School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, P.R. China.
Department of Ecology and Evolution, The University of Chicago, Chicago, IL, 60637, USA.
Sci Rep. 2017 Jun 6;7(1):2912. doi: 10.1038/s41598-017-03080-6.
The age-specific seroclearance pattern of hepatitis B surface antigen (HBsAg) in chronic hepatitis B virus (HBV) infections of China remains unclear. In this study, based on three national serosurvey data of hepatitis B in China, we propose an age- and time-dependent discrete model and use the method of non-linear least squares to estimate the age-specific annual rate of HBsAg seroclearance. We found that the HBsAg seroclearance in chronic HBV infections of China aged 1-59 years occurred at an average annual rate of 1.80% (95% CI, 1.54-2.06%) from 1993 to 2006. The HBsAg seroclearance occurred predominantly in the early childhood, 20-24 and 35-39 year age groups. Moreover, our model estimated that HBsAg seroclearance resulted in 23.38% of the decrease of total HBsAg prevalence for population aged 1-59 years in 2006. It also prevented 9.30% of new HBV infections (about 7.43 million people) and 9.95% of HBV-related deaths (about 0.25 million people) from 1993 to 2006. This study develops a new and efficient method to estimate the age-specific incidence of HBsAg seroclearance at a population-level and evaluate its effect.
在中国慢性乙型肝炎病毒（HBV）感染中，乙型肝炎表面抗原（HBsAg）的血清清除模式随年龄变化的特征尚不清楚。本研究基于中国三次全国乙型肝炎血清学调查数据，提出了一个年龄和时间相关的离散模型，并采用非线性最小二乘法估计 HBsAg 血清学清除的年龄特异性年发生率。我们发现，1993 年至 2006 年，1-59 岁中国慢性 HBV 感染者的 HBsAg 血清清除率平均每年为 1.80%（95%CI：1.54-2.06%）。HBsAg 血清清除主要发生在儿童早期、20-24 岁和 35-39 岁年龄组。此外，我们的模型估计，2006 年 HBsAg 血清清除导致 1-59 岁人群的总 HBsAg 流行率下降了 23.38%。该模型还预防了 1993 年至 2006 年期间 9.30%的新 HBV 感染（约 743 万人）和 9.95%的 HBV 相关死亡（约 25 万人）。本研究开发了一种新的、有效的方法，可在人群水平上估计 HBsAg 血清学清除的年龄特异性发生率并评估其效果。
