2014年中国六省份孕产妇乙型肝炎病毒表面抗原筛查及新生儿免疫预防调查分析

HBsAg Screening among Pregnant Women and Neonatal Immunization in Six Provinces of China,2014

目的了解中国不同地区孕产妇乙型肝炎病毒(Hepatitis B Virus,HBV)表面抗原筛查及新生儿免疫预防实施情况,为完善HBV母婴传播阻断策略提供参考依据。方法在东、中、西部地区共选取6个省份的18家医院,调查医院孕产妇产前HBV表面抗原(Hepatitis B Virus Surface Antigen,HBsAg)筛查、新生儿乙型肝炎疫苗(Hepatitis B Vaccine,Hep B)及乙型肝炎免疫球蛋白(Hepatitis B Immunoglobulin,HBIG)接种等情况。结果 18家调查医院均已开展HBV母婴传播阻断项目,孕产妇产前HBsAg总筛查率为99.36%,西部地区、县级医院筛查率较低,分别为98.14%和98.10%。18家医院自行采购检测试剂来自11家企业。调查医院的Hep B首剂次(HepB_1)及时接种率为93.56%,其中西部地区、省级医院分别为92.26%、93.14%。HBsAg阳性孕产妇所生新生儿HepB_1及时接种率和HBIG接种率分别为98.66%和99.28%。结论调查地区HBV携带传播母婴阻断措施实施总体良好,但需进一步关注西部地区孕产妇HBsAg筛查和新生儿HepB_1及时接种工作,促进基层医院分娩的HBsAg阳性产妇新生儿联合接种HBIG,并对HBsAg检测试剂开展评价。

Objective To evaluate screening of pregnant women for hepatitis B virus（ HBV） surface antigen（ HBsAg） and vaccination of infants against HBV in China,and to provide evidence to improve strategies to prevent perinatal transmission of HBV.Methods Eighteen hospitals were selected from 6provinces in eastern,middle and western China to investigate screening of pregnant women for HBsAg,vaccination with hepatitis B vaccine（ Hep B） and administration of hepatitis B immunoglobulin（ HBIG）to infants.Results All hospitals conducted programs to prevent maternal-neonatal transmission of HBV.The average HBsAg screening rate among pregnant women was 99.36%,with lower levels in western areas and county hospitals of 98.14% and 98.10%,respectively.The HBsAg assay kits were from 11 different manufacturers.The average coverage with a timely birth dose of Hep B（ HepB_1） was 93.56%,with lower levels in western areas and provincial hospitals of 92.26% and 93.14%,respectively.The averages for use of timely HepB_1 and administration of HBIG among infants born to HBsAg-positive mothers were 98.66% and 99.28%,respectively.Conclusions Implementation of hospital-based strategiesto prevent maternal-neonatal transmission of HBV were generally good.More effort should be made to promote the HBsAg screening of pregnant women in western areas,as well as timely HepB_1 and HBIG use in infants.The reliability of assay kits for HBsAg testing should be evaluated.