association between income and hepatitis b seroprevalence: a systematic review and meta-analysis

Context: hepatitis b serology is very important for both diagnosis and treatment of the diseases. however, evidence regarding the association between income and hepatitis b seroprevalence are not sufficient to make a definitive conclusion. objectives: this meta-analysis aimed to investigate the association between income inequality and hepatitis b seroprevalence. methods: we searched pubmed and web of science databases to identify all relevant epidemiological studies published up to february 10, 2020. a categorical meta-analysis was applied to pool risk effects of income on hepatitis b seroprevalence. results: a total of 1525 pieces of literature related to income level and hepatitis b seroprevalence were retrieved, of which 10 articles were finally included. the results revealed a borderline risk (or: 1.14, 95%ci: 1.00 - 1.30) for hepatitis b seroprevalence (positive for one or more seromarkers) among lowincome groups. a significant income effect was observed for hbsag seroprevalence with a 28% higher risk for low income versus high cases (or: 1.28, 95%ci: 1.16 - 1.41). however, no statistically significant associations were found between seroprevalence of anti-hbs, anti-hbc, and income. conclusions: this study demonstrated that low income may increase the risk of hepatitis b seroprevalence, especially for hbsag seroprevalence. programs on hepatitis b prevention should focus on those with low income. further studies are warranted to establish causality.