江苏省2010年和2020年乙型肝炎血清流行病学特征分析

Comparative analysis on seroprevalence of hepatitis B in 2010 and 2020 in Jiangsu Province

目的掌握江苏省社区人群乙型肝炎(简称乙肝)流行变化特征,评价江苏省乙肝综合防控措施的效果。方法采用横断面调查方法,于2010年和2020年在张家港市、丹阳市和泰兴市分别开展了两次大规模乙肝血清流行病学调查。结果2010年和2020年分别调查了148196人和100989人,2020年的HBsAg标化阳性率为5.33%,较2010年7.46%的水平下降了28.55%,张家港市、丹阳市、泰兴市三个示范区2020年的HBsAg标化阳性率分别为2.92%、5.25%和7.14%,较2010年的HBsAg水平均下降。按照不同年龄组比较,2020年较2010年的HBsAg阳性率在各年龄组均存在不同程度的降低,尤其在20~<35岁年龄组出现大幅度的降低。在2020年的调查中,明确有乙型肝炎疫苗(简称乙肝疫苗)接种史人群的HBsAg阳性率为4.88%,低于未接种乙肝疫苗人群8.16%的HBsAg阳性率(P<0.001)。2020年调查中抗-HBs总体阳性率为45.55%,1~<5岁的婴幼儿抗-HBs阳性率最高,而5~<20岁的青少年则呈现明显下降的趋势。结论通过乙肝综合防控策略的实施,江苏省传染病示范区的乙肝防控取得了显著成效,但成人乙肝疫苗接种仍需加强。

Objective To describe the characteristics of epidemic change of hepatitis B and to analyze the effect of comprehensive prevention and control measures for hepatitis B in Jiangsu Province.Methods According to the method of a cross-sectional survey,two large-scale seroepidemiological surveys of hepatitis B were carried out in 2010 and 2020 in Zhangjiagang City,Danyang City and Taixing City.Results A total of 148196 and 100989 people were investigated in 2010 and 2020,respectively.Age-standardHBsAgprevalence was 7.36%in 2010 and 5.33%in 2020,with a decrease by 28.55%.The HBsAg standard positive rates in Zhangjiagang City,Danyang City and Taixing City demonstration areas in 2020 were 2.92%,5.25%and 7.14%,respectively,which were significantly lower than the HBsAg levels in 2010.According to the comparison of different age groups,the HBsAg positive rate decreased from 2020 to 2010 in all age groups,especially in the 20-35 age group.In the 2020 survey,the HBsAg positive rate was 4.88%in the population with a history of hepatitis B vaccination,which was significantly lower than that in the unvaccinated population(P<0.001).The overall positive rate of anti-HBs was 45.55%in the 2020 survey,which was highest in infants aged 1-<5 years,and decreased significantly in adolescents aged 5-<20 years.Conclusion Through the implementation of the comprehensive prevention and control strategy for hepatitis B,the prevention and control of hepatitis B in the Jiangsu Province has achieved remarkable results,but the adult hepatitis B vaccination still needs to be strengthened.