{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T20:25:31Z","timestamp":1791404731476,"version":"4.3.3"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T00:00:00Z","timestamp":1636416000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["109130\/Z\/15\/Z"],"award-info":[{"award-number":["109130\/Z\/15\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["106158\/Z\/14\/Z"],"award-info":[{"award-number":["106158\/Z\/14\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["617 OPP1141321"],"award-info":[{"award-number":["617 OPP1141321"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Hepatitis B is the leading cause of cirrhosis and liver cancer in sub-Saharan Africa. To reduce mortality, antiviral treatment programs are needed. We estimated prevalence, vaccine impact, and need for antiviral treatment in Blantyre, Malawi.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a household study in 2016\u20132018. We selected individuals from a census using random sampling and estimated age-sex-standardized hepatitis B surface antigen (HBsAg) seroprevalence. Impact of infant hepatitis B vaccination was estimated by binomial log-linear regression comparing individuals born before and after vaccine implementation. In HBsAg-positive adults, eligibility for antiviral therapy was assessed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 97386 censused individuals, 6073 (median age 18 years; 56.7% female) were sampled. HBsAg seroprevalence was 5.1% (95% confidence interval [CI], 4.3%\u20136.1%) among adults and 0.3% (95% CI, .1%\u2013.6%) among children born after vaccine introduction. Estimated vaccine impact was 95.8% (95% CI, 70.3%\u201399.4%). Of HBsAg-positive adults, 26% were HIV-positive. Among HIV-negative individuals, 3%, 6%, and 9% were eligible for hepatitis B treatment by WHO, European, and American hepatology association criteria, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Infant HBV vaccination has been highly effective in reducing HBsAg prevalence in urban Malawi. Up to 9% of HBsAg-positive HIV-negative adults are eligible, but have an unmet need, for antiviral therapy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiab562","type":"journal-article","created":{"date-parts":[[2021,11,8]],"date-time":"2021-11-08T20:12:35Z","timestamp":1636402355000},"page":"871-880","source":"Crossref","is-referenced-by-count":14,"title":["Hepatitis B Vaccination Impact and the Unmet Need for Antiviral Treatment in Blantyre, Malawi"],"prefix":"10.1093","volume":"226","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5828-3328","authenticated-orcid":false,"given":"Alexander J","family":"Stockdale","sequence":"first","affiliation":[{"name":"Malawi-Liverpool-Wellcome Trust Programme , Blantyre , Malawi"},{"name":"Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool , Liverpool , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James E","family":"Meiring","sequence":"additional","affiliation":[{"name":"Malawi-Liverpool-Wellcome Trust Programme , Blantyre , Malawi"},{"name":"Oxford Vaccine Group, Department of Paediatrics, University of Oxford , Oxford , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac T","family":"Shawa","sequence":"additional","affiliation":[{"name":"Malawi-Liverpool-Wellcome Trust Programme , Blantyre , Malawi"},{"name":"Faculty of Biomedical Science and Health Professions, University of Malawi College of Medicine , Blantyre , Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deus","family":"Thindwa","sequence":"additional","affiliation":[{"name":"Malawi-Liverpool-Wellcome Trust Programme , Blantyre , Malawi"},{"name":"Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine , London , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niza M","family":"Silungwe","sequence":"additional","affiliation":[{"name":"Malawi-Liverpool-Wellcome Trust Programme , Blantyre , Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurice","family":"Mbewe","sequence":"additional","affiliation":[{"name":"Malawi-Liverpool-Wellcome Trust Programme , Blantyre , Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rabson","family":"Kachala","sequence":"additional","affiliation":[{"name":"Malawi Ministry of Health , Capitol Hill, Lilongwe , Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benno","family":"Kreuels","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Malawi College of Medicine , Blantyre , Malawi"},{"name":"Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine , Hamburg , Germany"},{"name":"1st Department of Medicine, University Medical Centre Hamburg-Eppendorf , Hamburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratiksha","family":"Patel","sequence":"additional","affiliation":[{"name":"Malawi-Liverpool-Wellcome Trust Programme , Blantyre , Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyanka","family":"Patel","sequence":"additional","affiliation":[{"name":"Malawi-Liverpool-Wellcome Trust Programme , Blantyre , Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc Y R","family":"Henrion","sequence":"additional","affiliation":[{"name":"Malawi-Liverpool-Wellcome Trust Programme , Blantyre , Malawi"},{"name":"Liverpool School of Tropical Medicine , Liverpool , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naor","family":"Bar-Zeev","sequence":"additional","affiliation":[{"name":"International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd D","family":"Swarthout","sequence":"additional","affiliation":[{"name":"Malawi-Liverpool-Wellcome Trust Programme , Blantyre , Malawi"},{"name":"National Institute for Health Research Global Health Research Unit on Mucosal Pathogens, Research Department of Infection, Division of Infection and Immunity, University College London , London , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert S","family":"Heyderman","sequence":"additional","affiliation":[{"name":"National Institute for Health Research Global Health Research Unit on Mucosal Pathogens, Research Department of Infection, Division of Infection and Immunity, University College London , London , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen B","family":"Gordon","sequence":"additional","affiliation":[{"name":"Malawi-Liverpool-Wellcome Trust Programme , Blantyre , Malawi"},{"name":"Liverpool School of Tropical Medicine , Liverpool , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Maria Geretti","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Fondazione Policlinico Tor Vergata, Faculty of Medicine, University of Rome Tor Vergata , Rome , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melita A","family":"Gordon","sequence":"additional","affiliation":[{"name":"Malawi-Liverpool-Wellcome Trust Programme , Blantyre , Malawi"},{"name":"Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool , Liverpool , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,11,9]]},"reference":[{"key":"2022091319155535000_CIT0001","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1016\/j.jhep.2016.10.013","article-title":"Battlefield against hepatitis B 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