424. Prevalence and risk for sexual transmission of hepatitis B in 15 million rural couples aged 20-49 years in China: a cross-sectional study
Session: Poster Abstract Session: Hepatitis B
Thursday, October 27, 2016
Room: Poster Hall
  • Hepatitis B infection in Couples_IDWeek_10202016.pdf (280.3 kB)
  • Background: Evidence regarding prevalence and risk for sexual transmission of hepatitis B in couples is scare. This study aimed to examine burden of hepatitis B and risk of sexual transmission in rural couples, using data from the National Free-pregnancy Checkups (NFPC) program in China.

    Methods: We included rural couples aged 20-49 years enrolled through NFPC during 2010-2014. Interviews regarding demographic information and testing for hepatitis B virus (HBV) and syphilis were conducted. Based on positivity of hepatitis B surface antigen (HBsAg), HBV status of couples was categorized: both had chronic hepatitis B (CHB) infection (M+F+), only wife had CHB (M-F+), only husband had CHB (M+F-) and none had CHB (M-F-). Multivariate logistic regression models were used to evaluate risk factors for 1) M+F+, M-F+ and M+F- in couples; 2) M+ in husbands; 3) F+ in wives.

    Results: Of 14,922,713 couples who had complete data, majority of them were aged 20-24 years and had a junior school level of education, and 20% had alanine aminotransferase (ALT) >40 U/L, 3% had positivity of hepatitis B e antigen (HBeAg) and 0.6% had positivity of syphilis. The prevalences of M+F+, M-F+ and M+F- were 0.74%, 4.4% and 6.3%, respectively. The prevalence of chronic HBV infection in husbands was significantly higher than in wives (7.0% vs 5.1%, P<0.001). At least one partner’s ALT>40 U/L, at least one partner’s syphilis, and living in a HIV high-risk region were associated with a higher odds of M+F+, M-F+ and M+F-. Risk factors for CHB in either husbands or wives included partner’s positivity of HBeAg (M: Adjusted Odds Ratio (AOR) =2.4; F: AOR=1.5), partner’s ALT>40 U/L (M: AOR=1.1; F: AOR=1.2), partner’s syphilis (M: AOR=1.5; F: AOR=2.3) and living in a HIV high-risk region (M: AOR=1.5; F: AOR=1.3) (Figure).

    Conclusion: The burden of CHB among rural couples in China is intermediate-high, and most of these infections are discordant. Since positivity of syphilis and HBeAg in either of couples are significantly associated with increased risk of CHB in their partner, it suggests a fraction of these CHB infections have been sexually transmitted. Public health efforts including screening married couples for HBsAg and HBeAg and counselling couples with discordant CHB to have safe sex should be enhanced.


    Long Zhang, MHS1,2, Yuanyuan Wang, PhD1,3, Yanjie Huang, ScM1,2, Kenrad Nelson, MD2, Anqi Wang, BS4, Xiaoli Liu, BS4, Zuoqi Peng, MD3, Ya Zhang, BS3, Xiaona Xin, MS3, Hongguang Zhang, BS3, Jun Zhao, PhD3, Qian Zhang, MS3, Yan Wang, BS3, Dujia Liu, BS3, Tongjun Guo, BS3, Ying Yang, PhD3, Yuan He, PhD3, Jihong Xu, PhD3, Hong Zhou, PhD4 and Xu Ma, MS1,3, (1)Environmental and Spatial Epidemiology Research Center, National Human Genetic Resources Center, Beijing, China, (2)Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, (3)National Research Institute for Family Planning, Beijing, China, (4)School of Public Health, Peking University, Beijing, China


    L. Zhang, None

    Y. Wang, None

    Y. Huang, None

    K. Nelson, None

    A. Wang, None

    X. Liu, None

    Z. Peng, None

    Y. Zhang, None

    X. Xin, None

    H. Zhang, None

    J. Zhao, None

    Q. Zhang, None

    Y. Wang, None

    D. Liu, None

    T. Guo, None

    Y. Yang, None

    Y. He, None

    J. Xu, None

    H. Zhou, None

    X. Ma, None

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