无锡市城区乙型肝炎流行病学调查分析

Prevalence of hepatitis B virus (HBV) in adults at community of Wuxi

目的了解无锡市社区成人乙型肝炎(HB)知识知晓率、乙型肝炎病毒(HBV)感染率和免疫水平,探讨成人HBV免疫策略.方法采用横断面整群抽样的方法入户问卷调查,采集空腹血样并采用ELISA方法检测HBsAg、抗-HBs、HBeAg、抗-Hbe和抗-HBc.结果3744名调查者8项HB相关知识知晓率较高,其中"HB是传染病"单项知晓率高达87.30%,有疫苗接种史者HB知晓率得分≥5分者占60.18%(239/393),明显高于无接种史的49.49%(1071/2164),x^2=17.07,P<0.01;有HBV家族史者知晓率得分≥5分者占60.00%(318/530),明显高于无家族史者的43.00%(1382/3214),x^2=53.05,P<0.01;HBV总感染率经标化后为49.88%;HBV 5项指标全部阴性者1109名,占29.62%;HBsAg、HBeAg和抗HBc 3项同时阳性者为8例,占0.21%;HBsAg、抗-Hbe和抗-HBc 3项同时阳性者133例,占3.55%;男性抗-HBc阳性率显著高于女性,分别为59.37%和53.08%,P=0.00;HBV 5项指标阳性率随着年龄的增长而上升,20岁、80岁年龄组的HBsAg分别是为2.84%和5.69%,抗-HBs分别为44.05%和65.85%,HBeAg分别为0.64%和0.81%,抗-Hbe分别为1.93%和4.07%,抗-HBc分别为33.44%和69.11%,趋势性x^2=256.16,P<0.001;3744名调查者中有HB家族史者占14.16%(530/3744),HBV疫苗接种率为11.77%(393/3339),经标化后为20.20%,有接种疫苗史者抗-HBs阳转率为21.12%(83/393).结论成人HBV感染率高,HBV疫苗接种率低,抗-HBs抗体水平低,提高成人HB免疫水平是降低HBV感染的重要措施.

Objecgive To investigate the HB awareness,the infection rate of HBV and the immunity status among adults at the communities of Wuxi,and to provide some evidences for vaccination strategy.Methods Two communities were enrolled in the study through cluster sampling method.A household survey was conducted to collect subjects' information through a face-to-face interview and blood samples were collected to detect HBsAg,anti-HBs,HBeAg,anti-HBe and anti-HBc.Results 3744 subjects were enrolled in this study.The general knowledge coverage rate of hepatitis B was high and 87.30%respondents claimed that hepatitis B was an infectious disease.The percentage of subjects who got more than 5 scores in persons had got hepatitis B vaccination was 60.18%(239/393),and this was significantly higher than in those without vaccine inoculation(x^2=17.07,P<0.01),with the proportion being 49.49%(1071/2164).rnIe percentage of subjects who got more than 5 scores in persons had family history of HBV infection was 60.00%(318/530),and this wag significantly higher than in those without family history (x^2=53.05,P<0.01),with the proportion of 43.00%(1382/3214).The standardized HBV infection rate was 49.88%.There were 1109(29.62%)subjects whose HBsAg,anti-HBs,HBeAg,anti-HBe and HBcAg were negative.There were 8 subjects(0.21%) whose HBsAg,HBeAg and anti-HBc were positive simultaneously,and there were 133 subjects(3.55%)whose HBsAg,anti-HBe and anti-HBc were positive simultaneously.The positive rate of anti-HBc was significantly higher in males than in females( 59.37%and 53.08%,P=0.00).The positive rates of HBsAg,anti-HBs,HBeAg,anti-HBe and HBcAg were 2.84%,44.05%,0.64%,1.93%,33.44%respectively in 20 year age group,while they were 5.69%,65.85%,0.81%,4.07%,69.44%respectively in 80 year age group.The positive rates of anti-HBs,HBeAg,anti-HBe and HBcAg increased with age(x^2trend=256.16,P<0.001).Among 3744 objects,530 subjects (accounted for 14.16%)had the family history of hepatitis B.HB immunization coverage rate was 11.77% (393/3339),with the standardized rate being 20.20%.The positive conversion rate of anti-HBs among those had HB vaccine inoculation was 21.12%(83/393).Conclusion The infection rate of HBV was high,whereas the immunization rate of hepatitis B vaccine and the level of anti-HBs were low in adults,Thus,to improve the immunization rate of hepatitis B vaccine is a key step to decrease the infection rate.