中国大陆居民2004-2017年乙型肝炎发病趋势分析

Changing trend in reported hepatitis B incidence among residents of China's Mainland,2004–2017

目的分析中国大陆居民2004-2017年乙型肝炎(乙肝)的发病趋势,为制定乙肝防控策略提供科学依据。方法收集公共卫生科学数据中心2004年3月-2017年3月中国大陆31个省/市/自治区(不包括台湾省、香港特别行政区和澳门特别行政区)居民的乙肝报告发病率数据,以年平均变化百分比(AAPC)作为量化指标分析中国2004-2017年不同地区、性别和年龄居民乙肝发病的趋势变化。结果中国大陆居民2004-2017年乙肝报告发病率依次为70.50/10万、75.57/10万、84.82/10万、89.00/10万、88.52/10万、88.82/10万、79.46/10万、81.54/10万、80.68/10万、71.12/10万、69.05/10万、68.57/10万、68.74/10万、72.61/10万,2004-2017年乙肝报告发病率总体无显著变化(AAPC=0.2%,P>0.05)。全国31个省/市/自治区中,山西省、安徽省、江西省、湖北省、湖南省、广东省、广西壮族自治区、海南省、西藏自治区和新疆维吾尔自治区2004-2017年乙肝报告发病率均呈上升趋势(均P<0.05),AAPC分别为5.80%、4.20%、1.50%、1.70%、11.30%、6.70%、3.50%、3.10%、14.50%和4.40%。男性和女性居民的年均乙肝报告发病率分别为97.03/10万和57.38/10万,2004-2017年男性和女性居民的乙肝报告发病率总体均无显著变化(AAPC=-0.1%和0.5%,均P>0.05)。0~4岁、5~9岁、10~19岁、20~39岁、40~59岁和≥60岁居民的年均乙肝报告发病率分别为12.78/10万、17.64/10万、80.21/10万、211.00/10万、181.62/10万和163.11/10万,2004-2017年0~4岁、5~9岁和10~19岁居民的乙肝报告发病率总体均呈下降趋势(AAPC=-7.7%、-13.6%和-11.6%,均P<0.001),≥60岁居民的乙肝报告发病率总体呈上升趋势(AAPC=5.0%,P<0.001)。结论中国大陆居民2004-2017年乙肝报告发病率总体无显著变化,但全国仍有部分地区居民乙肝报告发病率呈上升趋势,其中≥60岁居民是乙肝防控的重点人群。

Objective To analyze the trend of reported incidence of hepatitis B(HB)in China's Mainland from 2004 to2017 to provide evidences for developing strategies on HB prevention and control.Methods From National Public Health Science Data Center,we extracted the data on HB incidence in 31 provincial-level administrative divisions(not including Chinese Taiwan,Hong Kong Special Administrative Region and Macao Special Administrative Region)reported from March2004 through March 2017.The average annual percentage change(AAPC)in region-,gender-and age group-specific HB incidence were calculated to assess variation trend of HB incidence during the period.Results From 2004 to 2017,the average reported incidence(per 100000 population)of HB for the 31 divisions were 70.50,75.57,84.82,89.00,88.52,88.82,79.46,81.54,80.68,71.12,69.05,68.57,68.74 and 72.61,with no significant variation in the reported incidence as a whole(AAPC=0.2%,P>0.05);while,the increased HB incidences were reported in 9 of the divisions,with the APPCs of 5.80%for Shanxi,4.20%for Anhui,1.50%for Jiangxi,1.70%for Hubei,11.30%for Hunan,6.70%for Guangdong,3.50%for Guangxi Zhuang Autonomous Region,3.10%for Hainan,14.50%for Tibet Autonomous Region,and 4.40%for Xinjiang Production and Construction Corps,respectively(all P<0.05).The mean reported annual HB incidence(per 100000 population)during the period was 97.03 for males and 57.38 for females and there was no significant variation in the incidence for both the males(AAPC=-0.1%)and the females(AAPC=0.5%)(both P>0.05).The age group-specific HB incidences(per 100000 population)were 12.78,17.64,80.21,211.00,181.62 and 163.11 for the population aged 0-4,5-9,10-19,20-39,40-59,and 60 years and above,respectively;the age group-specific HB incidence decreased for the groups less than 20 years(AAPC=-7.7%,-13.6%,and-11.6%for groups of 0-4,5-9,10-19 years,all P<0.001)but increased for the age groups 60 years old and above(AAPC=5.0%,P<0.001).Conclusion During 2004-2017 in China's Mainland,the reported incidence of hepatitis B was not significantly changed generally but the incidence showed an increasing trend in some regions and the residents aged 60 years and above is the key population for hepatitis B prevention.