6% CI95% [27.6–29.4%] vs. 27.7% CI95% [26.5–28.9%] (p = 0.047) for anti-HBc; 6.4% CI95% [5.6–7.2%] vs. 4.5% CI95% [3.9–5.1%] (p < 10−3) for HBsAg and 3.6% CI95% [3.4–3.7%] vs. 2.4% CI95%

[2.0–2.8%] (p = 0.001) for chronic carriers. Prevalence of anti-HBc and HBsAg increases significantly with age globally for both males and females (p < 10−3). The distribution of HBV markers per governorates and districts is illustrated in Table 1. After standardisation per age significant differences were observed between the two governorates according to anti-HBc prevalence (32.1% CI95% [28.9–32.7%] in Béja and 27.8% CI95% [26.8–28.8%] in Tataouine; p = 0.005) and HBsAg prevalence (4.2% CI95% [3.2–4.8%] in Béja in the north and

selleck chemicals 5.6% CI95% [5.2–6.2%] in Tataouine in the south; p = 0.001). No significant differences were noted according to chronic carriage prevalence between the two governorates (2.6% CI95% [1.9–3.1%] in Béja vs. 2.8% CI95% [2.6–3.4%] in Tataouine). When the inhibitors analysis was refined at the subgovernorate level, significant differences were noted between districts according to these three markers (all p values <10−3). Ras el oued and Dhiba (in the south) showed a higher prevalence for all HBV markers than the other districts. If HBV chronic carriage prevalence Rigosertib mouse (7.7 and 12.0%, respectively) is considered, these two districts are classified as areas of high endemicity. Khniguet eddhene (in the north) and Rmada est (in the south) show an HBV chronic carriage prevalence of 4.9 and 2.0%, respectively, and can then be classified as areas of intermediate endemicity. All other districts have HBV chronic carriage prevalence less than 2% and are thus classified as areas of low endemicity. Interestingly, the relative proportion of carriers among HBsAg positive subjects differ

significantly Unoprostone (p < 10−3) between districts, and ranges from 30 to 90% ( Fig. 1). Not surprisingly, the age-distribution of HBsAg, anti-HBc, and chronic carriage prevalence increased as endemicity decreased. The median age of all HBV infection markers was lower in hyperendemic areas as compared to intermediate and hypo-endemic ones. The median age for anti-HBc positive subjects was 24.3 years, 30.8 years, and 40.0 years (p < 10−3); for HBsAg positive subjects, was 16.9 years, 23.0 years, and 29.9 years (p < 10−3); and for chronic carriers, was 14.7 years, 24.7 years and 29.8 years (p < 10−3) for hyperendemic regions, intermediate endemic regions, and low endemic regions (p < 10−3), respectively. Similarly, the age at which half the population have been infected decreased significantly from low (60 years) to intermediate (40 years) and high endemic regions (10 years) ( Fig. 2a). The age distribution of anti-HBc and chronic carriage showed different patterns according to endemicity ( Fig. 2b). In a hyperendemic area, chronic carriage increased quickly and saturated after the age of 20 years.