Patterns of Hepatitis B Viral Serodiagnostic Results in Thai People Born Before and After the Expanded Programme on Immunization
Keywords:
HBV serological marker, Atypical serological profile, Isolated anti-HBc, Born before and after EPIAbstract
Hepatitis B virus (HBV) infection is the major cause of chronic hepatitis, liver cirrhosis and hepatocellular carcinoma (HCC). Testing of HBV serological markers including HBsAg, anti-HBs and anti-HBc in blood samples, leads to the accurate diagnosis of HBV infection. Various serological profiles of HBV infection are clinically significant and depend on the stage of HBV infection. This retrospective study aimed to investigate the prevalence of various HBV serological profiles in Thai people tested in King Chulalongkorn Memorial Hospital (KCMH) between August 2021 and July 2022. Collective sample results of 5,054 individuals were assessed, and subjects were divided into two groups based on the Expanded Programme on Immunization (EPI) implemented in 1992, both born before and after the EPI. The prevalence of HBV infection was 5.35% in all subjects, while the prevalence of subjects born before and after EPI were 6.37% and 0.56%, respectively, (p<0.001). The various HBV serological profiles found in the present study were total HBV exposure (35.92%), resolved HBV infection (24.47%), HBV vaccine immunity (26.86 %) and susceptible individuals (37.22%). When comparing subjects born after the EPI programme to those born before, the prevalence of total HBV exposure and resolved HBV infection profiles were significantly lower (p<0.001), but the prevalence of HBV vaccine immunity and susceptible individual profiles were significantly higher (p<0.001). Additionally, atypical HBV serological profiles were also found, with one subject showing isolated HBsAg positivity, 309 subjects showing isolated anti-HBc positivity and 22 subjects showing both HBsAg and anti-HBs positivity. According to the present study, the prevalence of HBV infection in the Thai population declined significantly after the implementation of the EPI programme. However, atypical serological profiles were also discovered, raising interpretation concerns for physicians and medical technologists.
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