2018年浙江省健康人群乙型肝炎血清流行病学调查分析

Seroepidemiological survey of hepatitis B in healthy population in Zhejiang,2018

目的了解2018年浙江省健康人群乙型肝炎(乙肝)病毒血清标志物流行情况。方法按照多阶段整群随机抽样的方法,抽取浙江省11个市及义乌市常住人口(居住6个月及以上)家庭中0~59岁人群进行问卷调查,并采集静脉血2 ml进行乙肝相关抗原抗体检测。结果共调查4194人,乙肝表面抗原(HBsAg)和乙肝表面抗体(HBsAb)阳性率分别为4.58%(192/4194)和63.92%(2681/4194)。<5岁、0~14岁、15~29岁、30~59岁人群HBsAg阳性率随年龄增加呈上升趋势(χ~2=85.228,P<0.001),HBsAb阳性率呈现先下降后上升趋势(χ~2=110.413,P<0.001)。调查人群乙肝疫苗接种率为63.02%(2643/4194),接种率随年龄的增长呈逐渐下降趋势(χ~2=2229.121,P<0.001)。多因素logistic分析结果显示,性别、乙肝疫苗接种史是影响成人HBsAg阳性率的主要因素,男性HBsAg阳性率高于女性(OR=1.404,95%CI:1.014~1.944),乙肝疫苗接种史者HBsAg阳性率低于无乙肝疫苗接种史者(OR=0.548,95%CI:0.371~0.810)。结论浙江省儿童乙肝防控工作取得显著成绩,但需提高成年人乙肝疫苗接种率,加强乙肝抗原抗体检测,以利于成年人乙肝防控工作。

Objective To investigate the serum markers of hepatitis B virus in healthy population in Zhejiang province in 2018.Methods A questionnaire survey was conducted among 0–59 years old people with local residence>6 months who were selected through multistage stratified cluster random sampling,in 11 prefectures(municipality)and Yiwu of Zhejiang,and 2 ml of venous blood was collected from each study subjects for the detections of hepatitis B virus related antigen and antibody.Results A total of 4194 people were investigated,the positive rate of HBsAg was 4.58%(192/4194),and the anti-HBs rate was 63.92%(2681/4194).The positive rate of HBsAg in populations aged 0–14,15–29 and 30–59 years increased with age(χ~2=85.228,P<0.001).The positive rate of anti-HBs decreased first and then increased(χ~2=110.413,P<0.001).The immunization rate of hepatitis B vaccine was 63.02%(2643/4194).The vaccination rates decreased with age(χ~2=2229.121,P<0.001).The results of multivariate logistic analysis showed that gender and immunization history of hepatitis B vaccine were the main factors influencing the positive rate of HBsAg in adults.The positive rate of HBsAg was higher in men than in women(OR=1.404,95%CI:1.014–1.944).The positive rate of HBsAg was lower in patients with hepatitis B immunization history than in those without hepatitis B immunization history(OR=0.548,95%CI:0.371–0.810).Conclusion Remarkable achievements have been made in the prevention and control of hepatitis B in children in Zhejiang.It is beneficial for the prevention and control of hepatitis B in adults by increasing the immunization rate of hepatitis B vaccine and strengthening the detections of hepatitis B virus antigen and antibody in this population.