2020年西藏自治区1-69岁人群乙型病毒性肝炎血清流行病学调查

A seroepidemiological survey of hepatitis B markers in people aged 1-69 years in Xizang Autonomous Region in 2020

目的了解西藏自治区2020年1-69岁人群乙型病毒性肝炎(乙肝)血清流行率。方法采用多阶段整群随机抽样法选取西藏自治区5个疾病监测点1-69岁人群采集血清标本。使用酶联免疫吸附试验检测乙肝表面抗原(Hepatitis B surface antigen,HBsAg)、表面抗体(Hepatitis B surface antibody,HBsAb)和核心抗体(Hepatitis B core antibody,HBcAb),使用微粒子酶联免疫法对HBsAg阳性标本检测乙肝e抗原(Hepatitis B e antigen,HBeAg)和e抗体(Hepatitis B e antibody,HBeAb),分析乙肝病毒(Hepatitis B virus,HBV)标志物阳性率和组合模式。结果在4912例调查对象中,HBsAg、HBsAb、HBcAb阳性率分别为9.20%、37.11%、32.76%(标化率:8.65%、37.30%、30.35%)。1-4岁、5-14岁、15-29岁、30-69岁HBsAg阳性率分别为2.23%、2.85%、6.87%、12.46%,HBsAb阳性率分别为52.79%、32.67%、37.71%、36.03%,HBcAb阳性率分别为4.19%、6.42%、21.09%、46.95%。共检出13种HBV标志物组合模式,其中五项标志物阴性、HBsAb单项阳性、HBsAg+HBcAb+HBeAb阳性、HBsAg+HBcAb+HBeAg阳性分别占总调查对象的43.79%、22.39%、6.15%、1.65%。结论2020年西藏自治区1-69岁人群特别是儿童HBsAg阳性率和HBV感染率显著下降,存在一定比例易感人群。仍需重点加强新生儿乙肝疫苗及时和全程接种工作。

Objective To explore seroprevalence of hepatitis B markers among people 1-69 years of age in Xizang Autonomous Region in 2020.Methods We selected 1-69-year-olds from five disease surveillance points in Xizang using a multi-stage cluster random sampling method.We collected serum samples to test for hepatitis B surface antigen(HBsAg),surface antibody(HBsAb),and core antibody(HBcAb)using enzyme-linked immunosorbent assay,and hepatitis B e antigen(HBeAg)and e antibody(HBeAb)of HBsAg-positive samples using microparticle immunosorbent assay.We calculated positivity rates and patterns of the hepatitis B virus(HBV)markers.Results Among the 4912 subjects,HBsAg,HBsAb,and HBcAb positivity rates were 9.20%,37.11%,and 32.76%(adjusted:8.65%,37.30%,and 30.35%),respectively.In 1-4-,5-14-,15-29-,and 30-69-year-olds,HBsAg positive rates were 2.23%,2.85%,6.87%,and 12.46%;HBsAb positive rates were 52.79%,32.67%,37.71%,and 36.03%;HBcAb positive rates were 4.19%,6.42%,21.09%,and 46.95%.Thirteen HBV marker combinations were detected.Subjects who were negative to all five markers,positive to only HBsAb,positive to HBsAg+HBcAb+HBeAb,and positive to HBsAg+HBcAb+HBeAg accounted for 43.79%,22.39%,6.15%,and 1.65% of subjects.Conclusions HBsAg seroprevalence,which indicates HBV infection,declined significantly among people aged 1-69 years,especially children,in Xizang in 2020,but a susceptible population remains.We still need to strengthen timely and full-series hepatitis B vaccination of newborns.