2008年和2018年广州市乙型肝炎流行病学特征比较

目的:比较2008年和2018年广州市1~59岁人群乙型肝炎（乙肝）血清流行病学调查结果。方法:采用二阶段整群抽样法，于2008年和2018年在广州市随机抽取1~59岁常住人口进行乙肝血清流行病学调查。结果:2008年调查1~59岁人群4 989名，2018年3 980名。2018年1~59岁人群HBsAg阳性率为9....

Comparative analysis on seroprevalence of hepatitis B in Guangzhou in 2008 and 2018

Objective To compare the seroprevalence of hepatitis B in Guangzhou in 2008 and 2018. Methods According to the proportion of Guangzhou population size, two-stage cluster sampling was used to select the residents aged 1-59 years in the two surveys. Results 4 989 and 3 980 people aged 1-59 years were involved in 2008 and 2018, respectively. HBsAg prevalence was 9.50% (95%CI:7.34%-11.66%) in 2018 and 12.45% (95%CI:10.58%-14.33%) in 2008 among the people aged 1-59 years, with no significant difference statistically (χ²=18.302, P=0.075). The decrease of HBsAg prevalence was mainly in the population aged 7-16 years. For the people aged 7-16 years, the HBsAg prevalence was 0.88% (95%CI:0.35%-1.42%) in 2018 and decreased by 80.62% as compared with the rate 4.54% (95%CI:2.71%-6.36%) in 2008, with statistically significant difference (χ²=34.144,P=0.000). Anti-HBs prevalence was 72.30% (95%CI:69.56%-75.04%) in 2018 and ascended by 11.35% as compared with the rate of 64.93% (95%CI:61.65%-68.22%) in 2008 among the people aged 1-59 years, with statistically significant difference (χ²=51.618, P=0.001). The rise of anti-HBs prevalence was mainly in the population aged 17-59 years. For the people aged 17-59 years, the anti-HBs prevalence was 71.93% (95%CI:68.90%-74.96%) and risen by 12.80% as compared with the rate of 63.77% (95%CI:60.16%-67.37%) in 2008, with a statistically significant difference (χ²=28.422, P=0.001). HBV infection rate was 48.10% (95%CI:43.20%-53.00%) in 2018 and decreased by 22.76% as compared with the rate of 62.27% (95%CI:59.11%-65.44%) in 2008, with statistically significant difference (χ²=167.138, P=0.000). The HBV infection rates in the population aged 1-6 years, 7-16 years, and 17-59 years were 4.58%, 5.13%, and 56.56% (a decrease of 81.83%, 85.91%, and 18.47%), respectively. The infection rate of HBV was 48.87% (a decrease of 24.70%) in high epidemic areas and 28.81% (a decrease of 38.75%) in people with a history of hepatitis B immunization.Conclusion The prevention and control of hepatitis B in Guangzhou have achieved remarkable results it already reached the national goal of reducing HBsAg prevalence to less than 1% among children under five years since 2008. However, the target goal of reducing the hepatitis B mortality rate is quite demanding. The neonatal hepatitis B vaccination and monitoring and screening in adults are still needed.