Chronic hepatitis B prevalence in Australian Aboriginal and Torres Strait Islander people before and after implementing a universal vaccination program: a systematic review and meta-analysis.

ABSTRACT

Background A higher prevalence of chronic hepatitis B (CHB) has been reported in Aboriginal and Torres Strait Islander (Aboriginal) compared with non-Aboriginal Australians. An Australian infant and adolescent hepatitis B virus (HBV) vaccination program was implemented in 2000. Meta-analysis methods will be used to examine if the pooled prevalence of CHB decreased after 2000 among Aboriginal Australians. METHODS: Embase, Medline and Web of Science were searched from 1 January 1981 to 29 March 2018 and all issues of the Northern Territory and New South Wales Public Health Bulletins. Studies needed to report the number of individuals who were tested and tested positive for hepatitis B surface antigen (HBsAg). RESULTS: There were 36 studies; 16 before and 20 after 2000; reporting 84 prevalence estimates. Population groups included adults (14 studies), pregnant women (13 studies), prisoners (five studies) children or teenagers (10 studies) and infants (two studies). The pooled prevalence of HBsAg decreased overall (from 10.8% before 2000 vs 3.5% after 2000), in women (4.2% vs 2.2%), in males (17.5% vs 3.5%), in regional (7.8% vs 3.9%) and remote (14.4% vs 5.7%) areas, in New South Wales (12.3% vs 3.0%), in the Northern Territory (6.1% vs 5.1%), in adults (15.3% vs 4.3%) and in pregnant women (3.6% vs 2.6%). CONCLUSION: The prevalence of HBsAg decreased among Aboriginal people after 2000.