A cross sectional study of markers of hepatitis B infection in Niue.

To determine whether the island of Niue would be a suitable location to evaluate the efficacy of hepatitis B vaccine, the prevalence of hepatitis B infection in the adult population was studied. Sera were collected from 1147 of 1244 residents above the age of 20 years, and tested for the presence of hepatitis B surface antigen (HBsAg) and specific antibody to the surface and core antigens (anti-HBs and anti-HBc) by solid-phase radioimmunoassay (SPRIA). Hepatitis B was found to be hyperendemic; 11.9% of those tested were found to be carriers of HBsAg and an additional 84% had detectable levels of anti-HBs or anti-HBc indicative of current or past infection. In this population HBV infection appears to occur early in life as the peak prevalence of serological markers was found in young adults. The almost universal infection of the population, their high rate of compliance with the study and the relatively high birth rate indicate that Niue would be a suitable location to evaluate methods of preventing hepatitis B infection.