Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.
Xi'an Center for Disease Control and Prevention, Xi'an, Shaanxi, China.
Vaccine. 2024 Oct 24;42(24):126259. doi: 10.1016/j.vaccine.2024.126259. Epub 2024 Sep 3.
While hepatitis B virus (HBV) infection in children has declined dramatically in China due to the vaccination strategy for newborns, HBV infection in high-risk adults is receiving an increasing attention. The number of people who use drugs (PWUD) in China is huge, but their status of HBV infection and vaccination is less reported, especially from large samples. The related knowledge can help decision makers develop the further strategy of HBV prevention and control.
A seroepidemiological survey was conducted in all four compulsory isolated detoxification centers (CIDCs) and all eight methadone maintenance treatment (MMT) clinics located in Xi'an, China. All PWUD who were undergoing detoxification or treatment in these settings were included. A questionnaire was designed to obtain the information of HBV vaccination history of participants, and sociodemographic and behavioral data of participants were obtained from the registration records of their respective CIDCs or MMT clinics.
A total of 4705 PWUD participated in the survey. Positive rates of HBsAg (current infection) and HBsAg or anti-HBc (current/past infection) were 5.50% and 58.02%, notably higher than those reported for the general adult population in the same province during the same period. As age increased, the anti-HBc positive rate increased with statistically significant trend. The all-negative for HBsAg, anti-HBc, and anti-HBs accounted for 28.82%. Only 18.49% were identified by the questionnaire as having received HBV vaccine. The logistic regression found that compared with identified vaccinated PWUD, those unsure if having been vaccinated and those identified non-vaccinated had a significantly higher HBV current/past infection rate, with an increasing trend.
PWUD are a high-risk adult group of HBV infection in China. Of them, more than half have not received HBV vaccine, and a significant portion are susceptible to HBV. Catch-up vaccination is need for this population to prevent and control HBV transmission.
在中国，由于新生儿接种疫苗策略，儿童乙型肝炎病毒 (HBV) 感染率显著下降，但高危成年人的 HBV 感染受到越来越多的关注。中国的吸毒者人数庞大，但他们的 HBV 感染和疫苗接种状况报告较少，尤其是来自大样本的报告。相关知识可以帮助决策者制定进一步的 HBV 预防和控制策略。
在中国西安的所有四个强制隔离戒毒中心 (CIDC) 和所有八个美沙酮维持治疗 (MMT) 诊所进行了血清流行病学调查。所有在这些场所接受戒毒或治疗的吸毒者都包括在内。设计了一份问卷，以获取参与者的 HBV 疫苗接种史信息，并从各自 CIDC 或 MMT 诊所的登记记录中获取参与者的社会人口学和行为数据。
共有 4705 名吸毒者参加了调查。HBsAg（现症感染）和 HBsAg 或抗-HBc（现症/既往感染）的阳性率分别为 5.50%和 58.02%，明显高于同期同省一般成年人群的报告率。随着年龄的增长，抗-HBc 阳性率呈上升趋势，有统计学意义。HBsAg、抗-HBc 和抗-HBs 均为阴性的占 28.82%。只有 18.49%的人通过问卷被确定为接种过乙肝疫苗。逻辑回归发现，与已接种疫苗的吸毒者相比，不确定是否接种过疫苗和未接种疫苗的吸毒者 HBV 现症/既往感染率显著更高，呈上升趋势。
吸毒者是中国 HBV 感染的高危成年人群体。其中，超过一半的人未接种 HBV 疫苗，相当一部分人易感染 HBV。需要对这一人群进行补种疫苗，以预防和控制 HBV 传播。
