Chronic hepatitis B prevalence in Australian Aboriginal and Torres Strait Islander people before and after implementing a universal vaccination program: a systematic review and meta-analysis
Simon Graham A B F , Jennifer H. MacLachlan B C , Praveena Gunaratnam D and Benjamin C. Cowie B C E
+ Author Affiliations
- Author Affiliations
A London School of Hygiene and Tropical Medicine, Keppel Street, London WC1H 9SH, UK.
B The Peter Doherty Institute for Infection and Immunity, 792 Elizabeth Street, Melbourne, Vic. 3004, Australia.
C Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Grattan Street, Parkville, Vic. 3010, Australia.
D Kirby Institute, Wallace Wurth Building, UNSW Sydney, Sydney, NSW 2052, Australia.
E Victorian Infectious Disease Service, Royal Melbourne Hospital, 300 Grattan Street, Parkville, Vic. 3050, Australia.
F Corresponding author. Email: grahams1@unimelb.edu.au
Sexual Health 16(3) 201-211 https://doi.org/10.1071/SH18150
Submitted: 13 August 2018 Accepted: 22 February 2019 Published: 30 May 2019
Journal Compilation © CSIRO 2019 Open Access CC BY-NC-ND
Abstract
Background: A higher prevalence of chronic hepatitis B (CHB) has been reported in Aboriginal and Torres Strait Islander (Aboriginal) compared with non-Aboriginal Australians. An Australian infant and adolescent hepatitis B virus (HBV) vaccination program was implemented in 2000. Meta-analysis methods will be used to examine if the pooled prevalence of CHB decreased after 2000 among Aboriginal Australians. Methods: Embase, Medline and Web of Science were searched from 1 January 1981 to 29 March 2018 and all issues of the Northern Territory and New South Wales Public Health Bulletins. Studies needed to report the number of individuals who were tested and tested positive for hepatitis B surface antigen (HBsAg). Results: There were 36 studies; 16 before and 20 after 2000; reporting 84 prevalence estimates. Population groups included: adults (14 studies), pregnant women (13 studies), prisoners (five studies) children or teenagers (10 studies) and infants (two studies). The pooled prevalence of HBsAg decreased overall (from 10.8% before 2000 vs 3.5% after 2000), in women (4.2% vs 2.2%), in males (17.5% vs 3.5%), in regional (7.8% vs 3.9%) and remote (14.4% vs 5.7%) areas, in New South Wales (12.3% vs 3.0%), in the Northern Territory (6.1% vs 5.1%), in adults (15.3% vs 4.3%) and in pregnant women (3.6% vs 2.6%). Conclusion: The prevalence of HBsAg decreased among Aboriginal people after 2000.
Additional keywords: Australia, hepatitis B surface antigen, hepatitis B virus, Indigenous, sexually transmissible infection.
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