The epidemiology of laboratory-confirmed Hepatitis B Virus infection in the general population of South Africa, 2016-2018.

Introduction: despite the introduction of the Hepatitis B Virus (HBV) vaccine in South Africa in 1995, HBV remains endemic. South Africa's HBV vaccine coverage for the third dose was 71% in 2015. Information on the HBV prevalence in South Africa in recent years is limited, therefore, we estimated HBV prevalence and described annual trends.

Methods: we conducted a retrospective descriptive study of data extracted from the Notifiable Medical Conditions Surveillance System, and estimated HBV prevalence per 100,000 population using the mid-year population estimates obtained from Statistics South Africa, for the 2016-2018 period.

Results: in total, 105 308 laboratory-confirmed HBV cases were analysed, of which 50.2% (53 895/105 308), 95% CI (49.9-50.5) were males. HBV prevalence for males was 34.1 in 2016, 84.1 in 2017, and 72.3 per 100,000 population in 2018. The age group with the highest HBV cases and prevalence were ages 15-49 years having 80.5% (n=84 718), with 52.2 in 2016, 123.3 in 2017, and 99.6 per 100 000 population in 2018. Between 2016 and 2018, South Africa had an overall HBV prevalence of 33.8, 82.6, and 68.8 per 100,000 population, respectively. KwaZulu-Natal province had the highest number of HBV cases with 37.8% (n=39 851) however, Mpumalanga province had the highest HBV prevalence with 73.2 in 2016, 188.8 in 2017, and 126.5 per 100,000 population in 2018.

Conclusion: our results indicated a high HBV prevalence is reflective of the group prior to the HBV vaccine introduction in South Africa.