Progress towards elimination of mother-to-child transmission of hepatitis B virus infection in China: a modelling analysis.
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Published version
Author(s)
Type
Journal Article
Abstract
Objective: To determine the projected burden of hepatitis B virus (HBV) in China, the intervention strategies that can eliminate mother-to-child transmission (MTCT) by 2030 or earlier and the measurable parameters that can be used to monitor progress towards this target. Methods: We developed a dynamic, sex- and age-stratified model of the HBV epidemic in China, calibrated using hepatitis B surface antigen (HBsAg) and e antigen (HBeAg) prevalence data from sequential national serosurveys (1979-2014) and the numbers of HBV-related cancer deaths (2012). We determined whether China can achieve elimination of MTCT of HBV by 2030 under current prevention interventions. We modelled various intervention scenarios to represent different coverage levels of birth-dose HBV vaccination, hepatitis B immunoglobulin to newborns of HBsAg-positive mothers and antiviral therapy (tenofovir) to HBeAg-positive pregnant women. Findings: We project that, if current levels of prevention interventions are maintained, China will achieve the elimination target by 2029. By modelling various intervention scenarios, we found that this can be brought forward to 2025 by increasing coverage of birth-dose vaccination, or to 2024 by the administration of tenofovir to HBeAg-positive pregnant women. We found that achievement of the target by 2025 would be predicted by a measurement of less than 2% MTCT in 2020. Conclusion: Our results highlight how high-quality national data can be combined with modelling in monitoring the elimination of MTCT of HBV. By demonstrating the impact of increased interventions on target achievement dates, we anticipate that other high-burden countries will be motivated to strengthen HBV prevention policies.
Date Issued
2021-01-01
Date Acceptance
2020-09-14
Citation
Bulletin of the World Health Organization, 2021, 99 (1), pp.10-18
ISSN
0042-9686
Publisher
World Health Organization
Start Page
10
End Page
18
Journal / Book Title
Bulletin of the World Health Organization
Volume
99
Issue
1
Copyright Statement
© 2020 The Author(s). This article is licensed with the CC Attribution-NonCommercial-ShareAlike 3.0 IGO (CC BY-NC-SA 3.0 IGO) licence.
Sponsor
Imperial College Healthcare NHS Trust- BRC Funding
Medical Research Council (MRC)
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/33658732
PII: BLT.19.248146
Grant Number
RDF01
MR/R015600/1
Subjects
11 Medical and Health Sciences
Tropical Medicine
Publication Status
Published
Coverage Spatial
Switzerland
Date Publish Online
2020-10-28