海南省2013年乙型病毒性肝炎高流行区育龄妇女血清学调查

A hepatitis B serological survey among women of childbearing age in high-prevalence areas of Hainan province,2013

目的了解2013年海南省乙型病毒性肝炎(乙肝)高流行区育龄妇女乙肝病毒(HBV)感染情况,评估乙肝疫苗(HepB)接种效果。方法采用分层随机抽样方法在海南省3个乙肝高流行县(区、市),抽取15-49岁女性进行调查并采集血清标本;检测血清HBV表面抗原(HBsAg)、抗HBsAg抗体(Anti-HBs)、抗HBV核心抗原抗体(AntiHBc)、HBV e抗原(HBe Ag)、抗HBe Ag抗体(Anti-HBe)、HBV-DNA载量和HBV基因型,进行描述性分析。结果育龄妇女的HBsAg、Anti-HBs、Anti-HBc阳性率分别为8.88%(151/1 701)、55.50%(944/1 701)、15.23%(259/1 701);HBsAg阳性者中HBe Ag、Anti-HBe、HBV-DNA载量阳性率分别为32.45%(49/151)、65.56%(99/151)、47.68%(72/151);HBV-DNA载量阳性者中B、C、B+C基因型分别占25.00%(18/72)、72.22%(52/72)、2.78%(2/72)。育龄妇女的年龄别HBsAg阳性率在7.04%(40-49岁)-10.65%(20-29岁)之间(χ~2=5.27,Р<0.05);有、无、不详HepB免疫史人群HBsAg阳性率分别为6.43%、12.09%、8.65%(χ~2=9.77,Р=0.008);职业别人群HBsAg阳性率在2.53%(学生)-15.04%(公共场所人员)之间(χ~2=11.60,Р=0.007)。结论海南省2013年乙肝高流行区育龄妇女的HBV感染率处于较高水平,以C基因型为主;需继续加强HepB预防接种工作,落实HBV母婴传播阻断干预措施。

Objective To determine the infection status of hepatitis B virus（ HBV） among women of childbearing age in high-prevalence areas of Hainan province in 2013,and to evaluate the impact of hepatitis B vaccine（ HepB）. Methods We used stratified random sampling to select 15-49-year-old women from 3 high-HBV-prevalence counties for a survey with serum sample collection. We measured HBV surface antigen（ HBsAg）,antibody against HBsAg（ Anti-HBs）,antibody against HBV core antigen（ Anti-HBc）,HBV e antigen（ HBe Ag）,antibody against HBe Ag（ Anti-HBe）,HBV-DNA load,and HBV genotype for descriptive analyses. Results The positivity rates of HBsAg,Anti-HBs and Anti-HBc among childbearing age women were 8. 88%（ 151/1 701）,55. 50%（ 944/1 701） and 15. 23%（ 259/1 701）,respectively; the positivity rates of HBe Ag,Anti-HBe and HBV-DNA load among HBsAg positive subjects were 32. 45%（ 49/151）,65. 56%（ 99/151） and 47. 68%（ 72/151）,respectively; and the distribution of genotypes B,C and B ＋ C in HBV-DNA load positive subjects were 25. 00%（ 18/72）,72. 22%（ 52/72） and 2. 78%（ 2/72）,respectively. The age-specific positivity rates of HBsAg among childbearing age women ranged from 7. 04%（ 40-49 years old） to 10. 65%（ 20-29 years old）（ χ^2= 5. 27,Р〈0. 05）. The positivity rates of HBsAg in subjects who received,did not receive,and unclearly received HepB were 6. 43%,12. 09%,and 8. 65%（ χ^2= 9. 77, Р = 0. 008）,respectively. The occupation-specific HBsAg positivity rates ranged from 2. 53%（ students） to15. 04%（ public place staff）（ χ^2= 11. 60,Р =0. 007）. Conclusions The HBV infection rate was high among childbearing age women in Hainan in 2013,and was predominately genotype C. We should continue to strengthen HepB vaccination and intervention measures for interrupting mother-to-child transmission of HBV.