti-HBc alone. No HIV seropositivity was detected. There was also no statistically significant difference between the prevalence rate in males and females in urban and rural areas, but there was a significantly higher prevalence of infection in rural areas (27.35 vs. 22.83% in urban areas). HBV infection was lowest in children and young adults under 19 years of age, and it increased with age. HBV prevalence remained higher in rural areas regardless of age. The level of education attained was inversely related to the prevalence of HBV infection (35% prevalence among illiterates and 15% prevalence among subjects with at least a high school education), and HBV prevalence was also significantly higher in widows and divorcees (52%) as compared with single men and women (18%). These point to a greater risk associated with more difficult socioeconomic conditions. Further studies are underway in Iran to map the HBV infection rate in different provinces and determine the pattern of transmission and serological marker profiles in order to expedite targeting of vaccines.
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