Salleras Lluís, Domínguez Angela, Bruguera Miquel, Plans Pere, Espuñes Jordi, Costa Josep, Cardeñosa Neus, Plasència Antoni
Department of Public Health, University of Barcelona, Barcelona, Spain.
J Clin Virol. 2009 Apr;44(4):329-32. doi: 10.1016/j.jcv.2009.01.002. Epub 2009 Feb 20.
In recent years there has been a substantial reduction in hepatitis B incidence as a result of routine vaccination of preadolescents and the selective vaccination of high risk groups and newborns of HBsAg+ mothers.
To determine the prevalence of hepatitis B virus infection markers and of serologic markers of hepatitis B vaccination in a representative sample of pregnant women in Catalonia.
A representative sample was obtained by random cluster sampling (hospitals with maternity units) stratified by provinces. Anti-HBc, anti-HBs and HBsAg were determined using an ELISA test (Behring, Marburg, Germany). The crude and adjusted odds ratios for the sociodemographic variables analyzed were also calculated.
The global prevalence of carriers of HBsAg+ was 0.1% (95% CI 0.0-0.3), that of hepatitis B infection (anti-HBc+) was 5% (95% CI 3.9-6.1) and that of serologic markers of vaccination (anti-HBs+ and anti-HBc-) was 16.4% (95% CI 14.5-18.2) The prevalence of infection increased with age from 3.0% (15-19 years age group) to 14.8% (40-44 years age group). The prevalence of anti-HBc+ was higher in women born in Asia (27.6%) and Africa (18.8%) than in those born in Spain (3.7%), Europe (3.3%) and America (4.6%), with the differences being statistically significant.
The results of this study confirm the change in the pattern of endemicity of hepatitis B infection in pregnant women in Catalonia after the introduction of vaccination programmes. They also confirm the increasingly important role played by immigration in the epidemiology of hepatitis B.
近年来，由于对青春期前儿童进行常规疫苗接种以及对高危人群和乙肝表面抗原阳性母亲的新生儿进行选择性疫苗接种，乙肝发病率大幅下降。
确定加泰罗尼亚孕妇代表性样本中乙肝病毒感染标志物和乙肝疫苗接种血清学标志物的流行情况。
通过随机整群抽样（设有产科病房的医院）获得一个按省份分层的代表性样本。使用酶联免疫吸附试验（德国马尔堡贝林公司产品）检测乙肝核心抗体、乙肝表面抗体和乙肝表面抗原。还计算了所分析的社会人口统计学变量的粗比值比和调整比值比。
乙肝表面抗原阳性携带者的总体流行率为0.1%（95%可信区间0.0 - 0.3），乙肝感染（乙肝核心抗体阳性）的流行率为5%（95%可信区间3.9 - 6.1），疫苗接种血清学标志物（乙肝表面抗体阳性且乙肝核心抗体阴性）的流行率为16.4%（95%可信区间14.5 - 18.2）。感染率随年龄增长从3.0%（15 - 19岁年龄组）升至14.8%（40 - 44岁年龄组）。出生在亚洲（27.6%）和非洲（18.8%）的女性中乙肝核心抗体阳性的流行率高于出生在西班牙（3.7%）、欧洲（3.3%）和美洲（4.6%）的女性，差异具有统计学意义。
本研究结果证实了疫苗接种计划实施后加泰罗尼亚孕妇乙肝感染流行模式的变化。它们还证实了移民在乙肝流行病学中发挥的作用日益重要。
