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目的了解广东省2013年乙型病毒性肝炎(乙肝)高流行区农村育龄妇女乙肝病毒(Hepatitis B Virus,HBV)感染现状,评估乙肝疫苗(Hepatitis B Vaccine,Hep B)接种效果,为完善HBV母婴阻断策略提供参考。方法2013年采用分层随机抽样在广东省乙肝高流行区3个县(市,下同)农村抽取15~49岁育龄妇女进行乙肝血清流行病学调查。用酶联免疫吸附试验检测乙肝血清学标志物,调查人口学特征、肝炎病史、Hep B接种史等。结果共调查育龄妇女2076人,平均年龄30.64岁。3个调查县育龄妇女乙肝病毒表面抗原(HBV Surface Antigen,HBs Ag)、抗乙肝病毒表面抗原抗体(Antibody to HBs Ag,Anti-HBs)、抗乙肝病毒核心抗原抗体(Antibody to HBV Core Antigen,Anti-HBc)年龄标化阳性率分别为12.81%、63.73%、65.90%。HBs Ag阳性妇女中乙肝病毒e抗原(HBV e Antigen,HBe Ag)和抗乙肝病毒e抗原抗体(Antibody to HBe Ag,Anti-HBe)阳性率分别为29.76%和63.94%。不同年龄组育龄妇女HBs Ag、Anti-HBc、HBe Ag和Anti-HBe阳性率差异有统计学意义(χ2HBs Ag=42.01,χ2Anti-HBc=443.35;χ2HBe Ag=38.10,χ2Anti-HBe=36.51;P均<0.01),但Anti-HBs阳性率差异无统计学意义(χ2Anti-HBs=5.41,P=0.14)。不同地区、职业育龄妇女HBs Ag、Anti-HBs、Anti-HBc阳性率差异均有统计学意义(地区间比较:χ2HBs Ag=9.07,χ2Anti-HBs=7.04,χ2Anti-HBc=39.44;P均<0.01;职业间比较:χ2HBs Ag=46.17,χ2Anti-HBs=13.30,χ2Anti-HBc=445.18;P均<0.05)。育龄妇女Hep B接种率为31.22%,有Hep B接种史组Anti-HBs阳性率(71.87%)高于无Hep B接种史组(58.57%)和Hep B接种史不详组(63.73%)。结论广东省2013年乙肝高流行区农村育龄妇女HBs Ag携带率处于较高水平,小年龄组育龄妇女HBs Ag携带率下降明显,Hep B接种预防效果显著,仍需继续落实HBV母婴阻断干预措施。
Objective To understand the status of Hepatitis B Virus (HBV) infection in rural women of childbearing age in 2013 in Hepatitis B (HBV) high prevalence area in Guangdong Province and to evaluate the effect of hepatitis B vaccine (Hep B) Infant block strategy for reference. Methods In 2013, stratified random sampling was used to collect hepatitis B seroprevalence among 15-49 years old women of childbearing age in 3 counties (cities, the same below) in Guangdong’s hepatitis B high endemic area. Serological markers of hepatitis B were detected by enzyme-linked immunosorbent assay, demographic characteristics, history of hepatitis and history of Hep B vaccination were investigated. Results A total of 2076 women of childbearing age were surveyed, with an average age of 30.64 years. Three surveyed women of childbearing age in our county investigated HBV surface antigen (HBsAg), anti-HBsAg (Anti-HBsAg), anti-HBV toxin (Antibody to HBV Core Antigen, Anti -HBc) age-standardized positive rates were 12.81%, 63.73%, 65.90%. The positive rates of HBeAg and anti-HBeAg in HBsAg-positive women were 29.76% and 63.94% respectively. The positive rates of HBs Ag, Anti-HBc, HBe Ag and Anti-HBe in women of childbearing age in different age groups were significantly different (χ2HBs Ag = 42.01, χ2Anti-HBc = 443.35; χ2HBe Ag = 38.10, χ2nti-HBe = 36.51; <0.01), but there was no significant difference in the positive rate of Anti-HBs (χ2Anti-HBs = 5.41, P = 0.14). The positive rates of HBsAg, Anti-HBs and Anti-HBc in professional women of childbearing age in different regions were significantly different (inter-region comparison: χ2HBs Ag = 9.07, χ2nti-HBs = 7.04, χ2nti- HBc = 39.44; ; Occupational comparison: χ2HBs Ag = 46.17, χ2nti-HBs = 13.30, χ2nti-HBc = 445.18; P <0.05). The vaccination rate of Hep B was 31.22% in women of childbearing age. The positive rate of Anti-HBs in Hep B vaccination group was 71.87% higher than that in Hep B vaccination group (58.57%) and Hep B inoculation history unknown group (63.73%). Conclusion The carrier rate of HBsAg among rural women of childbearing age in 2013 in Guangdong Province is at a high level. The carrier rate of HBsAg in women of child-bearing age in the small age group dropped significantly, and the preventive effect of Hep B inoculation was significant. Measures.