福建省2004—2020年不同免疫策略时期乙型肝炎病毒流行病学及免疫效果评价

张冬娟; 林光灿; 黄丽芳

doi:10.16462/j.cnki.zhjbkz.2023.11.018

福建省2004—2020年不同免疫策略时期乙型肝炎病毒流行病学及免疫效果评价

doi: 10.16462/j.cnki.zhjbkz.2023.11.018

1.
福建省疾病预防控制中心综合处，福州 350012
2.
福建省疾病预防控制中心免疫规划所，福州 350012

基金项目:

福建省卫生健康科技计划项目 2020CXA019

福建省卫生健康科技计划项目 2020GGB020

福建省科技创新平台建设项目 2019Y2001

中国肝炎防治基金会中国乙型肝炎防控科研基金 YGFK20210077

详细信息

通讯作者:
黄丽芳，E-mail: huanglf351@126.com

中图分类号: R12.6+2
计量
- 文章访问数: 134
- HTML全文浏览量: 101
- PDF下载量: 44
- 被引次数: 0
出版历程
- 收稿日期: 2022-12-15
- 修回日期: 2023-05-05
- 网络出版日期: 2023-11-20
- 刊出日期: 2023-11-10

Epidemiology and immune effectiveness evaluation during different immunization strategies for hepatitis B virus in Fujian Province, 2004-2020

1.
General Department, Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350012, China
2.
Department of Immunization Program, Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350012, China

Funds:

Medical Innovation Project of Health Science and Technology Program in Fujian Province 2020CXA019

Young and Middle-aged Backbone Personnel Training Project of Health Science and Technology Program in Fujian Province 2020GGB020

Construction of Fujian Provincial Scientific and Technological Innovation Platform 2019Y2001

China Hepatitis Prevention and Control Foundation China Hepatitis B Prevention and Control Research Fund YGFK20210077

More Information

Corresponding author: HUANG Lifang, E-mail: huanglf351@126.com

摘要

摘要: 目的了解福建省乙型肝炎(乙肝)病毒疫苗不同免疫策略时期真实世界数据的流行病学特征。方法根据国家不同时期乙肝疫苗免疫策略，按照观察法与队列研究设计，将人群分为不同的出生队列组，分析评价不同队列组乙肝发病的流行病学特征。结果 2004—2020年，福建省乙肝人年发病率为145.80/10万，急性、慢性乙肝人年发病率分别为35.72/10万和110.08/10万。1992年前出生队列组急性乙肝仍然高发(人年发病率46.44/10万)；2002—2020年出生队列组、1992—2001年出生队列组和1992年前出生队列组慢性乙肝人年发病率均呈上升趋势，尤其是1992—2001年出生队列组上升差异有统计学意义(R²=0.68)，呈沿海地区相对高发的地区分布特点。结论按照目前中国乙肝疫苗的免疫策略，福建省小年龄组人群乙肝发病率保持在较低水平，管理随访慢性乙肝病人，延缓肝硬化、肝癌的发展，是实现2030年消除目标的重点工作。
- 真实世界数据 /
- 队列研究设计 /
- 乙肝疫苗免疫策略 /
- 流行病学效果评价
Abstract: Objective To understand the real-world epidemiological characteristics of hepatitis B virus (HBV) infection under different hepatitis B vaccine (HepB) immunization strategies in Fujian Province. Methods HBV infection data were obtained from the Nationally Notifiable Disease Reporting System. The study population was divided into three birth cohort groups based on the national HepB immunization strategy in effect when they were born. Epidemiological characteristics of HepB incidence in different cohorts were analyzed and evaluated. Results In the 2002-2020 birth cohort group, the overall annual incidence of hepatitis B was 145.80/100, 000; the acute hepatitis B (AHB) annual incidence was 35.72/100 000 and the chronic hepatitis B (CHB) annual incidence was 110.08/100 000. Before 1992, the AHB incidence was 46.44/100 000. The annual incidence of CHB increased in all three groups, with the 1992-2001 group having a statistically significant increase (R²=0.68). The incidence rates in coastal areas were relatively high. Conclusions The incidence of hepatitis B is low among young people born under the free Hep B policy from 2002-2020 in Fujian Province. Following up and managing CHB patients to prevent or delay the development of cirrhosis and liver cancer is essential work to achieve the goal of eliminating hepatitis B as a public health problem by 2030.
- Real world data /
- Cohort study design /
- Hepatitis B vaccine immunization strategy /
- Epidemiological efficacy evaluation

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图 1 福建省不同免疫队列人群乙肝人年发病率趋势

Figure 1. Annual incidence rate trend of hepatitis B in different immunization cohorts

下载: 全尺寸图片幻灯片

表 1 2004—2020年福建省不同免疫策略时期乙肝发病情况

Table 1. Incidence of hepatitis B during different immunization strategies in Fujian Province from 2004 to 2020

组别Group	观察人数 Number of Observations	观察人年数 Number of people and years observed	人年发病率/10万^-1 Annual incidence rate /100 000^-1
组别Group	观察人数 Number of Observations	观察人年数 Number of people and years observed	总乙肝 Total hepatitis B	急性乙肝 Acute hepatitis B	慢性乙肝 Chronic Hepatitis B
A组+B组A group+B group	13 392 972	173 558 066	38.77	7.32	31.45
男Male	7 141 064	92 431 315	46.29	9.25	37.03
女Female	6 251 908	81 126 751	30.20	5.11	25.09
A组group	8 028 632	80 952 086	8.38	1.78	6.61
男Male	4 332 950	43 471 961	10.00	2.11	7.89
女Female	3 695 682	37 480 125	6.51	1.39	5.12
B组group	5 364 340	92 605 980	65.33	12.16	53.17
男Male	2 808 114	48 959 354	78.50	15.60	62.91
女Female	2 556 226	43 646 626	50.55	8.30	42.24
C组group	28 404 925	459 540 826	186.22	46.44	139.78
男Male	14 289 961	231 402 926	258.00	65.67	192.33
女Female	14 114 964	228 137 900	113.42	26.94	86.48
合计Total	41 797 897	633 098 892	145.80	35.72	110.08
男Male	21 431 025	323 834 241	197.57	49.57	148.01
女Female	20 366 872	309 264 651	91.59	21.21	70.38

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表 2 福建省各地区急、慢性乙肝与不同队列乙肝人年发病率分布

Table 2. Annual incidence rate distribution of acute and chronic hepatitis B and different cohorts of hepatitis B in different region in Fujian Province

地区 Region	人年发病率/10万^-1 Annual incidence rate /100 000^-1						A组∶C组 A group∶C group
地区 Region	总乙肝 Total hepatitis B	急性乙肝 Acute hepatitis B	慢性乙肝 Chronic Hepatitis B	A组 group	B组 group	C组 group	RR值 value	95% CI
福州Fuzhou	208.04	35.03	173.01	12.96	82.5	267.64	0.048	0.046~0.051
厦门Xiamen	117.39	17.93	99.46	8.45	63.79	148.99	0.057	0.052~0.061
莆田Putian	216.43	45.78	170.65	12.04	94.97	276.26	0.044	0.041~0.047
三明Sanming	119.14	27.58	91.57	4.93	50.07	152.65	0.032	0.029~0.036
泉州Quanzhou	101.90	32.97	68.93	6.11	44.32	130.46	0.047	0.044~0.050
漳州Zhangzhou	111.40	35.40	75.99	5.82	47.41	142.76	0.041	0.038~0.044
南平Nanping	109.64	32.25	77.39	3.47	34.65	142.77	0.024	0.021~0.028
宁德Ningde	155.88	55.65	100.24	8.72	86.13	195.02	0.045	0.041~0.049
龙岩Longyan	115.38	36.29	79.10	4.85	52.24	147.01	0.033	0.029~0.037
平潭Pingtan	395.59	59.07	336.51	37.67	327.99	472.92	0.08	0.071~0.088
合计Total	145.89	35.72	110.08	8.38	65.33	186.22	0.045	0.044~0.046

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