Modelling the prevalence of hepatitis B towards eliminating it as a major public health threat in China
Abstract Background The World Health Organization (WHO) requires reduction in the prevalence of hepatitis B virus (HBV) surface antigen (HBsAg) in children to 0.1% by 2030, a key indicator for eliminating viral hepatitis as a major public health threat. Whether and how China can achieve this target...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-022-13594-y |
| _version_ | 1818555362086748160 |
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| author | Wenjun Liu Tianyi Zhuang Ruyi Xia Zhuoru Zou Lei Zhang Mingwang Shen Guihua Zhuang |
| author_facet | Wenjun Liu Tianyi Zhuang Ruyi Xia Zhuoru Zou Lei Zhang Mingwang Shen Guihua Zhuang |
| author_sort | Wenjun Liu |
| collection | DOAJ |
| description | Abstract Background The World Health Organization (WHO) requires reduction in the prevalence of hepatitis B virus (HBV) surface antigen (HBsAg) in children to 0.1% by 2030, a key indicator for eliminating viral hepatitis as a major public health threat. Whether and how China can achieve this target remains unknown, although great achievements have been made. We aimed to predict the decline of HBsAg prevalence in China and identify key developments needed to achieve the target. Methods An age- and time-dependent dynamic compartmental model was constructed based on the natural history of HBV infection and the national history and current status of hepatitis B control. The model was run from 2006 to 2040 to predict the decline of HBsAg prevalence under three scenarios including maintaining current interventions (status quo), status quo + peripartum antiviral prophylaxis (PAP, recommended by WHO in 2020), and scaling up current interventions + PAP. Results Under the status quo, HBsAg prevalence would decrease steadily in all age groups, but the WHO’s target of 0.1% prevalence in children aged < 5 years would not be achieved until 2037. The results are robust according to sensitivity analyses. Under the status quo + PAP, the HBsAg prevalence of children aged < 5 years would significantly decrease with the introduction of PAP, and the higher the successful interruption coverage is achieved by PAP, the more significant the decline. However, even if the successful interruption coverage reaches 90% by 2030, the 0.1% prevalence target would not be met until 2031. Under the scaling up current interventions + PAP, combined with scale-up of current interventions, the WHO’s 0.1% target would be achieved on time or one year in advance if PAP is introduced and the successful interruption coverage is scaled up to 80% or 90% by 2030, respectively. Conclusions It is difficult for China to achieve the WHO’s target of 0.1% HBsAg prevalence in children by 2030 by maintaining current interventions. PAP may play an important role to shorten the time to achieve the target. A comprehensive scale-up of available interventions including PAP will ensure that China achieves the target on schedule. |
| first_indexed | 2024-12-12T09:52:22Z |
| format | Article |
| id | doaj.art-b2cf146d9ef445cf8fc89399af57118a |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-12T09:52:22Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-b2cf146d9ef445cf8fc89399af57118a2022-12-22T00:28:14ZengBMCBMC Public Health1471-24582022-06-0122111010.1186/s12889-022-13594-yModelling the prevalence of hepatitis B towards eliminating it as a major public health threat in ChinaWenjun Liu0Tianyi Zhuang1Ruyi Xia2Zhuoru Zou3Lei Zhang4Mingwang Shen5Guihua Zhuang6Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science CenterXi’an Center for Disease Control and PreventionDepartment of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science CenterDepartment of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science CenterChina-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi’an Jiaotong University Health Science CentreDepartment of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science CenterDepartment of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science CenterAbstract Background The World Health Organization (WHO) requires reduction in the prevalence of hepatitis B virus (HBV) surface antigen (HBsAg) in children to 0.1% by 2030, a key indicator for eliminating viral hepatitis as a major public health threat. Whether and how China can achieve this target remains unknown, although great achievements have been made. We aimed to predict the decline of HBsAg prevalence in China and identify key developments needed to achieve the target. Methods An age- and time-dependent dynamic compartmental model was constructed based on the natural history of HBV infection and the national history and current status of hepatitis B control. The model was run from 2006 to 2040 to predict the decline of HBsAg prevalence under three scenarios including maintaining current interventions (status quo), status quo + peripartum antiviral prophylaxis (PAP, recommended by WHO in 2020), and scaling up current interventions + PAP. Results Under the status quo, HBsAg prevalence would decrease steadily in all age groups, but the WHO’s target of 0.1% prevalence in children aged < 5 years would not be achieved until 2037. The results are robust according to sensitivity analyses. Under the status quo + PAP, the HBsAg prevalence of children aged < 5 years would significantly decrease with the introduction of PAP, and the higher the successful interruption coverage is achieved by PAP, the more significant the decline. However, even if the successful interruption coverage reaches 90% by 2030, the 0.1% prevalence target would not be met until 2031. Under the scaling up current interventions + PAP, combined with scale-up of current interventions, the WHO’s 0.1% target would be achieved on time or one year in advance if PAP is introduced and the successful interruption coverage is scaled up to 80% or 90% by 2030, respectively. Conclusions It is difficult for China to achieve the WHO’s target of 0.1% HBsAg prevalence in children by 2030 by maintaining current interventions. PAP may play an important role to shorten the time to achieve the target. A comprehensive scale-up of available interventions including PAP will ensure that China achieves the target on schedule.https://doi.org/10.1186/s12889-022-13594-yHepatitis BPrevalenceMathematical modelPredictionPeripartum antiviral prophylaxis |
| spellingShingle | Wenjun Liu Tianyi Zhuang Ruyi Xia Zhuoru Zou Lei Zhang Mingwang Shen Guihua Zhuang Modelling the prevalence of hepatitis B towards eliminating it as a major public health threat in China BMC Public Health Hepatitis B Prevalence Mathematical model Prediction Peripartum antiviral prophylaxis |
| title | Modelling the prevalence of hepatitis B towards eliminating it as a major public health threat in China |
| title_full | Modelling the prevalence of hepatitis B towards eliminating it as a major public health threat in China |
| title_fullStr | Modelling the prevalence of hepatitis B towards eliminating it as a major public health threat in China |
| title_full_unstemmed | Modelling the prevalence of hepatitis B towards eliminating it as a major public health threat in China |
| title_short | Modelling the prevalence of hepatitis B towards eliminating it as a major public health threat in China |
| title_sort | modelling the prevalence of hepatitis b towards eliminating it as a major public health threat in china |
| topic | Hepatitis B Prevalence Mathematical model Prediction Peripartum antiviral prophylaxis |
| url | https://doi.org/10.1186/s12889-022-13594-y |
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