A new analysis pooled data from 11,524 hospital-based nurses worldwide to estimate how common hepatitis B surface antigen (HBsAg) is in this group. HBsAg in the blood means a person is currently infected with hepatitis B. The overall global prevalence was 3.2%. But the rate varied widely by region: 5.6% in Africa and 1.5% in Europe. When grouped by income, nurses in low- and middle-income countries had a prevalence of 3.6%, compared with 0.8% in high-income countries. The analysis also found an inverse link between full vaccination coverage and HBsAg positivity, meaning places with more vaccination had less infection. However, the prevalence over time appeared stagnant, not falling. The study did not report safety data or side effects. It is a meta-analysis, so it combines different studies and cannot prove cause and effect. The main limitation is that the authors did not report any limitations. The findings point to a protection gap for nurses, especially in lower-income settings, and suggest a need for better vaccination and monitoring. Readers should talk to their doctor about their own hepatitis B risk and vaccination status.
Global HBsAg prevalence 3.2% in nurses, with 5.6% in Africa and 3.6% in LMICsNurses Face Higher Hepatitis B Risk in Poorer Countries
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This meta-analysis pooled data from 11,524 hospital-based nurses worldwide to estimate the global prevalence of hepatitis B surface antigen (HBsAg). The overall pooled HBsAg prevalence was 3.2% (95% CI 2.3-4.4), with high heterogeneity across studies (I = 88.7%).
Prevalence varied by region and income level. In Africa, HBsAg prevalence was 5.6% (95% CI 4.1-7.3), compared with 1.5% (95% CI 0.4-3.0) in Europe. Nurses in low- and middle-income countries had higher prevalence than those in high-income countries (3.6% vs 0.8%; p = 0.003).
An inverse correlation was reported between full vaccination coverage and HBsAg positivity (coefficient -0.0028; p < 0.001). The temporal trend in HBV prevalence among nurses was stagnant (p = 0.190).
The authors identify a protection gap in the nursing workforce, particularly in low- and middle-income countries, and suggest a need for mandatory three-dose immunization and post-exposure surveillance. Limitations of the analysis were not reported, and the association between vaccination coverage and HBsAg positivity is correlational.
How this fits prior evidence
This meta-analysis extends prior coverage of hepatitis B epidemiology by focusing specifically on hospital-based nurses, a group not addressed in earlier reports. It aligns with the high HBsAg prevalence observed in Cameroon (9.98%) and with the recognition that viral hepatitis infections pose a higher risk for liver cancer than smoking-related lung cancer. The finding of an inverse correlation between vaccination coverage and HBsAg positivity is consistent with the protective role of immunization, though it does not establish causality. The stagnant temporal trend contrasts with the declining global hepatitis B burden often assumed, highlighting a potential occupational protection gap.
Common questions
How common is hepatitis B among nurses worldwide?
The analysis found that 3.2% of hospital nurses globally had hepatitis B surface antigen (HBsAg), based on 11,524 nurses. But the rate varied by region: 5.6% in Africa and 1.5% in Europe. In low- and middle-income countries, it was 3.6%, compared with 0.8% in high-income countries.
Why is hepatitis B more common in nurses from poorer countries?
The study found an inverse link between full vaccination coverage and HBsAg positivity, meaning places with higher vaccination rates had fewer infections. Low- and middle-income countries had both lower vaccination coverage and higher prevalence. The analysis suggests a protection gap in these settings, but it cannot prove cause and effect.
Is hepatitis B vaccination effective for nurses?
The analysis reported an inverse correlation between full vaccination coverage and HBsAg positivity, with a coefficient of -0.0028 and p < 0.001. This suggests that more vaccination is linked to less infection. However, the study did not measure vaccine effectiveness directly. Nurses should follow their local vaccination guidelines and talk to their doctor.
What are the side effects of hepatitis B vaccination?
The study did not report any safety data, adverse events, or side effects. It only looked at HBsAg prevalence and its link to vaccination coverage. For information about vaccine safety, please speak with your healthcare provider.
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