Hepatitis B markers and measles, mumps, and rubella IgG seroprevalence among women attending premarital screening in Jazan, Saudi Arabia

Hepatitis B markers and measles, mumps, and rubella IgG seroprevalence among women attending premarital screening in Jazan, Saudi Arabia

Authors

Keywords:

premarital screening, hepatitis B, measles, mumps, rubella, Saudi Arabia

Abstract

Background and aim: Premarital screening is an important strategy for preventing infectious diseases among couples. The current study aimed to screen for hepatitis B virus (HBV) and assess immunity to measles, mumps, and rubella (MMR) among women of reproductive age in Jazan, Saudi Arabia.

Methods: A total of 400 women were prospectively enrolled and underwent mandatory premarital screening testing for hepatitis B surface antigen (HBsAg) and antibodies to hepatitis B surface antigen (anti-HBs). Women with confirmed HBsAg positivity subsequently underwent quantification HBV DNA testing and further serological testing including hepatitis B e antigen (HBeAg), antibodies to hepatitis B e antigen (anti-HBe), and total antibodies to hepatitis B core antigen (anti-HBc). Immunity to measles, mumps, and rubella was evaluated using commercial indirect ELISA assays.

Results: HBsAg positivity was confirmed in 38 (9.5%) women. Among the 362 HBsAg negative women, 224 (61.9%) demonstrated anti-HBs antibody levels ≥10 mIU/mL, while 138 (38.1%) had levels below the conventional protective threshold. All confirmed HBsAg-positive individuals had detectable HBV DNA, with most having low viral loads. IgG seropositivity was 86.3%, 87.3% and 92.3% for measles, mumps, and rubella, respectively.

Conclusions: A substantial proportion of HBsAg-negative women had anti-HBs levels below the conventional serological threshold of 10 mIU/mL, while some had no detectable MMR IgG antibodies. These findings support continued HBV screening and highlight the need for further investigation of strategies to address immunity gaps among women of reproductive age.

Author Biography

Elfadil Mustafa Abass, Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.

Elfadil M. Abass, PhD holder, Associate Professor at the Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.

References

1. Al Zuayr SN, Sulimani SM, Abd-Ellatif EE. Outcomes of the premarital screening program in Riyadh Region, KSA in 2021-2022: A cross-sectional study. J Taibah Univ Med Sci. 2024;19(5):1067-1074. Published 2024 Oct 29. doi:10.1016/j.jtumed.2024.10.007

2. Alomari A, Al-Qahtani M. MMR Vaccination Coverage and Epidemiological Patterns in Al-Baha, Saudi Arabia, 2020-2024: Analysis of Suspected and Laboratory-Confirmed Cases. Int J Environ Res Public Health. 2025;22(9):1404. Published 2025 Sep 8. doi:10.3390/ijerph22091404

3. Rizzo GEM, Cabibbo G, Craxì A. Hepatitis B Virus-Associated Hepatocellular Carcinoma. Viruses. 2022;14(5):986. Published 2022 May 7. doi:10.3390/v14050986

4. Matthews PC, Maponga T, Ghosh I, et al. Hepatitis B Virus: Infection, liver disease, carcinogen or syndemic threat? Remodelling the clinical and public health response. PLOS Glob Public Health. 2022;2(12):e0001359. Published 2022 Dec 2. doi:10.1371/journal.pgph.0001359

5. Alshabi A, Fatima N, Marwan A, et al. Epidemiology screening and genotyping analysis for Hepatitis B virus in Southwestern region of Saudi Arabia. J Infect Public Health. 2021;14(2):187-192. doi:10.1016/j.jiph.2020.11.016

6. di Filippo Villa D, Navas MC. Vertical Transmission of Hepatitis B Virus-An Update. Microorganisms. 2023;11(5):1140. Published 2023 Apr 27. doi:10.3390/microorganisms11051140

7. Hudu SA, Jimoh AO, Shinkafi SH, et al. Hepatitis B Vaccine Nonresponse and Associated Risk Factors: Insights From a Cohort Study. J Trop Med. 2025;2025:3879562. Published 2025 Mar 27. doi:10.1155/jotm/3879562

8. Liu Q, Bi Q, Liu S, et al. Vaccination Status and Incidences of Measles, Mumps, and Rubella - Worldwide, 2014-2023. China CDC Wkly. 2025;7(17):561-567. doi:10.46234/ccdcw2025.094

9. Robert A, Suffel AM, Kucharski AJ. Long-term waning of vaccine-induced immunity to measles in England: a mathematical modelling study. Lancet Public Health. 2024;9(10):e766-e775. doi:10.1016/S2468-2667(24)00181-6

10. Lebo E, Vynnycky E, Alexander JP Jr, et al. Estimated Current and Future Congenital Rubella Syndrome Incidence with and Without Rubella Vaccine Introduction - 19 Countries, 2019-2055. MMWR Morb Mortal Wkly Rep. 2025;74(18):305-311. Published 2025 May 22. doi:10.15585/mmwr.mm7418a3

11. Mehra S, Kludkleeb S, Chaimayo C, et al. Unveiling immunity gaps and determining a suitable age for a third dose of the measles-containing vaccine: a strategic approach to accelerating measles elimination. Lancet Reg Health Southeast Asia. 2024;32:100523. Published 2024 Dec 21. doi:10.1016/j.lansea.2024.100523

12. Gosadi IM. Epidemiology of communicable diseases in Jazan region: Situational assessment, risk characterization, and evaluation of prevention and control programs outcomes. Saudi Med J. 2023;44(11):1073-1084. doi:10.15537/smj.2023.44.11.20230269

13. Alzahrani AAK, Altalhi YA, Alghamdi AAS, et al. Premarital screening of the viral hepatitis among Saudi nationals. Microbiol Immunol. 2023;67(5):258-263. doi:10.1111/1348-0421.13058

14. Mir SA, Alshehri B. Seroprevalence of hepatitis B and C viral infections in the premarital adult population of Al Majmaah, Saudi Arabia. Malawi Med J. 2021;33(3):221-225. doi:10.4314/mmj.v33i3.10

15. Lu H, Cao W, Zhang L, et al. Effects of hepatitis B virus infection and strategies for preventing mother-to-child transmission on maternal and fetal T-cell immunity. Front Immunol. 2023;14:1122048. Published 2023 Feb 16. doi:10.3389/fimmu.2023.1122048

16. Ryani MA. Hepatitis Management in Saudi Arabia: Trends, Prevention, and Key Interventions (2016-2025). Medicina (Kaunas). 2025;61(9):1509. Published 2025 Aug 22. doi:10.3390/medicina61091509

17. Sanai FM, Alghamdi M, Dugan E, et al. A tool to measure the economic impact of Hepatitis B elimination: A case study in Saudi Arabia. J Infect Public Health. 2020;13(11):1715-1723. doi:10.1016/j.jiph.2020.09.004

18. Arya SC, Ashraf SJ, Parande CM, et al. Hepatitis B virus in Gizan, Saudi Arabia. J Med Virol. 1985;17(3):267-274. doi:10.1002/jmv.1890170308

19. Parande CM, Arya SC, Ashraf SJ. Hepatitis B virus among Saudi children in Gizan, Saudi Arabia. Infection. 1986;14(5):223-225. doi:10.1007/BF01644267

20. Bagheri-Jamebozorgi M, Keshavarz J, Nemati M, et al. The persistence of anti-HBs antibody and anamnestic response 20 years after primary vaccination with recombinant hepatitis B vaccine at infancy. Hum Vaccin Immunother. 2014;10(12):3731-3736. doi:10.4161/hv.34393

21. Tahir A, Shinkafi SH, Alshrari AS, et al. A Comprehensive Review of Hepatitis B Vaccine Nonresponse and Associated Risk Factors. Vaccines (Basel). 2024;12(7):710. Published 2024 Jun 25. doi:10.3390/vaccines12070710

22. Gentile I, Borgia G. Vertical transmission of hepatitis B virus: challenges and solutions. Int J Womens Health. 2014;6:605-611. Published 2014 Jun 10. doi:10.2147/IJWH.S51138

23. The Lancet Microbe. Stopping vertical transmission requires global resolve. Lancet Microbe. 2026;7(2):101345. doi:10.1016/j.lanmic.2025.101345

24. Sarawanangkoor N, Wanlapakorn N, Srimuan D, Thatsanathorn T, Thongmee T, Poovorawan Y. Persistence of Antibodies against Measles, Mumps, and Rubella after the Two-Dose MMR Vaccination: A 7-Year Follow-Up Study. Vaccines (Basel). 2024;12(7):744. Published 2024 Jul 5. doi:10.3390/vaccines12070744

25. Arora M, Lakshmi R. Vaccines - safety in pregnancy. Best Pract Res Clin Obstet Gynaecol. 2021;76:23-40. doi:10.1016/j.bpobgyn.2021.02.002

26. Al-Rawahi B, Patel P, Al-Farsi N, et al. Cross-sectional, laboratory-based study of measles seroprevalence in Oman. East Mediterr Health J. 2025;31(1):30-36. Published 2025 Jan 26. doi:10.26719/2025.31.1.30

27. Wanlapakorn N, Vichaiwattana P, Thongmee T, Chansaenroj J, Poovorawan Y. Age-Specific Seroprevalence of Measles, Mumps, and Rubella IgG across All Age Groups in Chonburi Province, Thailand after the Coronavirus Disease 2019 Pandemic. Am J Trop Med Hyg. 2025;112(6):1385-1390. Published 2025 Apr 8. doi:10.4269/ajtmh.25-0005

28. Nuruzzaman M, Wichaidit W, Islam QM, Nessa A, Liabsuetrakul T. Rubella Seropositivity and Associated Factors Among Young Female Adults in Bangladesh: A Cross-Sectional Study. Int J Gen Med. 2025;18:6043-6054. Published 2025 Oct 3. doi:10.2147/IJGM.S536793

29. Banko A, Cirkovic A, Petrovic V, et al. Seroprevalence of Measles-, Mumps-, and Rubella-Specific Antibodies in Future Healthcare Workers in Serbia: A Cross-Sectional Study. Vaccines (Basel). 2025;13(7):700. Published 2025 Jun 27. doi:10.3390/vaccines13070700

30. Manandhar P, Wannemuehler K, Danovaro-Holliday MC, Nic Lochlainn L, Shendale S, Sodha SV. Use of catch-up vaccinations in the second year of life (2YL) platform to close immunity gaps: A secondary DHS analysis in Pakistan, Philippines, and South Africa. Vaccine. 2023;41(1):61-67. doi:10.1016/j.vaccine.2022.10.040

31. World Health Organization. Guidance for planning and implementing catch-up vaccination. Geneva: World Health Organization; 2021.

Downloads

Published

30-10-2026

Issue

Section

ORIGINAL RESEARCH ARTICLE

How to Cite

1.
Hamdi TA, Hamdi MN, Msmar AH, Abass EM. Hepatitis B markers and measles, mumps, and rubella IgG seroprevalence among women attending premarital screening in Jazan, Saudi Arabia. Acta Biomed. 2026;97(5):19443. doi:10.23750/abm.2026.19443