State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
Eur J Gastroenterol Hepatol. 2011 Aug;23(8):695-700. doi: 10.1097/MEG.0b013e328347322b.
Hepatitis B is a major public health problem in China. However, in the past 10 years, estimates of the prevalence of hepatitis B virus (HBV) have been sparse, with results that do not always agree. The purpose of this study was to investigate the epidemiology of HBV in adults and to provide the most recent baseline data for planning and monitoring of health.
The prevalence of HBV was determined in a community-based, cross-sectional, age-stratified sample of adults (aged 20 years or older). The study population was selected using random multistage cluster sampling. Demographic information and serological samples were obtained from 19 933 participants.
The prevalence of anti-HBV core antibody, HBV surface antigen (HBsAg), and anti-HBV surface antibody was 38.6, 7.9, and 44.9%, respectively. We found statistically significant differences in hepatitis B infection between men and women (P<0.001). The prevalence of HBV infection increased with age. The rates of HBsAg positivity and HBV infection in individuals living on an island were higher than those of individuals living in plains. The alanine aminotransferase level was elevated (≥38 IU/l) in 15.7 and 7.2% of HBsAg-positive and HBsAg-negative patients; the proportion of elevated alanine aminotransferase was markedly higher in men (12.7%) than in women (4.7%) (P<0.001). The α-fetoprotein-positive rate was 2% in HBsAg-positive individuals who were aged 30 years or older.
Borderline intermediate/high endemicity was found among adults in the northern region of Zhejiang Province. The vaccination program has contributed to a reduction in infection over the last 20 years, although further efforts are required to turn the region into a 'low-endemicity' area.
乙型肝炎是中国的一个主要公共卫生问题。然而，在过去的 10 年中，乙型肝炎病毒（HBV）流行率的估计值很少，结果并不总是一致的。本研究的目的是调查成人乙型肝炎病毒的流行病学情况，为规划和监测健康提供最新的基线数据。
采用基于社区的、横断面、年龄分层的成年人（年龄在 20 岁或以上）样本，确定 HBV 的流行率。使用随机多级聚类抽样选择研究人群。从 19933 名参与者中获得人口统计学信息和血清学样本。
抗 HBV 核心抗体、HBV 表面抗原（HBsAg）和抗 HBV 表面抗体的流行率分别为 38.6%、7.9%和 44.9%。我们发现男女之间的乙型肝炎感染存在统计学上的显著差异（P<0.001）。HBV 感染的流行率随年龄增长而增加。居住在岛屿上的个体的 HBsAg 阳性率和 HBV 感染率高于居住在平原上的个体。丙氨酸氨基转移酶水平升高（≥38IU/L）的 HBsAg 阳性和 HBsAg 阴性患者分别为 15.7%和 7.2%；男性（12.7%）的丙氨酸氨基转移酶水平升高比例明显高于女性（4.7%）（P<0.001）。年龄在 30 岁或以上的 HBsAg 阳性个体中，甲胎蛋白阳性率为 2%。
在浙江省北部地区的成年人中发现了边缘中度/高度流行。过去 20 年来，疫苗接种计划已有助于减少感染，但仍需要进一步努力将该地区转变为“低流行区”。
