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在秘鲁引入首个乙型肝炎疫苗试点计划 23 年后,该地区乙型肝炎和丁型肝炎病毒感染的流行率下降。

Decrease in the prevalence of hepatitis B and D virus infections in an endemic area in Peru 23 years after the introduction of the first pilot vaccination program against hepatitis B.

机构信息

Centro Nacional de Salud Puública, Instituto Nacional de Salud, Lima, Peru.

Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru.

出版信息

PLoS One. 2020 Aug 6;15(8):e0236993. doi: 10.1371/journal.pone.0236993. eCollection 2020.

Abstract

In 1991, Peru launched the first vaccination program against hepatitis B in children aged under 5 years in the hyperendemic [hepatitis B virus (HBV) and hepatitis D virus (HDV)] province of Abancay. We conducted a cross-sectional study to determine the prevalence of HBV and HDV infections, 23 years after the launch of the vaccination program, as well as the post-vaccine response against hepatitis B in terms of prevalence of hepatitis B surface antibody (anti-HBs ≥10 mUI/ml). Among 3165 participants aged from 0 to 94 years, the prevalence rates of hepatitis B surface antigen (HBsAg), and hepatitis B core antibody (total anti-HBc) were 1.2% [95% confidence interval (CI) 0.85-1.64%], and 41.67% (95% CI 39.95-43.41%), respectively. The prevalence rate of anti-HBs at protective levels (≥10 mUI/ml) in individuals who HBsAg and anti-HBc negative was 66.36% (95% CI 64.15-68.51%). The prevalence rate of HBsAg in children aged <15 years was nil, and among adult HBsAg carriers, the prevalence of hepatitis D antibody (anti-HDV) was 5.26% (2/38; 95% CI 0.64-17.74). These findings showed that HBV prevalence has changed from high to low endemicity, 23 years following implementation of the vaccination program against hepatitis B, and HDV infection was not detected in those aged <30 years.

摘要

1991 年,秘鲁在阿班凯(乙型肝炎病毒[HBV]和丁型肝炎病毒[HDV]高度流行)省启动了针对 5 岁以下儿童的乙型肝炎疫苗接种计划。23 年后,我们开展了一项横断面研究,以确定 HBV 和 HDV 感染的流行率,以及疫苗接种计划后针对乙型肝炎的疫苗反应,具体表现为乙型肝炎表面抗体(抗-HBs≥10mUI/ml)的流行率。在 3165 名年龄在 0 至 94 岁之间的参与者中,乙型肝炎表面抗原(HBsAg)和乙型肝炎核心抗体(总抗-HBc)的流行率分别为 1.2%(95%置信区间[CI]0.85-1.64%)和 41.67%(95%CI39.95-43.41%)。HBsAg 和抗-HBc 均阴性者的保护性抗-HBs(≥10mUI/ml)流行率为 66.36%(95%CI64.15-68.51%)。15 岁以下儿童的 HBsAg 流行率为零,而在成年 HBsAg 携带者中,抗-HDV 的流行率为 5.26%(2/38;95%CI0.64-17.74)。这些发现表明,乙型肝炎疫苗接种计划实施 23 年后,HBV 的流行率已从高流行转为低流行,且在年龄<30 岁的人群中未检测到 HDV 感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aec7/7410281/59793961806f/pone.0236993.g001.jpg

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