通过“预防为主”切断母婴传播促进我国乙型肝炎和肝癌发病率持续下降

Facilitating the continuous decline on the incidence rates of hepatitis B and liver cancer through cutting off the mother-to-child viral transmission,based on the"prevention first"strategy,in China

全世界共有600万~1000万乙型肝炎(乙肝)慢性患者,联合国制定的《2030年可持续发展议程》中要求消灭肝炎,并要求到2030年减少90%慢性患者。上海市接种乙肝疫苗后,乙肝发病率已减少了85%,肝癌发病率下降1/2。2015年,联合国要求乙肝母婴传播阻断成功率要达到95%以上,乙肝新感染人数要减少90%。为了早日实现联合国目标,根据上海市经验,建议在乙肝疫苗接种阻断母婴传播时,坚持做到"3个96%",即婴儿出生24 h内接种率达到96%,出生后1、6个月疫苗加强时继续2个96%。抓住切断母婴传播关键环节,我国预防肝炎定有希望,有可能提前达到消灭乙肝和控制肝癌的任务。

There have been 6-10 million reported patients with chronic hepatitis B virus(HBV)infection worldwide,and the United Nations(UN)called for a"90%reduction by 2030"strategy.Since the wide practice of HBV vaccination,the numbers of HBV cases have been reduced by 85%and the incidence of hepatocellular carcinoma has also decreased by 50%.As formulated by the UN in 2015,the sustainable development agenda for the eradication of hepatitis B included the success rate of preventing mother-to-child viral transmission by 95%,together with the reduction of new hepatitis B infections by 90%in 2030.In order to achieve the agenda,we proposed a strategy to achieve the"three 96%"goals derived from the Shanghai experience.In brief,hepatitis B vaccine should cover for 96%newborns within 24 h,and the vaccination boosting rate should reach 96%for both one and six months after birth.If cutting off the mother-to-child viral transmission strategy can be successfully achieved,the future of hepatitis B prevention will be promising,and the task of eliminating hepatitis B and controlling hepatocellular carcinoma can be completed ahead of 2030,time proposed by the UN.