The prevalence and risk factors of hepatitis B virus infection in an adult population in Romania: a nationwide survey

Aim The prevalence and risk factors of hepatitis B virus (HBV) infection in the general population in Romania are still largely unknown. Methods A nationwide cross-sectional survey among a Romanian adult population (18-69 years) was conducted during 2006-2008 using a stratified, multistage sampling design. A total of 17 600 individuals were enrolled randomly into the study; the prevalence of chronic HBV infection (HBsAg-positive and anti-HBcAb-positive samples) was assessed on 13 127 individuals (74.6%) and a history of previous HBV infection (anti-HBcAb-positive, but HBsAg-negative samples) was assessed on 12 470 individuals (70.5%). A questionnaire was used to collect information on the sociodemographic characteristics of the participants and the potential risk factors for HBV transmission. Results The overall prevalence rate of HBV chronic infection among all the participants tested was 4.4% (confidence interval: 4.0-4.8%), with significant differences (P=0.0001) between participants from the main geographical regions of residence (Moldavia 4.5%, Muntenia and Dobrogea 5.4%, and Transylvania and Banat 3.1%). The total prevalence of previous HBV infection of all participants was 27.0% (confidence interval: 26.2-27.8%). The proportion of individuals with previous HBV infection, as well as with chronic HBV infection, showed a statistically significant increasing trend with age. The personal history of blood or blood product transfusion, surgical interventions, tattooing, and alcohol consumption greater than 60 g/day were risk factors associated with both anti-HBcAb and HBsAg seropositivity. Conclusion A prevalence rate of 4.4 and 27.0% for HBsAg and anti-HBcAb, respectively, represents a high figure within the European Union and a strong motivation for developing adequate strategies for prevention, active detection, and treatment of HBV infection in Romania. Eur J Gastroenterol Hepatol 25:56-64 (C) 2012 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins. European Journal of Gastroenterology & Hepatology 2013, 25:56-64