2009-2016年安徽省急性乙型病毒性肝炎监测分析

Acute hepatitis B in Anhui province,2009 to 2016

目的研究安徽省急性乙型病毒性肝炎（乙肝）报告发病率的现况。方法从传染病报告信息管理系统中获取安徽省2009-2016年乙肝病例数据;通过检测乙肝核心抗原IgM（IgM against hepatitis B core antigen,HBc-IgM）对2013-2016年6个监测点乙肝病例分类进行订正,比较全省和监测点急性乙肝报告发病率。结果 2013-2016年6个监测点报告急性、慢性和未分类乙肝分别为115例（2.09%）、5 273例（95.73%）、120例（2.18%）;订正后分别为88例（1.60%）、5 406例（98.33%）、4例（0.07%）。6个监测点急性乙肝报告发病率从2009年的2.45/10万下降到2016年的0.36/10万;同期全省从4.53/10万下降到2.41/10万。2013-2016年6个监测点2000年后出生人群（〈15岁）急性乙肝报告发病率维持在0.13/10万以下,1986-1990年出生人群发病率最高（1.19/10万）,之后逐渐降低到0.29/10万;同期全省2001-2005年出生人群发病率最低（0.28/10万）,1986-1990年出生人群发病率最高（5.60/10万）。结论乙肝疫苗纳入免疫规划后使急性乙肝得到了有效控制。HBc-IgM检测可指导乙肝监测和分类。

Objective To determine the incidence of acute hepatitis B in Anhui province. Methods We obtained data on hepatitis B cases reported in Anhui from 2009 to 2016 from the Chinese Disease Prevention and Control Information System. We detected IgM antibody against hepatitis B core antigen（ HBc-IgM） to correct the classifications of hepatitis B cases reported between 2013 and 2016 at 6 monitoring points,and compared acute hepatitis B incidence rates between the province and the monitoring points. Results From 2013 to 2016,115（ 2. 09%）,5 273（ 95. 73%）,and 120（ 2. 18%） cases of acute,chronic,and unclassified hepatitis B,respectively,were reported in the monitoring points. After correction,the reported cases were classified as acute,88（ 1. 60%）; chronic,5 406（ 98. 33%）; and unclassified,4（ 0. 07%）. The incidence of reported acute hepatitis B dropped from 2. 45 per 100 000 population in 2009 to 0. 36 per 100 000 population in 2016 in the monitoring points,and from 4. 53 per 100 000 to 2. 41 per 100 000 in the province. In the monitoring points,the incidence of acute hepatitis B during 2013-2016 remained less than 0. 13 per 100 000 among people born after 2000（ 15 years old）,with the highest incidence of 1. 19 per 100 000 among people born between 1986 and 1990,subsequently decreasing to 0. 29 per 100 000. In the province,the lowest incidence was 0. 28 per 100 000 among people born between 2001 and 2005,and the highest incidence was 5. 60 per 100 000 among people born during 1986-1990. Conclusions Acute hepatitis B was controlled effectively after introducing hepatitis B vaccine into the Expanded Program on Immunization. HBc-IgM testing can be used to help classify hepatitis B reports for more accurate monitoring.