Prevalence of hepatitis B and C virus infections in the general Chinese population. Results from a nationwide cross-sectional seroepidemiologic study of hepatitis A, B, C, D, and E virus infections in China, 1992

Viral hepatitis is a major public health problem in China and has a substantial impact on the health of people. To understand the distribution of hepatitis virus infection in the general Chinese population and provide basis for developing and evaluating preventive procedures and public health practices on viral hepatitis control, a nationwide cross-sectional seroepidemiologic study of hepatitis virus infections was carried out in China, 1992. Using two-stage cluster sampling, a total of 68 000 subjects were studied, aged 1–59 years, covering all 145 national disease surveillance points of 30 provinces, autonomous regions and municipalities. Serum specimens were assayed using commercial reagents. Tested markers include HBsAg, anti-HBc, anti-HBs, HBeAg and anti-HCV. The overall prevalence of HBsAg carrier was 9.75% of 61 702 subjects studied (range 4.49–17.85%) in 30 provinces of China. The rate in the 1–4 age group was as high as the overall rate. There were higher rates in both the 10–14 and 30–34 age groups, and lower in the 50–59 age group. There were considerable variations in the prevalence of HBsAg carrier in different regions and sex in China, with the highest rate being in middle south and lower rates in north China. The overall prevalence of HBV infection, anti-HBc and anti-HBs were 57.63%, 49.81% and 27.42%, respectively; increasing significantly with age from 38.47%, 30.08% and 15.75% in the 1–4 age group to 70.69%, 61.77% and 32.42% in 50–59 age group, respectively. The overall prevalence of HBeAg was 31.94% among HBsAg carriers. The overall prevalence of anti-HCV was 3.2% of 66975 subjects studied (range 0.9–5.1%) among 30 provinces of China, increasing significantly with age from 2.08% in the 1–4 age group to 3.96% in the 50–59 age group. There was no difference in the rate of anti-HCV by sex and living district. However, there were significant difference in rates of anti-HCV in different geographical areas and administrative divisions in China, with the highest rates being in the northeast of China. These results indicate that hepatitis B and C are hyperendemic in China. According to characteristics of distribution among age, sex and regions, we suggest that the main modes of transmission of the two virus are probably different in China.