Characteristics of population susceptible to hepatitis B infection in Guangzhou, 2008 and 2018
-
摘要:
目的 分析比较2008年和2018年广州市1~59岁HBV易感人群的流行病学特征,评价免疫策略效果。 方法 采用二阶段整群抽样法,于2008年和2018年在广州市随机抽取1~59岁常住人口进行乙肝血清流行病学调查。 结果 2008年和2018年调查显示,广州市1~59岁人群中HBV易感率分别为17.34%(95% CI:16.29%~18.39%)和19.77%(95% CI:18.54%~21.01%), 7~16岁人群易感率(2008年23.93%,2018年36.22%)较其他年龄组高。广州市1~59岁人群中单项HBcAb阳性率分别为6.63%(95% CI:5.94%~7.33%)和2.76%(95% CI:1.62%~3.91%),下降(58.34%)。有乙肝疫苗免疫史人群单项HBcAb阳性率降幅达81.73%。 结论 对易感人群,包括单项HBcAb阳性成年人补种、加强或重新接种乙肝疫苗,提高人群免疫水平,降低易感性。 -
关键词:
- 肝炎 /
- 血清流行病学 /
- 易感 /
- 乙型肝炎病毒核心抗体 /
- 乙型肝炎疫苗
Abstract:Objective To compare the epidemiological characteristics of hepatitis B virus susceptible population aged 1-59 in Guangzhou in 2008 and 2018, and to evaluate the effect of immunization strategy. Methods A two-stage cluster sampling method was used to conduct the seroepidemiological survey of hepatitis B among permanent residents aged 1-59 in Guangzhou in 2008 and 2018. Results In the two surveys the prevalence rates of HBV susceptibility were 17.34% (95% CI: 16.29%-18.39%) and 19.77% (95% CI: 18.54%-21.01%) among the population aged 1 to 59 years, and were 23.93% and 36.22% among the population aged 7 to 16 years. The prevalence rates of single anti-HBc positivity were 6.63% (95% CI: 5.94%-7.33%) and 2.76% (95% CI: 1.62%-3.91%) in two surveys among the population aged 1 to 59 years, the difference was statistically significant. The positive rate of single anti-HBc decreased by 81.73% in the population with history of hepatitis B vaccine immunization. Conclusions Efforts should be made to strengthen the implementation of catch-up vaccination, booster vaccination and revaccination in susceptible population, including the single anti-HBc positive population. -
Key words:
- Hepatitis /
- Seroepidemiology /
- Disease susceptibility /
- Hepatitis B core antibody /
- Hepatitis B vaccine
-
表 1 2008和2018年广州市乙肝血清学调查人群HBV易感率比较
Table 1. Comparison of susceptibility rate of hepatitis B virus among serological survey population in Guangzhou in 2008 and 2018
变量 2008年HBV易感性 2018年HBV易感性 10年
增幅(%)调查人数 构成比(%) 例数 阳性率(%) 95% CI值 调查人数 构成比(%) 例数 阳性率(%) 95% CI值 年龄(岁) ≥1 1 402 28.10 241 17.19 15.21~19.16 937 23.54 146 15.58 13.26~17.90 -9.35 7~a 1 475 29.57 353 23.93 21.75~26.11 1 085 27.26 393 36.22 33.36~39.08 51.35 17~59 2 112 42.33 271 12.83b 11.41~14.26 1 958 49.20 248 12.67b 11.19~14.14 -1.29 出生年份(年) 2008-2017 - 1 400 35.18 330 23.57 21.35~25.79 2002-2007a 1 402 28.10 241 17.19 15.21~19.16 622 15.63 209 33.60 29.89~37.31 95.47 1992-2001 1 475 29.57 353 23.93 21.75~26.11 346 8.69 91 26.30 21.66~30.94 9.90 1959-1991a 1 690 33.87 202 11.95 10.14~13.50 1 612 40.50 157 9.74b 8.29~11.19 -18.52 1949-1958 422 8.46 69 16.35b 12.82~19.88 - - 性别 男 2 421 48.53 411 16.98 15.48~18.47 1 904 47.84 365 19.17 17.40~20.94 12.92 女 2 568 51.47 454 17.68 16.20~19.15 2 076 52.16 422 20.33 18.60~22.06 14.98 区域 中流行区a 1 216 24.37 213 17.52 15.38~19.65 405 10.18 55 13.58 10.24~16.92 -22.47 高流行区a 3773 75.63 652 17.28 16.07~18.49 3 575 89.82 732 20.48b 19.15~21.80 18.49 免疫史 有 3 088 61.90 572 18.52 17.15~19.89 2 735 68.72 629 23.00 21.42~24.58 24.16 无 923 18.50 143 15.49 13.16~17.83 479 12.04 54 11.27 8.44~14.11 -27.23 不详 975 19.54 150 15.38b 13.12~17.65 766 19.25 104 13.58b 11.15~16.00 -11.75 合计 4 989 100.00 865 17.34 16.29~18.39 3 980 100.00 787 19.77 18.54~21.01 14.05 注:a表示2008和2018年阳性率的差异有统计学意义;b表示同一年份HBV易感率在不同年龄、出生人群、性别、区域、免疫史方面比较差异有统计学意义。 表 2 2008和2018年广州市乙肝血清学调查人群HBcAb单项阳性率比较
Table 2. Comparison of single positive rate of HBcAb between 2008 and 2018 in Guangzhou
变量 2008年HBcAb单项阳性 2018年HBcAb单项阳性 10年
增幅(%)调查人数 构成比(%) 例数 阳性率(%) 95% CI值 调查人数 构成比(%) 例数 阳性率(%) 95% CI值 年龄(岁) ≥1a 1 402 28.10 80 5.71 4.49~6.92 937 23.54 2 0.21 -0.54~0.96 -96.26 7~a 1 475 29.57 97 6.58 5.31~7.84 1 085 27.26 7 0.65 -0.15~1.44 -90.19 17~59a 2 112 42.33 154 7.29 6.18~8.40 1 958 49.20 101 5.16b 2.41~7.91 -29.26 出生年份(年) 2008-2017 - 1 400 35.18 4 0.29 -0.29~0.86 2002-2007a 1 402 28.10 80 5.71 4.49~6.92 622 15.63 5 0.80 -0.41~2.01 -85.91 1992-2001a 1 475 29.57 97 6.58 5.31~7.84 346 8.69 3 0.87 -1.04~2.77 -86.82 1959-1991 1 690 33.87 116 6.86 5.66~8.07 1 612 40.50 98 6.08b 2.34~9.82 -11.43 1949-1958 422 8.46 38 9.00 6.27~11.74 - 性别 男a 2 421 48.53 138 5.70 4.78~6.62 1 904 47.84 44 2.31 0.77~3.85 -59.46 女a 2 568 51.47 193 7.52b 6.50~8.54 2 076 52.16 66 3.18 1.51~4.85 -57.70 区域 中流行区a 1 216 24.37 86 7.07 5.63~8.51 405 10.18 13 3.21 -1.45~7.87 -54.61 高流行区a 3 773 75.63 245 6.49 5.71~7.28 3 575 89.82 97 2.71 1.54~3.89 -58.22 免疫史 有a 3 088 61.90 173 5.60 4.79~6.41 2 735 68.72 28 1.02 0.24~1.81 -81.73 无 923 18.50 77 8.34 6.56~10.13 479 12.04 45 9.39 1.61~17.18 12.61 不详a 975 19.54 81 8.31b 6.58~10.04 766 19.25 37 4.83b 0.71~8.95 -41.86 合计a 4989 100.00 331 6.63 5.94~7.33 3 980 100.00 110 2.76 1.62~3.91 -58.34 注:a表示2008和2018年阳性率的差异有统计学意义;b表示同一年份HBcAb单项阳性率在不同年龄、出生人群、性别、区域、免疫史方面比较差异有统计学意义。 表 3 2008年和2018年广州市1~59岁人群不同乙肝疫苗接种史HBV易感率和HBcAb单项阳性率
Table 3. HBV susceptibility rate and single positive rate of HBcAb among people aged 1-59 in Guangzhou in 2008 and 2018
年龄(岁) 乙肝疫苗
免疫史HBV易感率[%, (95% CI)值] HBcAb单项阳率[%,(95% CI)值] 2008年 2018年 10年增幅(%) 2008年 2018年 10年增幅(%) ≥1 有 16.90(14.91~18.88) 15.58(13.26~17.90) -7.81 5.56(4.34~6.77) 0.21(-0.54~0.96) -96.22a 无 100.00(100.00~100.00) 0.00 - 0.00 0.00 - 7~ 有 23.34(21.00~25.69) 36.26(33.38~39.14) 55.36a 6.16(4.82~7.49) 0.65(0.17~1.14) -89.45a 无 38.24(21.90~54.57) 0.00 - 5.88(-2.03~13.79) 0.00 - 17~ 有 8.92(4.46~13.38) 21.8(17.04~26.56) 144.39a 4.46(1.23~7.69) 0.35(-0.33~1.02) -92.15a 无 11.11(4.27~17.96) 16.67(6.16~27.21) 50.05 4.94(0.22~9.66) 10.42(1.77~19.06)b 110.93a 30~ 有 8.19(4.08~12.30) 7.06(3.92~10.20) -13.80 3.51(0.75~6.27) 1.57(0.04~3.09) -55.27 无 13.51(9.35~17.68) 15.38(9.18~21.59)b 13.84 3.47(1.24~5.71) 4.62(1.01~8.22) 33.14 40~ 有 13.54(6.70~20.39) 7.94(3.22~12.66) -41.36 6.25(1.41~11.09) 7.94(3.22~12.66) 27.04 无 15.23(11.18~19.28) 7.80(3.37~12.23) -48.79 11.59(7.89~15.20) 11.35(6.11~16.58) -2.07 50~59 有 17.39(6.44~28.34) 6.90(0.38~13.42) -60.32 2.17(-2.04~6.39) 6.9(0.38~13.42) 217.97 无 15.51(10.98~20.04) 9.38(4.68~13.89) -39.52 11.02(7.10~14.94) 11.25(6.35~16.15) 2.09 合计 有 10.42(7.66~13.19) 13.05(10.60~15.50) 25.24 4.26(2.43~6.08) 2.61(1.45~3.77) -38.73 无 14.43(12.12~16.74) 11.27(8.44~14.11) -21.90 8.46(6.62~10.29) 9.39(6.78~12.01) 10.99 注:a表示2018年与2008年相比,差异有统计学意义;b表示在相同年份同一年龄组不同免疫史之间HBV易感率/ HBcAb单项阳率的差异有统计学意义。 -
[1] Liang X, Bi S, Yang W, et al. Evaluation of the impact of hepatitis B vaccination among children born during 1992-2005 in China[J]. J Infect Dis, 2009, 200(1): 39-47. DOI: 10.1086/599332. [2] 刘甲野, 吕静静, 颜丙玉, 等. 乙型肝炎病毒核心抗体单项阳性及健康的成年人乙肝疫苗免疫效果配对比较研究[J]. 中华流行病学杂志, 2014, 35(10): 1091-1094. DOI: 10.3760/cma.j.issn.0254-6450.2014.10.003.Liu JY, Lyu JJ, Yan BY, et al. Matching study on immune response between single anti-HBc positivity and healthy adults after primary immunization and revaccination of hepatitis B vaccine[J]. Chin J Epidemiol, 2014, 35(10): 1091-1094. DOI: 10.3760/cma.j.issn.0254-6450.2014.10.003. [3] Gessoni G, Beggio S, Barin P, et al. Significance of anti-HBc only in blood donors: a serological and virological study after hepatitis B vaccination[J]. Blood Transfus, 2014, 12 Suppl 1(Suppl 1): s63-s68. DOI: 10.2450/2013.0227-12. [4] 杨北方. 湖北省人群乙型病毒性肝炎血清流行病学特征及乙肝疫苗效果分析[D]. 武汉: 华中科技大学, 2013.Yang BF. Study on the seroepidemic situation fo HBV and evaluation HepB vaccine in Hubei province[D]. Wuhan: Huanzhong University of Science and Technology, 2013. [5] 郑徽, 王富珍, 张国民, 等. 2006和2014年中国1-29岁乙型肝炎病毒易感人群的流行病学特征分析[J]. 中华预防医学杂志, 2017, 51(7): 581-586. DOI: 10.3760/cma.j.issn.0253-9624.2017.07.002.Zheng H, Wang FZ, Zhang GM, et al. The epidemiological characteristics of HBV susceptibility in 1-29 years old young people in China in 2006 and 2014: based on the national sero-survey data analysis[J]. Chin J Prev Med, 2017, 51(7): 581-586. DOI: 10.3760/cma.j.issn.0253-9624.2017.07.002. [6] 郑徽, 王富珍, 陈园生, 等. 新生儿接种重组乙型肝炎疫苗(酵母)后低无应答率及影响因素分析[J]. 中国计划免疫, 2007, 13(4): 303-305. DOI: 10.3969/j.issn.1006-916X.2007.04.004.Zheng H, Wang FZ, Chen YS, et al. Infants non-and-lowersponse after recombinant yeast derived Hepatitis B vaccinated and influencing factors analysis[J]. Chin J Vac Immu, 2007, 13(4): 303-305. DOI: 10.3969/j.issn.1006-916X.2007.04.004. [7] Yuen MF, Lim WL, Chan AO, et al. 18-year follow-up study of a prospective randomized trial of hepatitis B vaccinations without booster doses in children[J]. Clin Gastroenterol Hepatol, 2004, 2(10): 941-945. DOI: 10.1016/s1542-3565(04)00384-2. [8] 张丽, 徐爱强, 颜丙玉, 等. 山东省1~59岁人群乙型肝炎疫苗接种情况调查分析[J]. 中国疫苗和免疫, 2009, 15(2): 159-162. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJM200902025.htmZhang L, Xu AQ, Yan BY, et al. Analysis on Hepatitis B vaccine coverage among the population of 1-59 years old in Shandong province[J]. Chin J Vaccines Immu, 2009, 15(2): 159-162. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJM200902025.htm [9] Gibney KB, Torresi J, Lemoh C, et al. Isolated core antibody hepatitis B in sub-Saharan African immigrants[J]. J Med Virol, 2008, 80(9): 1565-1569. DOI: 10.1002/jmv.21267. [10] 崔富强, 毕胜利, 张勇, 等. 中国人群大样本调查乙型肝炎病毒感染血清学标志物检出模式分析[J]. 中国疫苗和免疫, 2009, 15(4): 294-299. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJM200904005.htmCui FQ, Bi SL, Zhang Y, et al. Combination profiles of hepatitis B marks for Chinese in serosurvey in 2006[J]. Chin J Vaccines Immu, 2009(4): 294-299. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJM200904005.htm