Liang Xiaofeng, Bi Shengli, Yang Weizhong, Wang Longde, Cui Gang, Cui Fuqiang, Zhang Yong, Liu Jianhua, Gong Xiaohong, Chen Yuansheng, Wang Fuzhen, Zheng Hui, Wang Feng, Guo Jing, Jia Zhiyuan, Ma Jingchen, Wang Huaqing, Luo Huiming, Li Li, Jin Shuigao, Hadler Stephen C, Wang Yu
Chinese Center for Disease Control and Prevention, Beijing, China.
Vaccine. 2009 Nov 5;27(47):6550-7. doi: 10.1016/j.vaccine.2009.08.048. Epub 2009 Sep 1.
To determine the prevalence of hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), and hepatitis B core anti-body (anti-HBc) in a representative population in China 14 years after introduction of hepatitis B vaccination of infants.
National serosurvey, with participants selected by multi-stage random sampling. Demographics and hepatitis B vaccination history collected by questionnaire and review of vaccination records, and serum tested for HBsAg, antibody to anti-HBc and anti-HBs by ELISA.
The weighted prevalences of HBsAg, anti-HBs and anti-HBc for Chinese population aged 1-59 years were 7.2%, 50.1%, 34.1%, respectively. HBsAg prevalence was greatly diminished among those age <15 years compared to that found in the 1992 national serosurvey, and among children age <5 years was only 1.0% (90% reduction). Reduced HBsAg prevalence was strongly associated with vaccination among all age groups. HBsAg risk in adults was associated with male sex, Western region, and certain ethnic groups and occupations while risk in children included birth at home or smaller hospitals, older age, and certain ethnic groups (Zhuang and other).
China has already reached the national goal of reducing HBsAg prevalence to less than 1% among children under 5 years and has prevented an estimated 16-20 million HBV carriers through hepatitis B vaccination of infants. Immunization program should be further strengthened to reach those remaining at highest risk.
在婴儿接种乙肝疫苗14年后，确定中国具有代表性人群中乙肝表面抗原（HBsAg）、乙肝表面抗体（抗-HBs）和乙肝核心抗体（抗-HBc）的流行率。
全国血清学调查，通过多阶段随机抽样选择参与者。通过问卷调查和疫苗接种记录审查收集人口统计学和乙肝疫苗接种史，并采用酶联免疫吸附测定法检测血清中的HBsAg、抗-HBc抗体和抗-HBs。
1-59岁中国人群中HBsAg、抗-HBs和抗-HBc的加权流行率分别为7.2%、50.1%、34.1%。与1992年全国血清学调查相比，<15岁人群中的HBsAg流行率大幅下降，<5岁儿童中仅为1.0%（降低了90%）。在所有年龄组中，HBsAg流行率的降低与疫苗接种密切相关。成年人的HBsAg风险与男性、西部地区、某些民族和职业有关，而儿童的风险包括在家或小型医院出生、年龄较大以及某些民族（壮族等）。
中国已实现将5岁以下儿童HBsAg流行率降至1%以下的国家目标，并通过婴儿乙肝疫苗接种预防了约1600万至2000万乙肝病毒携带者。应进一步加强免疫规划，以覆盖那些仍处于高风险的人群。
