Significance of blood-related high-risk behaviors and horizontal transmission of hepatitis B virus in Iran.

Hepatitis B virus (HBV) is a significant public health problem and a leading cause of morbidity and mortality, and approximately 30% of the world's population is infected with HBV. The objective of our study was to determine the seroprevalence of HBV and major risk factors associated with its occurrence. Four thousand eighty-seven healthy Iranian subjects aged 8-80 years were screened for HBV serological markers by an enzyme immunoassay method. A structured questionnaire was administered to all participants. Multiple logistic regression, an unpaired t-test for continuous data and the χ (2) test for categorical data were performed. A total of 4087 participants were tested for hepatitis B surface antigen (HBsAg), of which 62 (1.5%) were seropositive. Fifteen percent of the subjects were positive for anti-HBs, 6.3% were positive for isolated anti-HBc and 12.5% were positive for both anti-HBs and anti-HBc. Laborers showed a higher HBsAg(+) seroprevalence and risk compared with jobless participants (Pearson's = 8.276, P = 0.004; OR = 4.1, 95% CI: 1.5-11.2). Bivariate logistic regression revealed that the following variables were significantly associated with HBV seropositivity: phlebotomy (P = 0.002; OR = 5.0, 95% CI: 2.1-11.9), tattooing (P = 0.003; OR = 3.4, 95% CI: 1.6-7.0), intravenous drug use (P = 0.001; OR = 2.4, 95% CI: 1.4-4.1). The adjusted prevalence ratios remained significantly associated with HBV seropositivity and thus likely served as possible risk factors for HBV. The overall positive seroprevalence was 1.5%. Among the variables, only phlebotomy, tattooing and intravenous drug injection emerged as major potential risk factors for hepatitis B infection and responsible for transmission of the disease.