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目的了解乙型肝炎(乙肝)疫苗免疫后20年,人群乙肝病毒(HBV)流行状况及其变化趋势。方法采用横断面调查方法,以家庭为单位对广西壮族自治区隆安县5个村的整体人群进行调查,用固相放射免疫法检测血清HBV标志物[乙肝病毒表面抗原(HBsAg)、乙肝病毒表面抗体(抗-HBs)和乙肝病毒核心抗体(抗-HBc)],并与1985年、1995年的历史资料进行比较。结果(1)0～19岁人群的HBV流行率较≥20岁人群显著下降;0～19岁人群中乙肝疫苗免疫组的HBV流行率显著低于未免疫组和免疫史不详组;(2)乙肝疫苗首针在出生后<24h内接种的人群其HBsAg阳性率为0.9%,显著低于1～6d接种者(2.8%)和≥7d接种者(2.8%);(3)1985年0～19岁人群的HBsAg阳性率为16.6%,HBV流行率为57.0%;1995年的分别为7.2%和24.0%;2005年的分别为2.4%和9.8%;每隔10年呈现显著下降。结论乙肝疫苗免疫取得良好效果,首针及时接种率高的人群HBV流行率低于未及时接种人群,乙肝疫苗长期免疫地区免疫人群的HBV流行率大幅度下降。
Objective To understand the prevalence and trend of hepatitis B virus (HBV) in people 20 years after immunization with hepatitis B vaccine. Methods A cross-sectional survey was conducted to investigate the overall population of 5 villages in Long’an County, Guangxi Zhuang Autonomous Region. The serum HBV markers (hepatitis B virus surface antigen (HBsAg), hepatitis B virus surface antibody (Anti-HBs) and hepatitis B virus core antibody (anti-HBc)], and compared with the historical data of 1985 and 1995. Results (1) The prevalence of HBV in 0 ~ 19-year-old population was significantly lower than that of the population≥20 years old. The prevalence of HBV in the group of 0 ~ 19 years old was significantly lower than that in the non-immune group and unknown history of immunization group. (2) HBsAg positive rate was significantly lower in those vaccinated within 24 hours after birth than in vaccinated children aged 1-6 days (2.8%) and those vaccinated ≥7 days (2.8%); (3) The 19-year-old population had a HBsAg positive rate of 16.6% and an HBV prevalence rate of 57.0%, with 7.2% and 24.0% respectively in 1995 and 2.4% and 9.8% respectively in 2005 and a significant decrease every 10 years. Conclusions Hepatitis B vaccine has achieved good results. The prevalence of HBV in the first-time timely immunization group is lower than that of the group not vaccinated in time. The prevalence of HBV in the immunized area of hepatitis B vaccine immunization area decreased significantly.