河南省18岁及以下住院患者HBV血清流行病学特征分析

Seroepidemiological characteristics of hepatitis B virus among hospitalized patients aged 18 years or below in Henan Province of China

目的调查1~18岁住院患者HBV感染现状,分析乙型肝炎疫苗接种后免疫情况。方法收集2020年7月—2021年7月1~18岁河南省人民医院住院患者的乙型肝炎血清学标志物(HBsAg、抗-HBs、HBeAg、抗-HBe和抗-HBc)以及乙型肝炎疫苗接种等信息,分析HBV感染流行现状和疫苗接种后的免疫效果。趋势分析采用趋势χ^(2)检验。结果共收集住院患者10658例,男6372例(59.79%),女4286例(40.21%)。人群整体HBsAg阳性占比为0.28%(30/10658),17、18岁年龄组HBsAg阳性占比较高,分别为0.68%和0.62%;抗-HBs阳性占比为51.82%(5523/10658),其中1~4岁年龄组抗-HBs阳性占比处于较高水平,均在63%以上,5~18岁年龄组抗-HBs阳性占比下降,波动在40%左右。随着年龄增长,无论男性还是女性,抗-HBs阳性均有下降趋势(男性:χ^(2)=8.217,P=0.004,女性:χ^(2)=10.048,P=0.002)。结论基于住院患者数据,河南省1~18岁人群HBV感染呈现低水平流行、高免疫特点,本地区计划免疫5年以上抗-HBs阳性占比下降的现象需要关注。

Objective To investigate the current status of hepatitis B virus(HBV)infection among hospitalized patients aged 1-18 years,as well as the status of immunity after hepatitis B vaccination.Methods Related data were collected from the patients aged 1-18 years who were hospitalized in Henan Provincial People’s Hospital from July 2020 to July 2021,including serological markers for hepatitis B(HBsAg,anti-HBs,HBeAg,anti-HBe,and anti-HBc)and hepatitis B vaccination.The epidemiological situation of HBV infection was analyzed,as well as the immune effect after vaccination.The trend chi-square test was used for trend analysis.Results A total of 10658 hospitalized patients were collected,among whom there were 6372 male patients(59.79%)and 4286 female patients(40.21%).In this population,the patients with positive HBsAg accounted for 0.28%(30/10658),with a relatively high proportion of 0.68%and 0.62%,respectively,in the 17-and 18-year age groups;the patients with positive anti-HBs accounted for 51.82%(5523/10658),with a relatively high proportion of>63%in the 1-4 years age groups,and there was a reduction in the proportion of patients with positive anti-HBs(fluctuating around 40%)in the 5-18 years age groups.With the increase in age,the positive rate of anti-HBs tended to decrease in both male and female patients(male:χ^(2)=8.217,P=0.004;female:χ^(2)=10.048,P=0.002).Conclusion Based on the data of hospitalized patients,HBV infection in the population aged 1-18 years in Henan Province has the characteristics of low prevalence rate and high immunity,and the reduction in the proportion of patients with positive anti-HBs at more than five years after vaccination should be taken seriously in this region.