Centers for Disease Control and Prevention (CDC), Atlanta, USA; CDC South Caucasus Office, Tbilisi, Georgia.
Public Health Center, Ministry of Health of Ukraine, Kyiv, Ukraine.
Vaccine. 2021 Mar 5;39(10):1485-1492. doi: 10.1016/j.vaccine.2021.02.004. Epub 2021 Feb 12.
Before hepatitis B vaccine (HepB) introduction, level of endemicity of hepatitis B virus (HBV) in Ukraine was estimated as intermediate but the prevalence of HBV infection markers has not been measured in population-based serosurveys. Coverage with 3 doses of HepB, introduced in 2002, was 92%-98% during 2004-2007 but declined to 21%-48% during 2010-2016. To obtain data on HBV prevalence among children born after HepB introduction, we tested specimens from a serosurvey conducted in Ukraine in 2017, following circulating vaccine-derived poliovirus outbreak in 2015, among birth cohorts eligible for polio immunization response.
The serosurvey was conducted in Zakarpattya, Sumy, and Odessa provinces, and Kyiv City, targeting 2006-2015 birth cohorts. One-stage cluster sampling in the provinces and stratified simple random sampling in Kyiv were used for participant selection. All participants were tested for antibodies against HBV core antigen (anti-HBc). Anti-HBc-positive children were tested for HBV surface antigen (HBsAg). We also obtained information on HepB vaccination status for all children.
Of 4,596 children tested, 81 (1.8%) were anti-HBc-positive and eight (0.2%) were HBsAg-positive. HBsAg prevalence was 0.7% (95% confidence interval, 0.3%-1.4%) in Zakarpattya, 0.1% (0.0%-0.4%) in Sumy, 0% (0.0%-03%) in Odessa, and 0.1% (0.0%-0.8%) in Kyiv. Across survey sites, the proportion of recipients of ≥ 3 HepB doses was 53%-80% in the 2006-2009 cohort and 28%-59% in the 2010-2015 cohort.
HBV prevalence among children in surveyed regions of Ukraine in 2017 was low, including in Zakarpattya-the only site above the 0.5% European Regional target for HBsAg seroprevalence. However, HepB vaccination was suboptimal, particularly among children born after 2009, resulting in large numbers of unvaccinated or incompletely vaccinated children at risk of future HBV infection. HepB coverage should be increased to further reduce HBV transmission among children in Ukraine and achieve regional and global hepatitis B control/elimination targets.
在乙型肝炎疫苗（HepB）引入之前，乌克兰乙型肝炎病毒（HBV）的流行程度估计为中等水平，但在基于人群的血清学调查中并未测量 HBV 感染标志物的流行率。2002 年引入的 3 剂 HepB 的覆盖率在 2004-2007 年期间为 92%-98%，但在 2010-2016 年期间下降至 21%-48%。为了获得乙型肝炎病毒在 HepB 引入后出生的儿童中的流行率数据，我们在 2015 年循环疫苗衍生脊髓灰质炎病毒爆发后，于 2017 年在乌克兰进行了一项血清学调查，该调查针对有资格接受脊髓灰质炎免疫反应的 2006-2015 年出生队列。
该血清学调查在扎卡尔帕蒂亚、苏梅和敖德萨省以及基辅市进行，针对 2006-2015 年出生的队列。在各省采用单阶段聚类抽样，在基辅采用分层简单随机抽样选择参与者。所有参与者均接受乙型肝炎核心抗原（抗-HBc）抗体检测。抗-HBc 阳性的儿童接受乙型肝炎表面抗原（HBsAg）检测。我们还为所有儿童获取了 HepB 疫苗接种情况的信息。
在接受检测的 4596 名儿童中，81 名（1.8%）抗-HBc 阳性，8 名（0.2%）HBsAg 阳性。HBsAg 的流行率在扎卡尔帕蒂亚为 0.7%（95%置信区间，0.3%-1.4%），在苏梅为 0.1%（0.0%-0.4%），在敖德萨为 0%（0.0%-03%），在基辅为 0.1%（0.0%-0.8%）。在整个调查地点，2006-2009 队列中≥3 剂 HepB 接种率为 53%-80%，2010-2015 队列中为 28%-59%。
2017 年乌克兰调查地区儿童的乙型肝炎病毒流行率较低，包括在扎卡尔帕蒂亚——唯一一个 HBsAg 血清阳性率超过 0.5%的欧洲区域目标的地区。然而，HepB 疫苗接种情况并不理想，尤其是在 2009 年后出生的儿童中，大量未接种或未完全接种疫苗的儿童面临未来感染乙型肝炎病毒的风险。应增加 HepB 疫苗接种覆盖率，以进一步减少乌克兰儿童中的乙型肝炎病毒传播，并实现区域和全球乙型肝炎控制/消除目标。
