Hepatitis B Virus Infection in Honolulu Students

Objectives. To determine hepatitis B virus (HBV) carrier and infection rates and HBV epidemiology in Honolulu students. Design. Cross-sectional survey. Setting. Honolulu public elementary, intermediate, and high schools. Patients. A volunteer sample of 4936 students from 43 Honolulu schools. Main outcome measures. HBV carrier rate (presence of hepatitis B surface antigen) and infection rate (presence of either hepatitis B surface antigen, antibody to hepatitis B surface antigen, antibody to hepatitis B core antigen, or any combinations of these) by school grade, ethnicity, and place of birth. Results. Eighty-three (1.68%) students were identified as HBV carriers, and a total of 353 (7.15%) students had serologic evidence of infection. Infection rates increased from elementary school age to high school age, more so in Asian/Pacific Island-born students. The prevalence of infection was higher in Asian/Pacific Island-born students than in those born in the United States. The majority of infected Hawaiian-born students were first-generation Asian/Pacific Island Americans. Conclusions. Horizontal transmission of HBV occurs in Honolulu school-age children. HBV immunization of all infants in Hawaii, not just those born to carrier mothers, is necessary to reduce HBV transmission in Hawaii.