Patterns of testing and seroprevalence of hepatitis B in a tertiary hospital

Introduction: Viral hepatitis B (HBV) remains a significant public health concern despite universal infant vaccination implemented in 1989. This study assesses HBV seroprevalence and screening patterns in Hospital Sul-tan Abdul Aziz Shah (HSAAS).Methodology: A retrospective, cross-sectional observational study was conducted, analyzing HBsAg tests performed between December 2023and May 2024. Data was extracted from electronic medical records and analyzed using descriptive statistics. Results: Of 437 HBsAg tests performed, 14 were positive (seroprevalence3.2%). The mean screening age was 57 years. The medical department re-quested most tests (60.5%). Primary indications were routine screening(75.7%), abnormal liver enzymes (21.6%), and chronic liver disease workup (2.7%). Among positive cases, males (64.3%) predominated, with equal prevalence between Malay and Chinese ethnicities. Only 50% of positive cases were referred to gastroenterology. Discussion: The 3.2% seroprevalence is lower than reported national prevalence in many Asian countries, possibly reflecting effective vaccination programs or indicating a need for more targeted screening approaches. Malay and Chinese ethnicity has equal prevalence among positive cases. Routine screening yielded the majority of positive cases, but abnormal liver enzymes were also a significant indicator. Two neonates tested positive during prolonged jaundice workup, likely false positives due to recent vaccination. Conclusion: This study highlights the need for a comprehensive review of current screening strategies, focusing on cost-effectiveness and targeted screening of high-risk groups. Initiatives should optimize referrals for positive cases and enhance interdepartmental collaboration in HBV screening and management.

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