贵州省1-29岁人群乙型肝炎病毒血清学标志物感染模式的变化分析

Prevalence of combinations of hepatitis B virus serological markers among people aged 1-29 years in Guizhou province

目的分析2006年和2014年贵州省1-29岁人群乙型肝炎（乙肝）病毒（Hepatitis B virus,HBV）血清学标志物（HBV marks,HBVM）模式,评价乙肝疫苗（Hep B）纳入免疫规划的效果。方法采用多阶段随机抽样方法分别抽取2006年和2014年1-29岁常住人口,采集血标本,采用酶联免疫吸附试验检测5项HBVM,包括HBV表面抗原（HBV surface antigen,HBs Ag）、抗HBs Ag抗体（Antibody to HBs Ag,Anti-HBs）、抗HBV核心抗原抗体（Antibodies to HBV core antigen,Anti-HBc）、HBV e抗原（HBV e antigen,HBe Ag）和抗HBe Ag抗体（Antibody to HBe Ag,AntiHBe）。结果 2006年、2014年调查分别检出HBVM模式9种、7种,均以模式7（Anti-HBs和Anti-HBc阳性）、模式8（单纯Anti-HBs阳性）、模式9（HBVM五项全阴性）为主,2006年分别占7.14%、39.44%、48.52%,2014年分别占4.47%、50.00%、41.73%。2006年和2014年1-4岁组模式7、模式8、模式9构成比分别为3.17%和0.66%、69.39%和75.42%、23.81%和22.59%;5-14岁组分别为6.35%和0.00%、26.93%和41.10%、62.54%和56.78%;15-29岁组分别为18.41%和15.50%、13.93%和22.00%、57.71%和53.00%。结论贵州省Hep B纳入免疫规划明显提高了与保护有关的HBVM模式8,降低了与感染和缺乏保护有关的模式7和模式9;建议对5-29岁人群开展Hep B查漏补种。

Objective To determine the prevalence of combinations of hepatitis B virus markers（HBVMs） among 1-29 year-olds,and to evaluate the effect of introducing hepatitis B vaccine（Hep B） into the Expanded Program on Immunization（EPI） in Guizhou province. Methods Multi-stage random sampling was used to select 1-29 year-olds in Guizhou in 2006 and again in 2014. Serum samples were obtained from each subject to measure with enzyme-linked immunosorbent assays 5 HBVMs,including HBV surface antigen（HBs Ag）,antibody to HBs Ag（Anti-HBs）,antibody to HBV core antigen（AntiHBc）,HBV e antigen（HBe Ag）,and antibody to HBe Ag（Anti-HBe）. Results We found 9 predominant combinations of HBVMs in 2006 and 7 in 2014. In 2006,combination 7（Anti-HBs and Anti-HBc positive）,combination 8（Anti-HBs positive）,and combination 9（all HBVMs negative） were the most prevalent, accounting for 7. 14%, 39. 44%, and 48. 52% of subjects, respectively; in 2014,prevalence rates of these combinations were 4. 47%,50. 00%,and 41. 73%,respectively. Relative,respective proportions of the three combinations for 2006 vs 2014 were 3. 17% vs 0. 66%,69. 39% vs75. 42%,and 23. 81% vs 22. 59% in 1-4 year-olds; 6. 35% vs 0. 00%,26. 93% vs 41. 10%,62. 54%vs 56. 78% in 5-14 years-olds; and 18. 41% vs 15. 50%,13. 93% vs 22. 00%,and 57. 71% vs53. 00% in 15-29 year-olds. Conclusions HBVM combination 8（associated with protection）increased,and combinations 7 and 9（associated with infection and lack of protection,respectively）decreased after introduction of Hep B into EPI in Guizhou. We suggest supplementary Hep B vaccination of5-29 year-olds.