ABSTRACT
Background: Infant immunization against hepatitis B began in Uganda in 2002. Objective: To determine the baseline prevalence of hepatitis B virus (HBV) infection and explore risk factors. Methods: A hepatitis B prevalence study was nested in the 2005 national HIV/AIDS serobehavioural survey. Demographic characteristics and risk factors were explored by questionnaire. One third of blood specimens (n=5875) from adults aged 15 to 59 years were tested for hepatitis B core antibodies (HBcAb); positive specimens were tested for hepatitis B surface antigen (HBsAg). Results: HBcAb was present in 52.3(95CI: 51.0-53.6) of adults; and HBsAg in 10.3(9.5-11.1). By 15-19 years of age; 40.0had been infected with HBV. Prevalence of both markers was significantly higher across northern Uganda; in rural areas; among the poor and least educated; and in uncircumcised men. Other independent predictors of infection were age; ethnic group; occupation; number of sex partners; and HIV and HSV-2 status. Conclusion: Hepatitis B virus infection is highly endemic in Uganda; with transmission occurring in childhood and adulthood. More than 1.4 million adults are chronically infected and some communities disproportionately affected. The hepatitis B infant immunization programme should be sustained and catch-up vaccination considered for older children