目的了解中国现阶段乙型肝炎(乙肝)病毒(HBV)感染现状和评价自1992年乙肝疫苗纳人儿童免疫策略所取得效果。方法利用中国疾病预防控制中心“2002年中国居民营养与健康状况调查”保留的血清开展乙肝血清学检测。以美国Abbott乙肝酶联免疫吸附试验(ELISA)试剂为金标准选择中国乙肝ELISA检测试剂,并用固相放射免疫方法校对检测结果。结果中国≥3岁人群HBsAg阳性率、抗-HBs阳性率、HBV流行率经调整后分别为9.09%、37.48%、50.04%;3~12岁儿童分别为5.03%、45.33%、29.10%。≥3岁城市人群HBsAg阳性率、HBV流行率分别为4.61%、43.51%,农村人群分别为9.41%、56.77%。3~12岁城市儿童HBsAg阳性率、HBV流行率分别为2.10%、20.45%,农村儿童分别为8.25%、39.22%。结论中国≥3岁人群乙肝流行病学特征已发生改变,乙肝疫苗纳人儿童免疫规划效果显著,人群HBsAg阳性率、HBV流行率均有不同程度下降,3~12岁儿童下降更为明显。
Objective To better understand and measure the impact from immunization activities over the last 10-years, we conducted a sero-epidemiological study using the remaining blood samples of a nationwide survey on Nutrition and Health in Chinese residents, in 2002. Methods HBsAg, anti-HBs and anti-HBc in blood samples were tested using enzyme-linked immunosorbent assay(ELISA) reagents and revised by solid phase radioimmunoassay and Abbott ELISA reagents. Results Among population older than 3 years, the prevalence rates of HBsAg, anti-HBs and hepatitis B virus(HBV) infection were 9.09% , 37.48% and 50.04% but for children between 3 and 12 year olds, they were 5.03%, 45.33% and 29.10% respectively. Among population older than 3 years, the rates of HBsAg and HBV infection in urban area were4.61% and 43.51% , but the rates in rural area were 9.41% and 56.77% respectively while for children from 3-years to 12-years old, they rates were 2.10%, 20.45% in urban area and 8.25%, 39.22% in rural areas, respectively. Conclusion Results revealed that since the hepatitis B vaccine was introduced into the expanded program on immunization(EPI) from 1992, the prevalence rates of HBsAg and HBV infection, especially in the children from 3 to 12 years of age, had obviously declined, suggesting that some changes had happened in the epidemic characters of hepatitis B in China.