The epidemiological characteristics of HBV susceptibility in 1-29 years old young people in China in 2006 and 2014:based on the national sero-survey data analysis

目的 分析比较中国2006和2014年1~29岁乙型肝炎病毒(HBV)易感人群的流行病学特征.方法 收集2006和2014年全国乙型肝炎血清流行病学调查中1~29岁人群数据资料;两次调查均覆盖内地31个省份(不包括中国香港、澳门、台湾数据)160个疾病监测点,并采用集中式调查方法,问卷调查内容包括出生日期、性别、民族、地区、HepB免疫史等主要信息.问卷调查后采集静脉血5 ml,检测HBsAg、抗-HBs和抗-HBc,以三项指标同时阴性为判定易感人群标准.采用χ2检验分析2006和2014年1~29岁不同免疫史人群HBV易感性差异;采用多因素非条件logistic回归模型分析影响2014年全国1~29岁有免疫史人群易感HBV的因素.结果 2006年共调查1~29岁人群49849名,2014年为31713名.与2006年相比,2014年1~29岁人群中有免疫史易感人群比例从20.87%(10401名)上升至28.55%(9055名)(χ2=630.69,P<0.001);无免疫史易感人群比例从15.02%(7485名)下降至7.66%(2460名)(χ2=953.73,P<0.001).与汉族人群相比,少数民族人群接种HepB后HBV易感性更高(OR=1.38);与接种不足3剂次相比,接种剂次≥3剂者HBV易感性更高(OR=0.68);与免疫后1年者相比,免疫后2~4年者(OR=3.33)和免疫后≥5年者(OR=6.53)HBV易感性均更高;以上P值均<0.001.西部地区无免疫史HBV易感人群比例(9.58%,1047/2460)高于中部地区(7.30%,756/2460)和东部地区(6.30%,657/2460).结论 我国目前新生儿HepB常规免疫能够稳定地维持在较高水平,易感者主要集中在15~29岁人群中;西部、农村地区和少数民族人群中HBV易感者更多.Objective To analyze the epidemiological characteristics of HBV susceptible people in 1-29 years old people in 2006 and 2014 in China. Method Data is from the 2006 and 2014 national sero-survey, and both of them were conducted in 160 disease surveillance points of 31 provinces (excluding Hong Kong, Macao Special Administrative Region and Taiwan province) in China. We used the centralized face-to face investigation method to collect basic information including birth date, gender, ethnicity, resident place, hepatitis B vaccination (HepB) history and so on, and 5 ml venous blood was collected for all subjects to test the sero-markers of HBsAg, anti-HBs and anti-HBc. We definite the HBV susceptible people as the HBsAg, anti-HBs and anti-HBc all negative together. And we use chi-square to analyze the epidemiological characteristics of HBV susceptibility in 1-29 years old young people in 2006 and 2014, and use multiple factors logistic regression to analyze the affect factors on HBV susceptible appearing in people with HepB vaccination. Result In 2006 and 2014 sero-surveys, the investigated 1-29 year-old people were 49849 and 31713, respectively. And compared with 2006, the proportion of HBV susceptible people with HepB among 1-29 in 2014 increased from 20.87% (10401) to 28.55% (9055) (χ2=630.69, P<0.001); and the proportion of susceptible people without HepB decreasing from 15.02% (7485) to 7.66% (2460) (χ2=953.73, P<0.001). Compared with Han nationality, the high risk of susceptible appearing in minority people after HepB vaccination (OR=1.38). And compared with less than 3 doses HepB vaccination, the more than 3 doses vaccination could reduce the anti-HBs disappearing rate (OR=0.68);Compared with one year after last dose vaccination, the 2-4 years interval (OR=3.33) and more than 5 years interval (OR=6.53) would have high risk for anti-HBs disappearing. All above were P<0.001. In western area, the proportion of susceptible people without HepB (9.58%, 1047/2460) was higher than the proportion in eastern (6.30%, 657/2460) and middle area (7.30%, 756/2460) (P<0.001). Conclusion The HepB coverage maintained in high level in 1-4 years old children. The HBV susceptible proportion mainly concentrated in 15-29 years old people, and the immunization gap was in western, rural areas and minority peoples.国家科技重大专项; 国家自然科学基金(11571272) National Science and Technology Major Project of China; National Natural Science Foundation of China中国科学引文数据库(CSCD)7581-586,5975