Wang F Z, Zhang G M, Shen L P, Zheng H, Wang F, Miao N, Yuan Q L, Sun X J, Bi S L, Liang X F, Wang H Q
Department of National Immunization Programme, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2017 Jun 6;51(6):462-468. doi: 10.3760/cma.j.issn.0253-9624.2017.06.002.
To evaluate the effect of hepatitis B prevention and control by comparative analysis on the results of HBsAg, anti-HBs and anti-HBc prevalence from national hepatitis B seroepidemiological surveys in 1992 and 2014 in different epidemic regions of China. Data was from the national seroepidemiological surveys of hepatitis B conducted in 1992 and 2014. The survey in 1992 was conducted in 145 disease surveillance points of 30 provinces (excluding Hong Kong, Macao Special Administrative Region and Taiwan province) in China. The survey in 2016 was conducted in 160 disease surveillance points of 31 provinces (excluding Hong Kong, Macao Special Administrative Region and Taiwan province) in China. In the two surveys, face-to-face interviews with the subject by door to door or on the investigation site were conducted by trained staff using standard questionnaires to obtain basic information including birth date, gender, ethnicity, resident place and so on. And then 5 ml venous blood was collected to test the sero-markers of HBsAg, anti-HBs and anti-HBc. We analyzed unweighted point prevalence and 95 of HBsAg, anti-HBs and anti-HBc in 1992 which had no design weighting, and analyzed weighted point prevalence and 95 of HBsAg, anti-HBs and anti-HBc in 2014 which had design weighting. 34 291 and 31 713 people aged 1-29 years were involved in 1992 and 2014 national serosurveys of China, respectively. For the people aged 1-29 years, HBsAg prevalence was 2.64% (95 2.28%-3.06%) in 2014 and decreased by 73.92% as compared with the rate 10.13% (95 9.81%-10.45%) in 1992. Anti-HBc prevalence was 13.01% (95 12.09%-14.00%) in 2014 and decreased by 71.61% as compared with the rate 45.84% (95 45.31%-46.37%) in 1992. Anti-HBs prevalence was 57.79% (95 56.33%-59.25%) in 2014 and ascended by 127.41% as compared with the rate 25.41% (95 24.95%-25.87%) in 1992. In high, medium and low epidemic region, for the people who born during 1992-2001 when hepatitis B vaccine was introduced in routine immunization management, HBsAg prevalence was 4.74% (95 3.79%-5.69%), 1.59% (95 1.09%-2.10%) and 2.53% (95 1.66%-3.39%), respectively, and anti-HBs prevalence was 64.25% (95 62.11%-66.39%), 56.34% (95 54.50%-58.57%), 54.49% (95 51.75%-57.23%), respectively, and anti-HBc prevalence was 15.16% (95 13.56%-16.76%), 11.07% (95 9.80%-12.33%), 7.61% (95 6.15%-9.07%), respectively. In high, medium and low epidemic region, for the people who born during 2002-2013 the duration which hepatitis B vaccine was integrated in expanded immunization program born during when HBsAg prevalence was 0.88% (95 0.66%-1.11%), 0.37% (95 0.24%-0.49%)and 0.71% (95 0.48%-0.94%), respectively, and anti-HBs prevalence was 60.74% (95 59.57%-61.90%), 59.46% (95 58.44%-60.49%), 52.56% (95 51.20%-53.92%), respectively, and anti-HBc prevalence was 3.30% (95 2.87%-3.72%), 1.91% (95 1.63%-2.20%), 2.25% (95: 1.85%-2.66%), respectively. China had made great achievement in hepatitis B prevention and control. HBsAg prevalence among people aged 1-29 years old in 2014 decreased dramatically as compared with that in 1992. Since hepatitis B vaccine was integrated into expanded immunization program, China reduced HBsAg prevalence to less than 1% among people aged 1-12 years in 2014 in different epidemic region.
通过比较分析1992年和2014年中国不同流行地区全国乙型肝炎血清流行病学调查中HBsAg、抗-HBs和抗-HBc流行率的结果,评估乙型肝炎防控效果。数据来自1992年和2014年全国乙型肝炎血清流行病学调查。1992年的调查在中国30个省(不包括香港、澳门特别行政区和台湾省)的145个疾病监测点进行。2016年的调查在中国31个省(不包括香港、澳门特别行政区和台湾省)的160个疾病监测点进行。在这两项调查中,由经过培训的工作人员使用标准问卷对受试者进行挨家挨户或在调查现场的面对面访谈,以获取包括出生日期、性别、种族、居住地点等基本信息。然后采集5毫升静脉血检测HBsAg、抗-HBs和抗-HBc血清标志物。我们分析了1992年未进行设计加权的HBsAg、抗-HBs和抗-HBc的未加权点流行率及95%可信区间,以及2014年进行了设计加权的HBsAg、抗-HBs和抗-HBc的加权点流行率及95%可信区间。1992年和2014年中国全国血清学调查分别纳入了34291名和31713名1-29岁的人群。对于1-29岁人群,2014年HBsAg流行率为2.64%(95%可信区间2.28%-3.06%),与1992年的10.13%(95%可信区间9.81%-10.45%)相比下降了73.92%。2014年抗-HBc流行率为13.01%(95%可信区间12.09%-14.00%),与1992年的45.84%(95%可信区间45.31%-46.37%)相比下降了71.61%。2014年抗-HBs流行率为57.79%(95%可信区间56.33%-59.25%),与1992年的25.41%(95%可信区间24.95%-25.87%)相比上升了127.41%。在高、中、低流行地区,对于1992-2001年期间出生且乙肝疫苗纳入常规免疫管理的人群,HBsAg流行率分别为4.74%(95%可信区间3.79%-5.69%)、1.59%(95%可信区间1.09%-2.10%)和2.53%(95%可信区间1.66%-3.39%),抗-HBs流行率分别为64.25%(95%可信区间62.11%-66.39%)、56.34%(