Zheng H, Wang F Z, Zhang G M, Miao N, Sun X J, Cui F Q
Epidemiology Division, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2017 Jul 6;51(7):581-586. doi: 10.3760/cma.j.issn.0253-9624.2017.07.002.
To analyze the epidemiological characteristics of HBV susceptible people in 1-29 years old people in 2006 and 2014 in China. Data is from the 2006 and 2014 national sero-survey, and both of them were conducted in 160 disease surveillance points of 31 provinces (excluding Hong Kong, Macao Special Administrative Region and Taiwan province) in China. We used the centralized face-to face investigation method to collect basic information including birth date, gender, ethnicity, resident place, hepatitis B vaccination (HepB) history and so on, and 5 ml venous blood was collected for all subjects to test the sero-markers of HBsAg, anti-HBs and anti-HBc. We definite the HBV susceptible people as the HBsAg, anti-HBs and anti-HBc all negative together. And we use chi-square to analyze the epidemiological characteristics of HBV susceptibility in 1-29 years old young people in 2006 and 2014, and use multiple factors logistic regression to analyze the affect factors on HBV susceptible appearing in people with HepB vaccination. In 2006 and 2014 sero-surveys, the investigated 1-29 year-old people were 49 849 and 31 713, respectively. And compared with 2006, the proportion of HBV susceptible people with HepB among 1-29 in 2014 increased from 20.87% (10 401) to 28.55% (9 055) (χ(2)=630.69, 0.001); and the proportion of susceptible people without HepB decreasing from 15.02% (7 485) to 7.66% (2 460) (χ(2)=953.73, 0.001). Compared with Han nationality, the high risk of susceptible appearing in minority people after HepB vaccination (1.38). And compared with less than 3 doses HepB vaccination, the more than 3 doses vaccination could reduce the anti-HBs disappearing rate (0.68); Compared with one year after last dose vaccination, the 2-4 years interval (3.33) and more than 5 years interval (6.53) would have high risk for anti-HBs disappearing. All above were 0.001. In western area, the proportion of susceptible people without HepB (9.58%, 1 047/2 460) was higher than the proportion in eastern (6.30%, 657/2 460) and middle area (7.30%, 756/2 460) (0.001). The HepB coverage maintained in high level in 1-4 years old children. The HBV susceptible proportion mainly concentrated in 15-29 years old people, and the immunization gap was in western, rural areas and minority peoples.
分析2006年和2014年我国1 - 29岁人群中乙肝病毒(HBV)易感人群的流行病学特征。数据来自2006年和2014年全国血清学调查,这两次调查均在中国31个省(不包括香港、澳门特别行政区和台湾省)的160个疾病监测点开展。我们采用集中面对面调查方法收集包括出生日期、性别、民族、居住地、乙肝疫苗(HepB)接种史等基本信息,并为所有受试者采集5ml静脉血检测HBsAg、抗 - HBs和抗 - HBc血清标志物。我们将HBsAg、抗 - HBs和抗 - HBc均为阴性的人群定义为HBV易感人群。我们用卡方检验分析2006年和2014年1 - 29岁年轻人中HBV易感性的流行病学特征,并用多因素logistic回归分析乙肝疫苗接种人群中出现HBV易感的影响因素。在2006年和2014年血清学调查中,调查的1 - 29岁人群分别为49849人和31713人。与2006年相比,2014年1 - 29岁接种乙肝疫苗人群中HBV易感人群比例从20.87%(10401人)增至28.55%(9055人)(χ² = 630.69,P < 0.001);未接种乙肝疫苗的易感人群比例从15.02%(7485人)降至7.66%(2460人)(χ² = 953.73,P < 0.001)。与汉族相比,少数民族接种乙肝疫苗后出现易感的风险较高(1.38)。与接种少于3剂乙肝疫苗相比,接种3剂以上可降低抗 - HBs消失率(0.68);与最后一剂接种后1年相比,间隔2 - 4年(3.33)和5年以上(6.53)抗 - HBs消失风险较高。以上均P < 0.001。在西部地区,未接种乙肝疫苗的易感人群比例(9.58%,1047/2460)高于东部地区(6.30%,657/2460)和中部地区(7.30%,756/2460)(P < 0.001)。1 - 4岁儿童乙肝疫苗接种率维持在较高水平。HBV易感比例主要集中在15 - 29岁人群,免疫空白存在于西部地区、农村地区和少数民族人群中。