Negar Rezaei
1,2, Mohsen Asadi-Lari
3,4, Ali Sheidaei
5, Kimiya Gohari
6, Mahboubeh Parsaeian
5, Sara Khademioureh
1, Mahtab Maghsoudlu
7, Sedigheh Amini Kafiabad
7, Maryam Zadsar
7, Seyed Abbas Motevalian
4, Farnaz Delavari
1, Shifteh Abedini
8, Farshad FarzadFar
1,2*1 Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
2 Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
3 Oncopathology Research Centre, Iran University of Medical Sciences, Tehran, IR Iran
4 Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, IR Iran
5 Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
6 Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
7 Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
8 University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands
Abstract
Background: Hepatitis B infection is the major risk factor for liver cancer in Iran. There is no comprehensive population-based study on the prevalence of hepatitis B by regional distribution. Moreover, systematic reviews of hepatitis B prevalence lack knowledge of some regions. We aimed to estimate the prevalence of hepatitis B and its temporal trends over 17 years by sex, age and geographical distribution.
Methods: We used the Iranian Blood Donors data in addition to systematic reviews on population-based studies at national and provincial levels and statistical methods (A two-stage spatio-temporal model and crosswalk approach) to address the missing points of hepatitis B prevalence among the general population. The direct age-standardized approach was applied using Iran’s national population in 2016.
Results: At national level, age-standardized hepatitis B prevalence in Iran decreased from 3.02% (95% uncertainty interval; 2.26 to 3.96) in 2000 to 1.09% (95% uncertainty interval; 0.85 to 1.37) in 2016, with a total -64.84% change. Hepatitis B prevalence was more than 1.3 times greater in males than females in 2016. Overall, the prevalence of hepatitis B increased with increasing age. At provincial level, in 2016, the province with the highest prevalence had a nearly 11-time greater rate compared to the lowest prevalence. The declining annual percent change (APC) of the prevalence trend varied between -11.53% to -0.5% at provincial level from 2000 to 2016. Only one province did not witness a downward trend in which the APC was 0.5% (95% UI:0.47-0.54).
Conclusion: The downward trend in prevalence of hepatitis B infection indicates the effectiveness of strategies and preventive measures adapted in Iran. Nevertheless, we need to eradicate this infection. In this regard, re-evaluating preventive measures, especially in high-risk age groups of the population, is recommended.