School of Public Health and Community Medicine, UNSW Sydney, Sydney, New South Wales, Australia.
Clinical and Population Perinatal Health Researchs, Kolling Institute, St Leonards, New South Wales, Australia.
J Viral Hepat. 2020 Jan;27(1):74-80. doi: 10.1111/jvh.13202. Epub 2019 Oct 7.
Routine antenatal screening for chronic hepatitis B (HBV) in countries with high migrant populations provides an opportunity to monitor trends in HBV prevalence and can inform estimates locally and in countries with limited seroprevalence data. We linked perinatal birth register records with HBV notifications in the largest Australian state, over the period 2000-2016. Among women aged 15-44 years, we estimated age-standardized chronic HBV prevalence overall and by country of birth and also estimated trends in age-standardized HBV prevalence over time using regression modelling. Among 903 831 women, 8001 linked to a chronic HBV infection record (overall age-standardized prevalence 0.76%, 95% CI: 0.74-0.78). Prevalence varied by country of birth with the highest estimates among women born in Sierra Leone (11.13%, 95% CI: 8.29-13.96), Taiwan (8.08%, 95% CI: 6.74%-9.43%), Cambodia (7.47%, 95% CI: 6.50%-8.45%) and Vietnam (7.36%, 95% CI: 6.97%-7.75%); more moderate estimates among women from North Korea (2.76%, 95% CI: 1.99-3.53) and Samoa (2.64%, 95% CI: 1.99%-3.29%); prevalence was 0.18% (95% CI: 0.17-0.19) in Australian-born women. Over 17 years, there were significant reductions in HBV prevalence among all women (from 0.88% in 2000 to 0.57% in 2016; P < .0001). Among women from high prevalence countries, the greatest absolute reductions were observed among those from Taiwan (10.1%, P < .001) followed by Tonga (5.4%, P < .001), whereas no reductions were observed for women born in Vietnam (P = .08), South Korea (P = .41) and Sudan (P = .06). In conclusion, routine antenatal HBV testing can be used to inform HBV prevalence estimates and vaccine programme impact in countries with limited surveillance and high migration to Australia.
在移民人口较多的国家，对慢性乙型肝炎（HBV）进行常规产前筛查为监测 HBV 流行趋势提供了机会，并可提供本地和血清流行率数据有限的国家的估计值。我们在澳大利亚最大的州，将围产期出生登记记录与 2000 年至 2016 年期间的 HBV 通报进行了关联。在 15-44 岁的女性中，我们按出生国家和年龄标准化估计了慢性 HBV 的总体流行率，并使用回归模型估计了随时间推移的年龄标准化 HBV 流行率趋势。在 903831 名女性中，有 8001 名与慢性 HBV 感染记录相关联（总体年龄标准化流行率为 0.76%，95%CI：0.74-0.78）。流行率因出生国家而异，其中塞拉利昂出生的女性患病率最高（11.13%，95%CI：8.29-13.96%），其次是中国台湾（8.08%，95%CI：6.74%-9.43%）、柬埔寨（7.47%，95%CI：6.50%-8.45%）和越南（7.36%，95%CI：6.97%-7.75%）；朝鲜出生的女性患病率中等偏高（2.76%，95%CI：1.99-3.53%），萨摩亚出生的女性患病率中等偏高（2.64%，95%CI：1.99%-3.29%）；澳大利亚出生的女性患病率为 0.18%（95%CI：0.17-0.19%）。17 年来，所有女性的 HBV 患病率均显著下降（从 2000 年的 0.88%降至 2016 年的 0.57%；P<0.0001）。在高流行率国家出生的女性中，台湾出生的女性的绝对降幅最大（10.1%，P<0.001），其次是汤加（5.4%，P<0.001），而越南出生的女性（P=0.08）、韩国（P=0.41）和苏丹（P=0.06）的女性没有观察到降幅。总之，常规产前 HBV 检测可用于为乙型肝炎流行率估计和疫苗接种计划在监测和向澳大利亚移民人数较多的国家提供影响。
