Centers for Disease Control and Prevention, Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, 1600 Clifton Rd. NE, MS G-37, Atlanta, GA 30333, USA.
Public Health Rep. 2011 Jul-Aug;126(4):522-32. doi: 10.1177/003335491112600408.
We described seroprevalence of antibody to hepatitis A virus (anti-HAV) in the United States during 1999-2006 and compared it with seroprevalence before the availability of vaccine.
We analyzed data from the 1988-1994 and 1999-2006 National Health and Nutrition Examination Survey (NHANES) to obtain estimates of anti-HAV seroprevalence for the U.S. household population. We grouped region of residence based on the 1999 Advisory Committee on Immunization Practices recommendations into 17 states with any recommendation (vaccinating) and 33 states without any recommendation (non-vaccinating).
During 1999-2006, the overall seroprevalence of anti-HAV was 34.9% (95% confidence interval [CI] 33.1, 36.7). During 1999-2006, U.S.-born children living in vaccinating states (33.8%, 95% CI 26.2, 42.2) had a higher seroprevalence than children in non-vaccinating states (11.0%, 95% CI 9.4, 12.8; p < 0.001). Seroprevalence among children increased from 8.0% (95% CI 6.3, 10.1) during 1988-1994 to 20.2% (95% CI 16.0, 24.8) during 1999-2006 (p < 0.001). For U.S.-born children aged 6-19 years, the strongest factor associated with seroprevalence was residence in vaccinating states. Among U.S.-born adults aged > 19 years, the overall age-adjusted seroprevalence of anti-HAV was 29.9% (95% CI 28.3, 31.5) during 1999-2006, which was not significantly different from the seroprevalence during 1988-1994 (32.2%, 95% CI 30.1, 34.4).
Increases in seroprevalence among children in vaccinating states suggest a positive effect of the 1999 vaccination recommendations.
我们描述了 1999-2006 年期间美国人群中抗甲型肝炎病毒（抗-HAV）抗体的血清流行率，并将其与疫苗使用前的流行率进行了比较。
我们分析了 1988-1994 年和 1999-2006 年全国健康和营养检查调查（NHANES）的数据，以获得美国家庭人群抗-HAV 血清流行率的估计值。我们根据 1999 年免疫实践咨询委员会的建议，将居住地区分为 17 个有推荐（接种）的州和 33 个无推荐（未接种）的州。
在 1999-2006 年期间，抗-HAV 的总体血清流行率为 34.9%（95%置信区间[CI] 33.1，36.7）。在 1999-2006 年期间，居住在接种州的美国出生儿童（33.8%，95%CI 26.2，42.2）的血清流行率高于非接种州的儿童（11.0%，95%CI 9.4，12.8；p<0.001）。1988-1994 年期间，儿童的血清流行率为 8.0%（95%CI 6.3，10.1），1999-2006 年期间增加到 20.2%（95%CI 16.0，24.8）（p<0.001）。对于 6-19 岁的美国出生儿童，与血清流行率相关的最强因素是居住在接种州。对于 19 岁以上的美国出生成年人，1999-2006 年期间总体年龄调整后的抗-HAV 血清流行率为 29.9%（95%CI 28.3，31.5），与 1988-1994 年期间的流行率（32.2%，95%CI 30.1，34.4）无显著差异。
接种州儿童血清流行率的增加表明 1999 年疫苗接种建议产生了积极影响。
