目的了解甘肃省武威市乙肝防治示范区社区儿童乙型肝炎病毒(hepatitisBvirus,HBV)实际感染情况,为阻断HBV的传播、控制儿童中乙肝的流行提供科学依据。方法在乙肝防治示范区社区人群中选择12岁及以下儿童作为研究对象,采集血清标本并进行流行病学调查。采用酶联免疫吸附试验(enzyme—linkedimmunesorbentassay,ELISA)方法检测血清中乙肝表面抗原(hepatitisBsurfaceantigen,HBsAg)和抗-HBs,乙肝e抗原(hep—atitisBeantigen,HBeAg)阳性者进行HBeAg、肝功能及HBVDNA的定量检测。结果参加本次调查的12岁及以下社区儿童共4159名,HBsAg阳性儿童52例,HBsAg阳性率为1.25%(52/4159)。各年龄组间HBsAg阳性率无统计学意义(x^2=2.90,P=0.407),以1-3岁组最高为2.23%(6/269)。儿童乙肝疫苗接种率为98.68%(4104/4159),儿童抗-HBs阳性率达到59.05%(2456/4159),各年龄组间抗-HBs阳性率差异有统计学意义(x^2=216.81,P〈0.001),以10-12岁组最高为73.57%(1116/1517)。52例HBsAg阳性儿童中,抗-HBs阳性者占15.38%(8/52),HBeAg阳性者占28.85%(15/52),HBVDNA〉1×10^3IU/mL者占51.92%(27/52),肝功异常者占5.77%(3/52)。结论乙肝防治示范区社区儿童中存在一定比例的HBV感染,4-6岁儿童抗-HBs阳性率较低,敦促我们应进一步加强母婴传播的阻断,同时建议对4~6岁儿童开展乙肝疫苗的加强免疫接种工作。
Objective To investigate children hepatitis B virus (HBV) infection in the community, evaluate the effects of immunization after HBV vaccination and provide scientific basis for the national HBV prevention and control dem- onstration areas of Wuwei City. Methods Children under 12 years old from 4 communities of Wuwei City were selected as study subjects. Epidemiological investigations were conducted in the parents or guardians of children for collecting the infor- mation of HBV infection and vaccination. Serum samples of children were collected and used for hepatitis B surface antigen (HBsAg) and anti-HBs enzyme-linked immunosorbent assay detection, only the HBsAg positive samples were tested for hepatitis B e antigen(HBeAg) alanine aminotransferase(ALT) and HBV DNA. Results Among the 4 159 children under 12 years old, 52( 1.25% ) HBsAg positive were determined. No significant differences were found for positive rate of HB- sAg in different age groups ( x^2 = 2.90, P = 0. 407 ). The highest HBsAg positive rate was 2. 23% ( 6/269 ) in 1-3 age group. The coverage rate of HB~ vaccination was 98.68% (4 104/4 159) , the anti-HBs positive rate was 59.05 % (2 456/ 4 159). The Chi-square test showed that the anti-HBs positive rates were significantly different among different age groups (x^2 = 216. 81, P 〈 0. 001 ). The highest anti-HBs positive rate was 73.57% ( 1 116/1 517) in 10-12 age group. Of the 52 HBsAg positive children,8 ( 15.38% ), 15 (28. 85% ) and 27 (51.92%) were positive for anti-HBs, HBeAg and HBV DNA, respectively. And 3 (5.77%) were described as abnormal ALT levels. Conclusions With high level coverage rate of HBV vaccine in the community, Anti-HBs positive rate of 4-6 years old children was not satisfied. We should further strengthen the prevention of mother-to-child transmission of HBV. After primary vaccination, booster vaccinations of hepati- tis B vaccine should be given for non-responders specially in 4-6 years old children.