{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T06:53:00Z","timestamp":1781679180881,"version":"3.54.5"},"reference-count":82,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:p>Despite global progress in hepatitis B (HB) control, assessing herd immunity and the hidden burden of infection remains critical.<\/jats:p>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study aimed to comprehensively evaluate immunity to hepatitis B virus and HB marker prevalence in the Belgradian population (Serbia) based on infection\/vaccination status and socio-demographic characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      A cross-sectional study was conducted in Belgrade in May 2024, involving 2,533 individuals. Serological markers (HBsAg, anti-HBc, anti-HBs) were evaluated using ELISA. Statistical analysis included the calculation of 95% confidence intervals, the \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      test, and Spearman's correlation analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The overall HBsAg prevalence was 1.0% (25\/2,533), classifying Serbia as a low-endemicity region. The seroprevalence of anti-HBc and anti-HBs was 8.7% (220\/2,533) and 21.6% (547\/2,533), respectively. A clear age-dependent trend was observed. Markers of infection (HBsAg, anti-HBc) increased significantly with age (\n                      <jats:italic>rs<\/jats:italic>\n                      = 0.823 and\n                      <jats:italic>rs<\/jats:italic>\n                      = 0.898, respectively) among adults, peaking in the 70+ years group for anti-HBc (22.2%, 42\/189). In contrast, protective anti-HBs antibodies showed a negative correlation with age (\n                      <jats:italic>rs<\/jats:italic>\n                      = \u22120.75), being most prevalent in children and young adults (76.9%, 10\/13, in the group 1\u20135 years). Vaccination coverage also showed a strong negative correlation with age (\n                      <jats:italic>rs<\/jats:italic>\n                      = \u22120.95), declining from 82.3% (93\/113) among individuals under 18 to 4.6% (16\/345) among retirees. These correlations clearly illustrate differing epidemiological profiles. They range from high natural viral circulation among older, unvaccinated cohorts to effective infection control through vaccine-induced immunity in the younger generation. A low level of population awareness was identified: only 1.1% (28\/2,533) of respondents reported a history of HBV, whereas serological data indicated that 8.7% (220\/2,533) of the population had markers of viral exposure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The study confirms the success of the universal child vaccination program in Serbia, which has led to the formation of a protected younger generation. However, a significant susceptible stratum persists among the adult population, alongside a high rate of undiagnosed infections, particularly in the older adults. These findings underscore the necessity of implementing targeted adult screening programs and optimizing vaccination strategies to achieve HB elimination.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1819814","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T05:56:40Z","timestamp":1781675800000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Population immunity to hepatitis B virus and infection marker seroprevalence in Belgrade, Serbia"],"prefix":"10.3389","volume":"14","author":[{"given":"Anna Yu.","family":"Popova","sequence":"first","affiliation":[{"name":"Federal Service for the Oversight of Consumer Protection and Welfare","place":["Moscow, Russia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alesia Yu.","family":"Olkhovskaya","sequence":"additional","affiliation":[{"name":"Saint Petersburg Pasteur Institute","place":["Saint 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