Immunisation, Hepatitis and Blood Safety Department, Health Protection Services Division, Health Protection Agency, London, UK.
Epidemiol Infect. 2013 May;141(5):916-25. doi: 10.1017/S0950268812001513. Epub 2012 Jul 31.
The aim of this study was to estimate the amount of childhood hepatitis B virus transmission in children born in the UK, a very low-prevalence country, that is preventable only by universal hepatitis B immunization of infants. Oral fluid specimens were collected from schoolchildren aged 7-11 years in four inner city multi-ethnic areas and tested for the presence of antibody to hepatitis B core antigen (anti-HBc). Those found positive or indeterminate were followed up with testing on serum to confirm their hepatitis B status. The overall prevalence of anti-HBc in children was low [0.26%, 95% confidence interval (CI) 0.14-0.44]. The estimated average annual incidence of hepatitis B was estimated to be 29.26/100 000 children (95% CI 16.00-49.08). The total incidence that is preventable only by a universal infant immunization programme in the UK was estimated to be between 5.00 and 12.49/100 000. The study demonstrates that the extent of horizontal childhood hepatitis B virus transmission is low in children born in the UK and suggests that schools in the UK are an uncommon setting for the transmission of the virus. Targeted hepatitis B testing and immunization of migrants from intermediate- and high-prevalence countries is likely to be a more effective measure to reduce childhood transmission than a universal infant immunization programme.
本研究旨在估计在英国出生的儿童中乙型肝炎病毒（HBV）的传播量，英国是一个 HBV 低流行国家，只有通过对婴儿进行普遍乙型肝炎免疫接种才能预防。在四个内城多族裔地区，采集了 7-11 岁学童的口腔液样本，以检测乙型肝炎核心抗原抗体（抗-HBc）的存在。对检测结果呈阳性或不确定的儿童进行了血清检测以确认其 HBV 状态。儿童中抗-HBc 的总体流行率较低[0.26%，95%置信区间（CI）0.14-0.44]。估计乙型肝炎的年平均发病率为 29.26/100000 名儿童（95%CI 16.00-49.08）。估计通过英国普遍婴儿免疫接种计划可预防的总发病率为 5.00-12.49/100000。该研究表明，在英国出生的儿童中，HBV 水平传播的程度较低，表明英国的学校不太可能成为病毒传播的场所。对来自中高流行国家的移民进行有针对性的乙型肝炎检测和免疫接种，可能比普遍的婴儿免疫接种计划更有效地减少儿童传播。
