Prevalence of hepatitis B virus infection in the United States: the National Health and Nutrition Examination Surveys, 1976 through 1994

Am J Public Health. 1999 Jan;89(1):14-8. doi: 10.2105/ajph.89.1.14.


Objective: Data from 2 National Health and Nutrition Examination Surveys (NHANES), NHANES II (1976-1980) and NHANES III (1988-1994), were analyzed to examine trends in the prevalence of hepatitis B infection in the United States.

Methods: Serum specimens were tested for markers of hepatitis B virus infection, and risk factors were determined from questionnaires.

Results: The overall age-adjusted prevalence of hepatitis B virus infection was 5.5% (95% confidence interval [CI] = 4.8, 6.2) in NHANES II, as compared with 4.9% (95% CI = 4.3, 5.6) in NHANES III. In both surveys, Black participants had the highest prevalence of infection (NHANES II, 15.8%; NHANES III, 11.9%). No differences in infection were found in the major racial groups between surveys, except for a decrease among those older than 50 years. Black race, increasing number of lifetime sexual partners, and foreign birth had the strongest independent associations with hepatitis B virus infection.

Conclusions: Testing of participants in 2 national surveys demonstrates no significant decrease in hepatitis B virus infection, despite the availability of hepatitis B vaccine.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Biomarkers / blood
  • Child
  • Child, Preschool
  • Female
  • Hepatitis B, Chronic / epidemiology*
  • Hepatitis B, Chronic / etiology
  • Hepatitis B, Chronic / immunology
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Nutrition Surveys
  • Population Surveillance
  • Prevalence
  • Racial Groups
  • Residence Characteristics
  • Risk Factors
  • Seroepidemiologic Studies
  • Sexual Partners
  • Surveys and Questionnaires
  • United States / epidemiology


  • Biomarkers