School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia.
University of Queensland, Brisbane, Queensland, Australia.
J Viral Hepat. 2021 Oct;28(10):1400-1412. doi: 10.1111/jvh.13580. Epub 2021 Aug 8.
Chronic hepatitis B prevalence is low in most Australian populations, with universal infant HBV vaccination introduced in 2000. Migrants from high prevalence countries are at risk of acquisition before arrival and non-immune adults are potentially at risk through skin penetrating procedures and sexual contact, particularly during international travel. The risk profile of young adult students, many from high prevalence countries, is inadequately understood. A cross-sectional online survey conducted among university students collected data on demographic, vaccination and travel characteristics and blood samples were tested for hepatitis B surface antibody (HBsAb) and hepatitis B core antibody (HBcAb). Analyses identified factors associated with HBsAb seroprevalence and self-reported vaccination. The serosurvey was completed by 804 students born between 1988 and 1993, with 613/804 (76.2%, 95% CI 73.2-79.1) self-reporting prior HBV vaccination. Overall, 526/804 (65.4%, 95% CI 62.0%-68.6%) students were seropositive to HBsAb, including 438/613 (71.5%, 95% CI 67.8-74.9) students self-reporting a prior HBV vaccine and 88/191 (46.1%, 95% CI 39.2-53.2) students self-reporting no prior HBV vaccine. Overall, 8/804 (1.0%, 95% CI 0.5%-2.0%) students were HBcAb positive, of whom 1/804 (0.1%, 95% CI 0.02%-0.7%) was currently infectious. The prevalence of chronic HBV infection was low. However, more than one in four students were susceptible to HBV and over-estimated their immunity. Future vaccination efforts should focus on domestic students born before the introduction of the infant program and all international students. Screening and vaccination of students, including through campus-based health services, are an opportunity to catch-up young adults prior to undertaking at-risk activities, including international travel.
在大多数澳大利亚人群中，慢性乙型肝炎的患病率较低，2000 年已普及婴儿乙型肝炎病毒（HBV）疫苗接种。来自高流行国家的移民在抵达前有感染风险，未免疫的成年人可能通过皮肤穿透性程序和性接触感染，尤其是在国际旅行期间。来自高流行国家的许多年轻成年学生的风险概况了解不足。一项针对大学生的横断面在线调查收集了人口统计学、疫苗接种和旅行特征的数据，并对乙型肝炎表面抗体（HBsAb）和乙型肝炎核心抗体（HBcAb）进行了血液检测。分析确定了与 HBsAb 血清阳性率和自我报告接种相关的因素。804 名学生完成了血清学调查，他们出生于 1988 年至 1993 年之间，其中 613/804 名（76.2%，95%CI73.2-79.1）报告曾接种过 HBV 疫苗。总体而言，804 名学生中有 526/804 名（65.4%，95%CI62.0%-68.6%）对 HBsAb 呈血清阳性，包括 438/613 名（71.5%，95%CI77.8-74.9）报告曾接种过 HBV 疫苗的学生和 88/191 名（46.1%，95%CI39.2-53.2）报告未接种过 HBV 疫苗的学生。总体而言，804 名学生中有 8/804 名（1.0%，95%CI0.5%-2.0%）HBcAb 阳性，其中 1/804 名（0.1%，95%CI0.02%-0.7%）目前具有传染性。慢性 HBV 感染的患病率较低。然而，超过四分之一的学生易感染 HBV，且对自身免疫力的估计过高。未来的疫苗接种工作应重点关注婴儿计划实施前出生的国内学生和所有国际学生。对学生进行筛查和接种疫苗，包括通过校园卫生服务，是在从事高风险活动（包括国际旅行）之前赶上年轻成年人的机会。
