The global burden of chronic hepatitis B virus infection: comparison of country-level prevalence estimates from four research groups
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Published version
Author(s)
Schmit, Nora
Nayagam, Shevanthi
Thursz, Mark
Hallett, Timothy
Type
Journal Article
Abstract
Background: Progress towards viral hepatitis elimination goals relies on accurate estimates of chronic hepatitis B virus (HBV) infection prevalence. We compared existing sources of the most recent country-level estimates from 2013-2017 to investigate the extent and underlying drivers of differences between them. Methods: The four commonly cited sources of global prevalence estimates, the Institute for Health Metrics and Evaluation, Schweitzer et al, World Health Organization (WHO) and CDA Foundation, were compared by calculating pairwise differences between sets of estimates and assessing their within-country variation. Differences in underlying empirical data and modelling methods were investigated as contributors to differences in sub-Saharan African estimates. Results: The four sets of estimates across all ages were comparable overall and agreed on the global distribution of HBV burden. WHO and CDA produced the most similar estimates, differing by a median of 0.8 percentage points. Larger discrepancies were seen in estimates of prevalence in children under 5 years of age and in sub-Saharan African countries, where the median pairwise differences were 2.7 and 2.4 percentage points for all age prevalence and in children, respectively. Recency and representativeness of included data, and different modelling assumptions of the age distribution of HBV burden, seemed to contribute to these differences. Conclusion: Current prevalence estimates, particularly those from WHO and CDA based on more recent empirical data, provide a useful resource to assess the population-level burden of chronic HBV infection. However, further seroprevalence data in young children is needed particularly in sub-Saharan Africa. This is a priority as monitoring progress towards elimination depends on improved knowledge of prevalence in this age group.
Date Issued
2021-04
Date Acceptance
2020-11-16
Citation
International Journal of Epidemiology, 2021, 50 (2), pp.560-569
ISSN
0300-5771
Publisher
Oxford University Press (OUP)
Start Page
560
End Page
569
Journal / Book Title
International Journal of Epidemiology
Volume
50
Issue
2
Copyright Statement
© The Author(s) 2020. Published by Oxford University Press on behalf of the International Epidemiological Association.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
License URL
Sponsor
Medical Research Council (MRC)
National Institute for Health Research
Identifier
https://academic.oup.com/ije/article/50/2/560/6053478
Grant Number
MR/R015600/1
NIHR200153
Subjects
Hepatitis B
disease burden
indicator
infectious diseases
modelling
monitoring
prevalence
sub-Saharan Africa
viral-hepatitis elimination
Epidemiology
0104 Statistics
1117 Public Health and Health Services
Publication Status
Published
Date Publish Online
2020-12-27