MMWR Morb Mortal Wkly Rep. 2020 Jul 31;69(30):988-992. doi: 10.15585/mmwr.mm6930a2.
In 2015, the World Health Organization (WHO) South-East Asia Region (SEAR)* reported an estimated 40 million persons living with chronic hepatitis B virus (HBV) infection and 285,000 deaths from complications of chronic infection, cirrhosis, and hepatocellular carcinoma (1). Most chronic HBV infections, indicated by the presence of hepatitis B surface antigen (HBsAg) on serologic testing, are acquired in infancy through perinatal or early childhood transmission (2). To prevent perinatal and childhood infections, WHO recommends that all infants receive at least 3 doses of hepatitis B vaccine (HepB), including a timely birth dose (HepB-BD) (1). In 2016, the SEAR Immunization Technical Advisory Group endorsed a regional hepatitis B control goal with a target of achieving hepatitis B surface antigen (HBsAg) seroprevalence of ≤1% among children aged ≥5 years by 2020, which is in line with the WHO Global Health Sector Strategy on Viral Hepatitis 2016-2021 (2,3). The South-East Asia Regional Vaccine Action Plan 2016-2020 (SEARVAP) (4) identified the acceleration of hepatitis B control as one of the eight regional goals for immunization. The plan outlined four main strategies for achieving hepatitis B control: 1) achieving ≥90% coverage with 3 doses of HepB (HepB3), 2) providing timely vaccination with a HepB birth dose (HepB-BD), 3) providing catch-up vaccination of older children, and 4) vaccinating adult populations at high risk and health care workers (1,4). In 2019, SEAR established a regional expert panel on hepatitis B to assess countries' HBV control status. This report describes the progress made toward hepatitis B control in SEAR during 2016-2019. By 2016, all 11 countries in the region had introduced HepB in their national immunization programs, and eight countries had introduced HepB-BD. During 2016-2019, regional HepB3 coverage increased from 89% to 91%, and HepB-BD coverage increased from 34% to 54%. In 2019, nine countries in the region achieved ≥90% HepB3 coverage, and three of the eight countries that provide HepB-BD achieved ≥90% HepB-BD coverage. By December 2019, four countries had been verified to have achieved the hepatitis B control goal. Countries in the region can make further progress toward hepatitis B control by using proven strategies to improve HepB-BD and HepB3 coverage rates. Conducting nationally representative hepatitis B serosurveys among children will be key to tracking and verifying the regional control targets.
2015 年，世界卫生组织（世卫组织）东南亚区域*报告估计有 4000 万人感染慢性乙型肝炎病毒（HBV），28.5 万人死于慢性感染、肝硬化和肝细胞癌（1）的并发症。大多数慢性 HBV 感染（由血清学检测中存在乙型肝炎表面抗原（HBsAg）表明）是在婴儿期通过围产期或幼儿期传播获得的（2）。为了预防围产期和儿童感染，世卫组织建议所有婴儿至少接种 3 剂乙型肝炎疫苗（HepB），包括及时的出生剂量（HepB-BD）（1）。2016 年，东南亚区域免疫技术咨询小组批准了一项区域乙型肝炎控制目标，到 2020 年，目标是将 5 岁及以上儿童的乙型肝炎表面抗原（HBsAg）血清流行率降至≤1%，这与 2016-2021 年世卫组织全球卫生部门病毒性肝炎战略（2、3）一致。《2016-2020 年东南亚区域疫苗行动计划》（SEARVAP）（4）将加速乙型肝炎控制确定为免疫领域的 8 个区域目标之一。该计划概述了实现乙型肝炎控制的四项主要战略：1）实现≥90%的 3 剂 HepB（HepB3）覆盖率，2）及时提供 HepB 出生剂量（HepB-BD），3）为大龄儿童补种疫苗，4）为高危人群和卫生保健工作者接种成人疫苗（1、4）。2019 年，东南亚区域设立了乙型肝炎问题专家小组，以评估各国的乙型肝炎控制状况。本报告介绍了 2016-2019 年期间东南亚区域在乙型肝炎控制方面取得的进展。到 2016 年，该区域的 11 个国家都在国家免疫规划中引入了 HepB，8 个国家引入了 HepB-BD。2016-2019 年期间，区域 HepB3 覆盖率从 89%增加到 91%，HepB-BD 覆盖率从 34%增加到 54%。2019 年，该区域 9 个国家实现了 HepB3 覆盖率≥90%，提供 HepB-BD 的 8 个国家中有 3 个实现了 HepB-BD 覆盖率≥90%。截至 2019 年 12 月，有 4 个国家已被证实达到了乙型肝炎控制目标。该区域各国可通过采用提高 HepB-BD 和 HepB3 覆盖率的既定战略，在乙型肝炎控制方面取得进一步进展。在儿童中开展具有代表性的全国性乙型肝炎血清学调查，将是跟踪和核实区域控制目标的关键。
