Ji Zhaohua, Wang Tingcai, Shao Zhongjun, Huang Dahong, Wang Anhui, Guo Zhiwen, Long Yong, Zhang Lei, Su Haixia, Zhang Qi, Yan Yongping, Fan Daiming
Department of Epidemiology and the Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Fourth Military Medical University, Xi'an, China.
Wuwei municipal Center for Disease Control and Prevention, Gansu, China.
PLoS One. 2014 May 15;9(5):e97474. doi: 10.1371/journal.pone.0097474. eCollection 2014.
Current baseline data regarding the prevalence of hepatitis B virus (HBV) infections and the immune status in hyperendemic areas is necessary in evaluating the effectiveness of ongoing HBV prevention and control programs in northwest China. This study aims to determine the prevalence of chronic HBV infections, past exposure rates, and immune response profiles in Wuwei City, northwest China in 2010.
Cross-sectional household survey representative of the Wuwei City population. 28,579 participants were interviewed in the seroepidemiological survey ≥1 year of age. House to house screening was conducted using a standard questionnaire. All serum samples were screened by enzyme-linked immunoassays for the presence of hepatitis B surface antigen, antibodies against HBV surface antigen, and antibodies to the hepatitis B core antigen.
Among individuals ≥1 year of age, 7.2% (95%CI: 6.3-8.1%) had chronic HBV infections, 43.9% (CI: 40.4-47.4%) had been exposed to HBV, and 23.49% (CI: 21.6-25.3%) had vaccine-induced immunity. Multi-factor weighted logistic regression analysis showed that having household contact with HBV carriers (OR = 2.6, 95%CI: 2.3-3.0) and beauty treatments in public places (OR = 1.2, 95%CI: 1.1-1.3) were the risk factors of HBV infection in whole population. Having household contact with HBV carriers (OR = 3.8, 95% CI: 2.2-6.5) and lack of hepatitis vaccination (OR = 2.0, 95% CI: 1.4-3.3) were the risk factors for HBV infection in children aged 1-14 years.
Hepatitis B infection remains a serious public health problem in northwest China. Having household contact with HBV carriers and beauty treatments in public places represented HBV infection risk factors. Hepatitis B vaccine immunization strategies need further improvement, particularly by targeting the immunization of rural migrant workers.
目前，了解乙肝病毒（HBV）感染流行率及高流行地区免疫状况的基线数据，对于评估中国西北地区现行乙肝防控项目的效果很有必要。本研究旨在确定2010年中国西北武威市慢性HBV感染的流行率、既往感染率及免疫反应情况。
采用横断面家庭调查，以代表武威市人群。对28579名年龄≥1岁的参与者进行了血清流行病学调查。通过逐户上门筛查，并使用标准问卷。所有血清样本均采用酶联免疫吸附试验检测乙肝表面抗原、乙肝表面抗体及乙肝核心抗体。
在年龄≥1岁的人群中，7.2%（95%可信区间：6.3 - 8.1%）患有慢性HBV感染，43.9%（可信区间：40.4 - 47.4%）曾接触过HBV，23.49%（可信区间：21.6 - 25.3%）有疫苗诱导的免疫力。多因素加权逻辑回归分析显示，与HBV携带者有家庭接触（比值比=2.6，95%可信区间：2.3 - 3.0）以及在公共场所接受美容治疗（比值比=1.2，95%可信区间：1.1 - 1.3）是整个人群HBV感染的危险因素。与HBV携带者有家庭接触（比值比=3.8，95%可信区间：2.2 - 6.5）以及未接种乙肝疫苗（比值比=2.0，95%可信区间：1.4 - 3.3）是1 - 14岁儿童HBV感染的危险因素。
在中国西北地区，乙肝感染仍是一个严重的公共卫生问题。与HBV携带者有家庭接触以及在公共场所接受美容治疗是HBV感染的危险因素。乙肝疫苗免疫策略需要进一步改进，特别是针对农民工进行免疫接种。
