Hepatitis B Virus (Hbv) Infection Among Children and Adults in the Solomon Islands

Abstract

A total of 593 inhabitants of Graciosa Bay, Santa Cruz, the Solomon Islands were tested for HBsAg and anti-HBs in 1974 and again in 1977. An additional 102 children born during this study period were tested for HBsAg and anti-HBs in 1977. Loss of HBsAg was observed in 20% of the 66 HBsAg-positive individuals identified in 1974 and retested in 1977. Conversely, acquisition of HBV infection, as documented by seroconversion on HBsAg or anti-HBs, was observed in 38% of the individuals identified as negative for all HBV markers in 1974. Acquisition of HBsAg was noted in 22 individuals, eight of whom were born after 1974. Acquisition of HBsAg was noted in 66 individuals, two of whom were born after 1974. Males and females acquired HBV infection at somewhat similar rates (42% vs. 34%), except between ages 15 and 29 years, when males were infected at a much higher rate (53%) than females (11%) (p = 0.008). Contact with a carrier appears to be the predominant mode of transmission of the virus. Acquisition of HBV by children and females was strongly correlated with the presence of an HBsAg-positive individual among the household contacts. Adult males, on the other hand, tended to acquire HBV infections from sources outside their family or household setting. The relationship between the patterns of acquisition of HBV infection and the cultural practices in this Melanesian population is discussed.

Markedly high seroprevalence of hepatitis B virus infection in comparison to hepatitis C virus and human T lymphotropic virus type-1 infections in selected Solomon Islands populations.

“…12 Our laboratory previously reported that the prevalence of HBV infection has remarkably decreased in children and young adults in Okinawa, a subtropical area in Japan that was endemic for HBV from 1970 to 1996 because of both the impact of vaccination and improvements in sanitary conditions, and suggested that HBV infection will be eliminated there in the near future. 31,34 It was reported in the Solomon Islands that the high prevalence of HBsAg determined by RIA was 11.2-13.0% in the 1970s, 33,35 a finding similar to our recent results. Because the sanitary conditions have not improved greatly in this area for two decades, the prevalence of HBsAg has not changed.…”

“…However, the present study was cross-sectional and could not determine the high carrier rate in the Solomon Islands. Mazzur and others 33 reported a loss of HBsAg in 20% of the HBsAg-positive subjects identified in 1974 and retested in 1977 in the Solomon Islands, although these HBsAg data were based on a reversed passive hemagglutination assay that is less sensitive than the RIA. 12 Our laboratory previously reported that the prevalence of HBV infection has remarkably decreased in children and young adults in Okinawa, a subtropical area in Japan that was endemic for HBV from 1970 to 1996 because of both the impact of vaccination and improvements in sanitary conditions, and suggested that HBV infection will be eliminated there in the near future.…”

Epidemiological patterns of hepatitis B virus (HBV) in highly endemic areasr

“…(c, d) Summarizes age dependent patterns in the force of infection from 16 different surveys, estimated by two methods (see text for details): discrete age-class (c) [42], and continuous age (d) [43]. In addition to the 13 surveys shown in (a) and (b), 3 more surveys from other highly endemic populations [35][36][37] importance of horizontal transmission is supported by t decline in the force of the results of the model which showed that the iue to common temporal observed patterns of infection could be generated by a growth. However, there is model of the horizontal spread of HBV.…”

“…The [26], Zambia [27], Nairobi [28], Senegal [30], South Africa [31], Taiwan [32], four surveys from the Philippines [33] and one from Shanghai [34]. In addition to the surveys from sub-Saharan Africa and east Asia, three more studies from other highly endemic populations were included, from French Polynesia [35], Solomon Islands [36] and Venezuela [37]. A variety of serological tests were used in the surveys for detection of serological markers.…”

Therapy of Acute and Fulminant Hepatitis B

“…Infection with HBV frequently remains unnoticed, and might only be noticed by seroconversion to HBsAg-positive or anti-HBc-positive results, or mild-to-moderate elevation of transaminases [7]. Several vaccine trials comparing vaccine to placebo arms have indicated that the majority of patients contracting HBV actually will have some liver enzyme elevation [8]; however, jaundice was not mentioned in these publications, suggesting significant jaundice is indeed a relatively infrequent event.…”