广东省乙型肝炎血清流行病学调查研究

Sero-epidemiological Study on Hepatitis B Virus Infection in Guangdong Province

目的了解广东省人群乙型肝炎（乙肝）病毒（HBV）感染现状,评价乙肝疫苗免疫策略的效果。方法采取多阶段随机抽样方法,对全省6县区3 927名1-59岁人群进行乙肝血清流行病学研究,用ELISA方法检测乙肝表面抗原（HBsAg）、乙肝表面抗体（抗-HBs）和乙肝核心抗体（抗-HBc）,并调查1-14岁儿童乙肝疫苗接种情况。结果广东省1-59岁人群HBsAg阳性率、抗-HBs阳性率、抗-HBc阳性率和HBV感染率经标化后分别为15.46%、61.51%、49.46%和66.20%。1-14岁人群HBsAg阳性率和HBV感染率明显低于15-59岁人群。1-4岁人群HBsAg阳性率和HBV感染率低于5-14岁人群,而抗-HBs阳性率高于5-14岁人群。HBsAg阳性率和HBV感染率：男性高于女性,农村高于城市,城市人群抗-HBs阳性率高于农村。1-4岁儿童乙肝疫苗接种率为91.90%,全程接种率89.01%,首针及时接种率为58.38%,明显高于5-14岁人群。结论广东省仍是乙肝高流行区;乙肝疫苗纳入儿童免疫策略效果显著,1-14岁人群HBsAg携带率和HBV感染有不同程度下降,1-4岁下降尤为明显。

Objective To understand the infection status of hepatitis B in Guangdong province and to evaluate the effects of immunization strategy of hepatitis B vaccine. Methods A multi - stage duster - randomized sampling was designed to survey 3 927 people aged 1 -59 years in 6 counties of the province. The HBsAg, anti - HBs and anti - HBc were tested with ELISA reagent. The vaccination coverage rate of hepatitis B for 1 - 14 year - old children was investigated. Results Among the population aged 1 - 59 years in Guangdong province, the standardized positive rates of HBsAg, anti - HBs, anti - HBc and the standardized infection rate of HBV were 15. 46%, 61.51%, 49. 46% and 66. 20%, respectively. The positive rate of HB- sAg and the infection rate of HBV for children aged 1 - 14 years were significantly lower than those for the age - group of 15 - 59. For 1 -4 year - old children, the positive rate of HBsAg and the infection rate of HBV were significantly lower than those for 5 -14 year-dd population, but the positive rate of anti -HBs was higher distinctly. For the positive rates of HBsAg and the infection rates of HBV, the male＇s rates were higher than female＇s and the rates of the rural population were higher than those of the urban population. The positive rate of anti - HBs for the urban population was higher than that of the rural population. The vaccination coverage rate, full course vaccination rate and timely first - dose vaccination rate of hepatitis B vaccine for 1 - 4 year old children were 91.90%, 89. 01% and 58.38%, respectively, which were higher than those of the age -group of 5 - 14. Conclusion Since hepatitis B vaccine was introduced into the Expanded Program on Immunization （EPI） in 1992, the prevalent rates of HBsAg and HBV infection for 1 - 14 year - old population, especially among the age - group of 1 - 4, had declined obviously, but HBV infection was still a disease of high endemicity in Guangdong province.