Background: Awareness of one's hepatitis B virus (HBV) infection status is the pre-requisite for achieving its elimination in the population, a 2030 target set by WHO. This study aims to determine the level of awareness of HBV infection status in the general population in Hong Kong.
Methods and materials: In this territory-wide seroprevalence study, households were invited through spatial random selection of residential address by building groups in Hong Kong. Blood samples, completed consent form and questionnaires were collected from participating household members. Information on socio-demographics, risk exposure to hepatitis virus, HBV vaccination history and known disease statuses were collected. Three HBV markers – HBsAg, anti-HBs and anti-HBc were tested. Lack of awareness of infection status was defined by inconsistency between self-reported status and laboratory test results. Factors associated with lack of awareness were explored in logistic regression.
Results: Between October 2018 and August 2019, 489 individuals from 273 households were recruited. Of 489 participants, the mean age was 51 year-old (SD = 16 year-old), 207 (42%) were male, 478 (98%) were local residents, 207 (42%) had attained post-secondary education level, and 274 (56%) were economically active. Among 480 blood samples, 39 (8%) were tested HBsAg +ve/anti-HBs −ve, 230 (48%) HBsAg −ve/anti-HBs +ve, 169 (35%) negative for HBsAg, anti-HBs and anti-HBc, and 42 (9%) were anti-HBc positive only. Among current HBsAg-positive participants (n = 39), 26 (67%) were aware of their infection status. Overall, 330 (67%) reported that they did not know their HBV infection status, and 338 (69%) participants’ self-reported status was not consistent with testing results. Factors associated with lack of awareness included male gender (OR = 1.55), lower education level (OR = 1.94), being economically inactive (OR = 1.93), absence of liver diseases (OR = 1.79), no family members diagnosed with hepatitis B (OR = 1.76), and absence of a hepatitis B vaccination history (OR = 4.04).
Conclusion: Low awareness of one's HBV infection status is not uncommon in the general population in Hong Kong. This could be an obstacle for implementing interventions for achieving HBV elimination. Population level HBV screening could move the step forward.
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