疫苗时代人群乙型肝炎血清流行病学研究

Serological Study on Status of Hepatitis B Virus Infection and Carry in Vaccinated Population: A Historical Comparison.

目的研究乙型肝炎(乙肝)疫苗免疫时代人群乙肝病毒(HBV)感染状况与抗体水平.方法于1984年、1999年分别采集上海市黄浦区(原南市区)1～49岁人群血清1 540份和838份,检测乙肝病毒表面抗原(HBsAg)、乙肝病毒表面抗体(抗-HBs)、乙肝病毒核心抗体(抗-HBc),分析并比较各组HBV携带率与感染率.结果1999年横断面调查中,各年龄组HBV携带率与感染率较1984年各年龄组均有所下降,其中以免疫人群下降更为显著.结论新生儿乙肝疫苗免疫是控制及消除人群HBV感染的有效措施.

Objective To study the status of hepatitis B virus infection and carry in mass immunized population. Methods Serological cross-section survey were conducted in 1984 and 1999 in Nanshi District, Shanghai. 1540 and 838 serum specimens were collected from population aged 1-49 years. In 1991,1067 serum specimens were collected from young children aged 1-6 years in Changning District, Shanghai. Each specimen was tested for HBsAg, anti-HBs and anti-HBc. The carry and infection rate of hepatitis B virus by different age groups were calculated and analyzed among three cross-section surveys. Result The positive rate of HBsAg and anti-HBc decreased in every age groups in vaccination era compared to it in non-vaccine era, especially in immunized population, the results were quite similar with the results of cohort study which vaccinated in 1986. The positive rate of anti-HBs of sujects who finished the primary regimens decreased with the increase of age. However, the positive rate of anti-HBs （titer≥10mIU/mL） still reached 56.67% to 60.00% in 12-13 years old age group, and there was no change on HBVM Conclusion Widespread immunization with hepatitis B vaccine is the efficient measure to control and eliminate hepatitis B virus infection. However, it was not the only factor impacted on the decline of hepatitis B virus infection.