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中国山东省消除乙肝母婴传播的进展:2017 - 2024年乙肝疫苗接种和乙肝免疫球蛋白接种的覆盖趋势

Progress toward elimination mother-to-child transmission of HBV in Shandong Province, China: Coverage trend in hepatitis B vaccination and HBIG administration, 2017-2024.

作者信息

Meng Xin, Zhang Weiling, Yan Bingyu, Feng Yi, Lu Jingjing, Zhang Li

机构信息

Institute of Immunization Prevention Management, Shandong Center for Disease Control and Prevention, Jinan, Shandong Province, China.

Immunization Program Division, Daiyue Center for Disease Control and Prevention, Taian, Shandong Province, China.

出版信息

Hum Vaccin Immunother. 2025 Dec;21(1):2554029. doi: 10.1080/21645515.2025.2554029. Epub 2025 Sep 5.

Abstract

To evaluate progress toward MTCT elimination of HBV, we analyzed 8-y trends in hepatitis B vaccine (HepB) and hepatitis B immune globulin (HBIG) administration coverage rates in Shandong province, focusing on high-risk populations. Data were collected from a provincial system, Shandong Vaccination Information System. Information of maternal HBsAg+ neonates born in 2017-2024 were extracted. Administration coverage in four groups (A: general newborn, B: maternal HBsAg+ neonates, C: preterm neonates with HBsAg+ mother, and D: birthweight <2000 g (LBW2000) neonates with HBsAg+ mother) were calculated. Joinpoint models were used to analyze changing trends over time, calculating annual percentage change (APC). From 2017 to 2024, the maternal HBsAg+ rate dropped from 2.85% to 2.10% (APC = -0.10,  < .001), with an accelerating rate of decrease after 2021. Timely HepB birth dose (HepB-BD) vaccination coverage rose annually, reaching 94.42% in Group C (APC = 4.92,  = .001) and 86.26% in Group D (APC = 5.86,  < .001). Timely HBIG administration coverage increased significantly before 2021, achieving high levels by 2024 except in Group D (93.96%). The 4th dose of HepB (HepB4) vaccination coverage in Group D showed a nonsignificant increase (56.51% to 72.93%), with median administration time decreasing from 13.24 to 8.59 months. MTCT Elimination of HBV has improved substantially. However, LBW2000 neonates born to HBsAg+ mothers require focused attention, particularly regarding administration coverage of timely HBIG and HepB4. Enhanced health education for parents and additional clinical training for healthcare providers are needed to improve intervention coverage.

摘要

为评估消除乙肝母婴传播(MTCT)的进展情况,我们分析了山东省乙肝疫苗(HepB)和乙肝免疫球蛋白(HBIG)接种覆盖率的8年趋势,重点关注高危人群。数据来自省级系统山东省疫苗接种信息系统。提取了2017 - 2024年出生的母亲乙肝表面抗原(HBsAg)阳性新生儿的信息。计算了四组人群(A组:普通新生儿;B组:母亲HBsAg阳性新生儿;C组:母亲HBsAg阳性的早产儿;D组:母亲HBsAg阳性且出生体重<2000g(LBW2000)的新生儿)的接种覆盖率。采用Joinpoint模型分析随时间的变化趋势,计算年度百分比变化(APC)。2017年至2024年,母亲HBsAg阳性率从2.85%降至2.10%(APC = -0.10,P <.001),2021年后下降速度加快。及时接种首剂乙肝疫苗(HepB - BD)的覆盖率逐年上升,C组达到94.42%(APC = 4.92,P =.001),D组达到86.26%(APC = 5.86,P <.001)。2021年前及时接种HBIG的覆盖率显著增加,到2024年除D组外均达到较高水平(93.96%)。D组第4剂乙肝疫苗(HepB4)接种覆盖率有不显著增加(从56.51%增至72.93%),接种中位时间从13.24个月降至8.59个月。消除乙肝母婴传播取得了显著改善。然而,母亲HBsAg阳性的LBW2000新生儿需要重点关注,特别是及时接种HBIG和HepB4的覆盖率。需要加强对家长的健康教育,并为医护人员提供额外的临床培训,以提高干预措施的覆盖率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2fc/12416202/9afc1a2cf535/KHVI_A_2554029_F0001_OC.jpg

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