Seroepidemiology of Hepatitis B virus infection in the United States 1976 to 1980

The prevalence of hepatitis B virus (HBV) infection was dtermined using sera from persons participating in the second National health and Nutrition Examination Survey, conducted from 1976 to 1980. Of 12 to 74,821 had evidence of past or presentinfection with HBV. In the white population, the weighted estimate of hepatitis B infection was 3.2 percent (95 percent confidence interval, 3.1 to 4.2). A steady increase with age was seen; by ages 65 to 74, the confidence interval, 5.2 to 8.5). In the black population, the overall weighted estimate of prevalence was 13.7 percent (95 percent confidence interval, 11.6 to 15.8). In this racial group, there was a dramatic increase with age, with the oldest age groups having a prevalence of 39.6 percent (95 percent confidence interval, 29.1 to 50.0). In both racial groups, there was a low prevalence of infection in young children that began to rise between ages 12 and 18. In a multivariate analysis of factors associated with infection, there was interaction of race with age; therefore, the odds ratio for race is presented for four ages. This ratio ranged from 3.0 (95 percent confidence interval, 1.8 to 4.2) for a 70-year-old. These relative odds estimates were not substantially affected by adjustment for the available information on risk factors for HBV infection. The results of this study in a representative sample of the United States population show that adult black Americans are at high risk for hepatitis B infection. Other independent predictions of HBV positivity include male sex; residing in a city of 250,00 or more people; serving in the armed forces; living below the poverty level; and having a positive treponemal test for syphilis. These dta suggest that the immunization practices for controlling this deases should be re-examined.