From the Guidelines
Regions with high hepatitis B prevalence include sub-Saharan Africa, East Asia (particularly China), parts of the Middle East, the Amazon Basin, and Pacific Island nations, where the prevalence of chronic hepatitis B infection typically exceeds 8% of the population 1. These areas are considered high-risk due to the high prevalence of HBV infection, with perinatal and early childhood transmission being the predominant routes of transmission 1. The geographic distribution of hepatitis B is significant because the virus is primarily transmitted through contact with infected blood or body fluids, mother-to-child transmission during childbirth, and sexual contact 1. In high-prevalence regions, understanding these regional patterns is essential for implementing appropriate prevention strategies, including:
- Universal infant vaccination
- Screening of pregnant women
- Targeted testing of individuals from high-prevalence regions who have migrated to low-prevalence areas 1. Key regions with high or intermediate prevalence of HBsAg include:
- Much of Eastern Europe
- Asia
- Africa
- The Middle East
- The Pacific Islands 1. It is crucial to note that the prevalence of HBV infection may gradually change over time, and some countries and regions with prevalence rates between 5% and 7% are considered to be highly endemic areas 1.
From the Research
Regions of High HBV Prevalence
The regions with high Hepatitis B (HBV) prevalence include:
- Asia, specifically China, which is now the only country in Asia where HBV endemicity is high 2
- Africa, where most countries have high HBV endemicity, with the exceptions of Tunisia and Morocco, which have intermediate endemicity, and Zambia, which has borderline intermediate/high endemicity 2
- The Middle East, where countries such as Egypt, Jordan, Oman, Palestine, Yemen, and Saudi Arabia have high endemicity 2
- Sub-Saharan Africa, the Western Pacific Region, and areas of Eastern Europe, which continue to pose a serious global health threat due to HBV infection 3
- South East Asia, where the prevalence of chronic HBV infection is high, with countries such as Taiwan having a prevalence of 15-20% 4
Countries with High HBV Prevalence
Some countries with high HBV prevalence include:
- China, with high HBV endemicity 2
- Egypt, Jordan, Oman, Palestine, Yemen, and Saudi Arabia, with high endemicity in the Middle East 2
- Cameroon, with a high pooled prevalence estimate of 8.0% in Africa 5
- Taiwan, with a high prevalence of 15-20% in South East Asia 4
Global HBV Burden
The global HBV burden is heterogeneous within and across regions, with variable implementation of childhood and birth-dose vaccination programs, inconsistent screening of blood products, injection drug use, and poor education initiatives contributing to the continued spread of HBV infection 3