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OBJECTIVE: To determine the projected burden of hepatitis B virus (HBV) in China, the intervention strategies that can eliminate mother-to-child transmission (MTCT) by 2030 or earlier and the measurable parameters that can be used to monitor progress towards this target. METHODS: We developed a dynamic, sex- and age-stratified model of the HBV epidemic in China, calibrated using hepatitis B surface antigen (HBsAg) and e antigen (HBeAg) prevalence data from sequential national serosurveys (1979-2014) and the numbers of HBV-related cancer deaths (2012). We determined whether China can achieve elimination of MTCT of HBV by 2030 under current prevention interventions. We modelled various intervention scenarios to represent different coverage levels of birth-dose HBV vaccination, hepatitis B immunoglobulin to newborns of HBsAg-positive mothers and antiviral therapy (tenofovir) to HBeAg-positive pregnant women. FINDINGS: We project that, if current levels of prevention interventions are maintained, China will achieve the elimination target by 2029. By modelling various intervention scenarios, we found that this can be brought forward to 2025 by increasing coverage of birth-dose vaccination, or to 2024 by the administration of tenofovir to HBeAg-positive pregnant women. We found that achievement of the target by 2025 would be predicted by a measurement of less than 2% MTCT in 2020. CONCLUSION: Our results highlight how high-quality national data can be combined with modelling in monitoring the elimination of MTCT of HBV. By demonstrating the impact of increased interventions on target achievement dates, we anticipate that other high-burden countries will be motivated to strengthen HBV prevention policies.
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Erradicación de la Enfermedad , Hepatitis B/prevención & control , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Complicaciones Infecciosas del Embarazo/prevención & control , Adulto , Antivirales/uso terapéutico , China/epidemiología , Femenino , Hepatitis B/epidemiología , Antígenos de Superficie de la Hepatitis B , Vacunas contra Hepatitis B , Antígenos e de la Hepatitis B , Humanos , Inmunoglobulinas/uso terapéutico , Recién Nacido , Embarazo , Tenofovir/uso terapéuticoRESUMEN
BACKGROUND: In 2008, China introduced live, attenuated hepatitis A vaccine (L-HepA, licensed in 1992) and inactivated hepatitis A vaccine (I-HepA, licensed in 2002) nationwide, and is currently the only country using L-HepA in routine immunization. We assessed seropositivity and its duration following vaccination, safety, and association with hepatitis A incidence and population seroprevalence for I-HepA and L-HepA. METHODS: We obtained seroprevalence data from two nationwide serosurveys (in 1992 and 2014), vaccination status from the 2014 serosurvey, and vaccine safety and disease incidence data from the national surveillance system. We compared long-term HAV seropositivity among vaccine recipients and described safety profiles of both vaccines. We categorized the 31 provinces into those predominately using I-HepA and achieving high coverage (n = 4), those predominately using L-HepA achieving high coverage (n = 4), and those predominately using L-HepA achieving lower coverage (n = 23). We compared population HAV seropositivity, coverage, and disease incidence among the three groups. RESULTS: One year after vaccination, seropositivity from I-HepA was significantly higher than from L-HepA (97.8% vs 90.7%), and seropositivity declined to 73.5% for L-HepA and 75.4% for I-HepA after 10 years - not significantly different by vaccine. The annual incidence of serious AEFI was <0.5/100 000 for both vaccines. Prior to licensure of either HepA vaccine, provinces that would go on to predominantly use I-HepA had lower incidences of hepatitis A and lower seropositivity levels to HAV than provinces that would go on to use L-HepA. By 2014, these differences were significantly diminished. Regardless of vaccine selection, all three province groups had lower immunity to HAV among individuals born during the 10 years prior to nationwide vaccine introduction - individuals who were 10 to 24 years old in 2014. CONCLUSION: Evidence of good immunogenicity, safety, and impact on incidence supports continued use of both I-HepA and L-HepA in the EPI system. These results may be useful for countries considering integrating HepA vaccines into their routine programs.
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Vacunas contra la Hepatitis A , Hepatitis A , Adolescente , Adulto , Niño , China/epidemiología , Estudios Transversales , Hepatitis A/epidemiología , Hepatitis A/prevención & control , Humanos , Estudios Seroepidemiológicos , Vacunación , Vacunas Atenuadas , Vacunas de Productos Inactivados , Adulto JovenRESUMEN
Objective@#To analyze the epidemiological characteristics of hepatitis E Virus antibody (anti-HEV) in people aged 1-29 years in China in 2014.@*Methods@#Based on database of the national serologic survey of hepatitis B in people aged 1-29 years in China, in 2014, the sample size was estimated. The serum samples of the people surveyed were randomly selected to detect anti-HEV IgG by using enzyme- linked immunosorbent assay (ELISA). Statistical software SAS 9.1.3 was used to calculate the positive rate of anti-HEV and 95% confidence interval (CI) in different age, gender groups, urban and rural areas and geographic areas by using the Taylor series linear method with sampling weight. The difference was determined by comparing 95%CI.@*Results@#A total of 14 106 serum samples were detected from people aged 1-29 years, including 6 996 males (49.60%), 7 013 urban residents (49.72%). The positive rate of anti-HEV was 8.12%(95%CI: 7.19-9.15) in people aged 1-29 years. There was no statistical difference between the men and women, between urban area and rural area. The positive rates of anti-HEV in western area(11.36%, 95%CI: 9.45-13.62) was higher than those in eastern and central areas. The positive rates of anti-HEV were 2.46%, 2.24%, 4.50%, 7.58%, 11.89% and 17.27% in people aged 1-, 5-, 10-, 15-, 20- and 25-29 years, respectively. As the age increased, the positive rate of anti-HEV gradually increased. In different ethnic groups, the positive rate of anti-HEV was higher in Tibetan (18.32%, 95%CI: 12.02-26.90), Zhuang (9.54%, 95%CI: 4.33-19.73) ethnic groups.@*Conclusion@#The positive rate of anti-HEV declined slightly in China in 2014. It is still necessary to pay close attention to the HEV infection, morbidity of hepatitis E and risk factors in people aged 1-29 years.
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Objective@#To analyze the changing epidemiological characteristics of hepatitis E cases in China, in order to promote in preventing and controlling hepatitis E.@*Methods@#Data of hepatitis E and outbreaks reported through national notifiable diseases reporting system were analyzed from 2004 to 2017, but data of Hongkong, Macau and Taiwan were not included. Data of hepatitis E were divided into three phases as 2004-2007, 2008-2011 and 2012-2017, representing eight years before, four years before and years after the postmarketing of hepatitis E vaccine. Linear regression was used for analyzing the trend of hepatitis E, improved muster method was used for analyzing the seasonal intensity.@*Results@#From 2004 to 2017, 329 519 hepatitis E cases were reported and the annual incidence were increasing from 1.27/100 000 to 2.10/100 000 (t=6.87, P<0.001). The concentrations of hepatitis E during 2004-2007, 2008-2011 and 2012-2017 were 17.43, 16.06, 11.17, respectively, with low seasonal intensity. Number of cases reported by Jiangsu, Guangdong and Zhejiang accounted for 31.54% of national cases. The incidence were lower in central (1.45/100 000) and western (1.11/100 000) region than that in eastern region (2.67/100 000), but were increasing continuously. There was an increasing trend of incidence with growing ages (t=7.85, P<0.001). The incidence was higher than 2/100 000 among cases aged ≥40, and was the highest (5.22/100 000) in the age group of 65-69 years old. Farmers, retired persons, houseworkers and unemployees accounted for 67.46% of total cases. A total of 7 outbreaks were reported, among which 3 were in nursing homes.@*Conclusion@#The incidence of hepatitis E in central and western regions were increasing continuously and the surveillance should be strengthened. There was higher risk among middle-aged population, farmers and nursing homes, so strategy for immunization among those population was in great need.
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Objective: Through analyzing the epidemiological characteristics of hepatitis A and E and the situation of vaccination, to promote the recommendation profile on Hepatitis E vaccination program, in China. Methods: Three phases of time span were divided as 2004-2007, 2008-2011 and 2012-2015, with age groups divided as <20, 20-29, 30-39 and ≥40. Incidence rates in both different phases and age groups were compared. Numbers of Hepatitis A and E vaccines released and used, were described. Results: Between 2004 and 2015, a declining trend in the reported incidence of hepatitis A (t=-12.15, P<0.001), but an increasing trend in hepatitis E (t=6.63, P<0.001) were noticed. The mean number of hepatitis A cases declined from 6 515 to 1 986 between 2004 and 2007 while the number of hepatitis E cases increased from 1 491 to 2 277 between 2012 and 2015. The peaks of hepatitis E appeared persistent annually, in March. The incidence of hepatitis A declined in three regions, with the western region (3.46/100 000) much higher than the eastern (1.13/100 000) or central regions (1.14/100 000) (χ(2)=32 630, P<0.01). The incidence of hepatitis E increased both in the central (1.74/100 000) and western regions (1.58/100 000), but more in the eastern region (2.66/100 000) (χ(2)=6 009, P<0.01). Incidence of hepatitis A declined in all age groups and declined by 84.36% among the 0-19 group. However, the incidence of hepatitis E showed an increasing trend among the ≥20 group. Incidence rates appeared higher in the older age groups. The coverage of hepatitis A vaccine increased from 62.05% to 93.54%, but with a negative association seen between the coverage of Hepatitis A vaccine and the incidence (F=10.69, χ(2)<0.05). Conclusion: The incidence of Hepatitis A declined sharply in China while hepatitis E was still increasing from 2004 to 2015, calling for the expansion on the coverage of Hepatitis E vaccine in the whole population.
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Adolescente , Adulto , Anciano , Humanos , Persona de Mediana Edad , Adulto Joven , China/epidemiología , Encuestas de Atención de la Salud , Hepatitis A/epidemiología , Vacunas contra la Hepatitis A/administración & dosificación , Hepatitis E/epidemiología , Inmunización/estadística & datos numéricos , Programas de Inmunización , Incidencia , Vigilancia de la Población , Vacunación/estadística & datos numéricosRESUMEN
<p><b>OBJECTIVE</b>To observe the effects of 2-deoxyglucose inhibiting synovial pannus of adjuvant arthritis rats and to explore its potential mechanism of inhibiting angiogenesis by investigating proliferation, migration and matrigel tube formation assay .</p><p><b>METHODS</b>The effect of 2-DG on synovial pannus was evaluated by histopathology of HE staining; HUVEC proliferation was determined by CCK-8 method; migration of FLS were determined by transwell; matrigel tube formation assay was made for assessing tube number of HUVEC; p-AMPK and Bcl-2 were detected by Western blot assay; AMPK signaling pathway in HUVEC was inhibited by compound C, which is an inhibitor of AMPK activation.</p><p><b>RESULTS</b>2-DG (200 mg/kg) obviously decreased appearance of synovial pannus ( < 0.01); , 2-DG (0.5 mmol/L and/or 5 mmol/L) obviously inhibited proliferation, migration and tube number of HUVEC ( < 0.01 or < 0.001), and its effects on HUVEC were reversed by using AMPK antagonist (Compound C); Western blot showed that 2-DG (5 mmol/L) increased expression of p-AMPK and decreased expression of Bcl-2 ( < 0.05).</p><p><b>CONCLUSIONS</b>Activating AMPK pathway and decreasing expression of Bcl-2 may the potential mechanism by which 2-DG contributes to anti-angiogenesis and effects of inhibiting proliferation, migration and tube number of HUVEC.</p>
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Objective Through analyzing the epidemiological characteristics of hepatitis A and E and the situation of vaccination,to promote the recommendation profile on Hepatitis E vaccination program,in China.Methods Three phases of time span were divided as 2004-2007,2008-2011 and 2012-2015,with age groups divided as <20,20-29,30-39 and ≥40.Incidence rates in both different phases and age groups were compared.Numbers of Hepatitis A and E vaccines released and used,were described.Results Between 2004 and 2015,a declining trend in the reported incidence of hepatitis A (t=-12.15,P<0.001),but an increasing trend in hepatitis E (t=6.63,P<0.00l) were noticed.The mean number of hepatitis A cases declined from 6 515 to 1 986 between 2004 and 2007 while the number of hepatitis E cases increased from 1 491 to 2 277 between 2012 and 2015.The peaks of hepatitis E appeared persistent annually,in March.The incidence of hepatitis A declined in three regions,with the western region (3.46/100 000) much higher than the eastern (1.13/100 000) or central regions (1.14/100 000) (x2=32 630,P<0.01).The incidence of hepatitis E increased both in the central (1.74/100 000) and western regions (1.58/100 000),but more in the eastern region (2.66/100 000) (x2=6 009,P < 0.01).Incidence of hepatitis A declined in all age groups and declined by 84.36% among the 0-19 group.However,the incidence of hepatitis E showed an increasing trend among the ≥20 group.Incidence rates appeared higher in the older age groups.The coverage of hepatitis A vaccine increased from 62.05% to 93.54%,but with a negative association seen between the coverage of Hepatitis A vaccine and the incidence (F=10.69,x2<0.05).Conclusion The incidence of Hepatitis A declined sharply in China while hepatitis E was still increasing from 2004to 2015,calling for the expansion on the coverage of Hepatitis E vaccine in the whole population.
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Objective@#To review the consistency of diagnosis and reporting of hepatitis B (HB) patient in non-surveillance hospitals in three provinces and analyze the influencing factors.@*Methods@#In 2016, using typical survey methods, we carried out a hospital-based pilot study in three provinces: Fujian, Hainan and Gansu. In each province, we chose two hospitals with grade 3 and grade 2 respectively in each province, using the following criteria: (1) in 2015, the hospital reported a greater number of hepatitis B cases compared the hospital-based provincial mean; (2) the hospital had an advanced laboratory information system (LIS) with access to HBsAg test results; (3) the hospital had an electronic hospital information system (HIS) which linked to the LIS via the inpatient medical record number; (4) general hospital; (5) non-surveillance hospitals for hepatitis B. Using national notifiable infectious disease reporting system (NNDRS), we chose all HB patients who were reported by the investigated hospitals in 2015, and we linked NNDRS HBV case-reports with patient-data from hospital information systems (HIS) to review the diagnosis, and then to compare the consistency of reviewed diagnosis and NNDRS report diagnosis, which we made a descriptive analysis. We used multivariable logistic regression to examine factors associated with misclassification of case-reports to NNDRS.@*Results@#We found the NNDRS report accuracy was 47.11% (669) among 1 420 eligible inpatient hepatitis B inpatients. Of the 352 reported acute HBV cases, 6.53% (23) were consistent with our medical record review, the accuracy rate for level 2 hospitals and level 3 hospitals was 9.42% (21) and 1.55% (2), respectively. Of the1 068 reported chronic HBV cases, 60.49% (646) were consistent with our medical record review, the accuracy rate for level 2 hospitals and level 3 hospitals was 57.92% (106) and 60.02% (540), respectively. Compared to primary diagnosis of HB patients, the OR(95%CI) for mis-report was 29.36 (19.21-44.76) in non-primary diagnosis of HB patients. Compared to Fujian Province, the mis-report risk was higher in Hainan province and Gansu Province, with the values of OR (95%CI) being 2.33 (1.58-3.44) and 20.38 (11.29-36.78), respectively; compared to level 3 hospitals, the OR (95%CI) for mis-report was 2.38 (1.66-3.42) for level 2 hospitals; compared to HB related wards, the OR (95%CI) for mis-report was 1.45 (1.04-2.01) in non-HB-related wards.@*Conclusion@#In some non-surveillance areas of China, the consistency between hepatitis B diagnosed in hospital and reported in NNDRS was low. Factors affecting the accuracy of HB surveillance data in NNDRS were level 2 hospitals, non-liver disease departments and nonprimary diagnosis of HB.
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Objective To understand the characteristics of acute hepatitis B inpatients reported by the hepatitis B surveillance pilot points and to estimate the consistency between the diagnosed and reported types of hepatitis B by the clinicians involved.Methods Data related to acute hepatitis B was from the NNDRS and the characteristics of acute hepatitis B were classified by querying Hospital Information System.We recorded the results based on clinical diagnosis and analyzed the consistency between the reported and diagnosed types that the clinicians made,on hepatitis B.Resulis A total of 179 patients were included in this study with all of them as acute hepatitis B reported through NNDRS in 2015-2016.In terms of the durations of disease,among the 179 cases who were HBsAg positive,32.40% (58/179) of them exceeding 6 months,2.79% (5/179) within 6 months and 64.80% (116/179) tested the first time or never.Among the 179 cases who claimed having the history of hepatitis,33.52% (60/179) of them identified as having hepatitis B,1.12% (2/179) were hepatitis A,C or E,41.34% (74/179) did not have the signs on hepatitis,while the rest 24.02% (43/179) did not know the situation.Only 79.89%(143/179) of the patients showed the symptoms or signs of hepatitis,but the rest 20.11%(36/179) did not.Among the 179 reported acute hepatitis patients,67 of them were diagnosed as acute hepatitis B while 112 cases were as non-acute hepatitis B.The consistent rate of acute hepatitis B was 37.43% (67/179).Among the 112 cases that were diagnosed as non-acute hepatitis B,proportions of chronic hepatitis B and cirrhosis were 49.11%(55/112) and 16.07%(18/112) respectively.Conclusion Consistency between the reported type of acute hepatitis B inpatients and the types diagnosed by clinicians was poor.Our results suggested that clinicians should make the accurate diagnosis at first place and then report to the Network in accordance with the clinical diagnosis classification criterfia,set by the government.
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Objective To analyze the sero-epidemiological features of hepatitis B among children aged 1-14 years old who were born to HBsAg positive mothers.Methods Based on the results from the hepatitis B national sero-survey in 2014,children aged 1-14 years old born to HBsAg positive mother were involved in this study.Positive rates on HBsAg,anti-HBs,anti-HBc by gender,age,nationality,birth place,residency (urban/rural),region (eastern/central/western) and related factors of HBsAg and anti-HBs for children under research,were analyzed by SPSS 18.0 statistical software.Results A total of 645 children aged 1-14 years old that born to HBsAg positive mothers were analyzed in the study.Positive rates on HBsAg,anti-HBs,anti-HBc among these children were 3.41% (22/645),71.94% (464/645) and 7.60% (49/645),respectively.HBsAg positive rates for children aged 1-2 years,3-4 years,5-9 years,10-14 years appeared 1.27% (3/236),3.23% (6/186),5.71% (8/140) and 6.02% (5/83),respectively.The anti-HBs positive rates were 85.17% (201/236),69.35% (129/186),56.43% (79/140),66.27% (55/83) while the anti-HBc positive rates were 4.66% (11/236),5.38% (10/186),11.43% (16/140) and 14.46% (12/83),respectively.Results from the multifactor logistic analysis showed that birth place,time of the first dose of HepB inoculation were major influencing factors on the positive rates among children with HBsAg.HBsAg positive rate for the children born outside the hospital was higher than those born in the hospital (OR=7.47,95% CI:1.50-37.25).HBsAg positive rate for children with the first dose of HepB inoculation>24 h after birth,was higher than that inoculation within 24 h after birth (OR=6.21,95% CI:2.15-17.99).Conclusions Some achievements in preventing mother-to-child transmission of hepatitis B had been seen in China.Hospital delivery for pregnant women and timely HepB vaccination with birth-dose for the neonates,remained the key strategy on prevention of HBV vertical transmission.
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Objective To evaluate the effects on Hepatitis B surveillance models at the surveillance pilot points in China.Methods Hepatitis B related records kept at the surveillance pilot points were downloaded from NNDRS.Data concerning proportion of unclassified Hepatitis B cases,consistency of additional records and the accuracy of reported acute Hepatitis B cases were evaluated.Results The proportion of unclassified Hepatitis B cases was decreasing year by year (P<0.05),from 32.07% in 2012 to 4.26% in 2015,with Kappa as 0.768,0.821 and 0.836 respectively in 2013-2015.The accuracy of reported acute Hepatitis B was improving (P<0.05),from 55.77% in 2013 to 74.49% in 2015.Conclusions Additional records and blood testings on acute Hepatitis B cases seemed to be effective in improving the accuracy of Hepatitis B reporting system and decreasing the proportion of unclassified Hepatitis B cases.We suggested that this model of surveillance could be applied elsewhere in the nation to improve the quality of report system on Hepatitis B.
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Objective To understand the characteristics of acute hepatitis B inpatients reported by the hepatitis B surveillance pilot points and to estimate the consistency between the diagnosed and reported types of hepatitis B by the clinicians involved.Methods Data related to acute hepatitis B was from the NNDRS and the characteristics of acute hepatitis B were classified by querying Hospital Information System.We recorded the results based on clinical diagnosis and analyzed the consistency between the reported and diagnosed types that the clinicians made,on hepatitis B.Resulis A total of 179 patients were included in this study with all of them as acute hepatitis B reported through NNDRS in 2015-2016.In terms of the durations of disease,among the 179 cases who were HBsAg positive,32.40% (58/179) of them exceeding 6 months,2.79% (5/179) within 6 months and 64.80% (116/179) tested the first time or never.Among the 179 cases who claimed having the history of hepatitis,33.52% (60/179) of them identified as having hepatitis B,1.12% (2/179) were hepatitis A,C or E,41.34% (74/179) did not have the signs on hepatitis,while the rest 24.02% (43/179) did not know the situation.Only 79.89%(143/179) of the patients showed the symptoms or signs of hepatitis,but the rest 20.11%(36/179) did not.Among the 179 reported acute hepatitis patients,67 of them were diagnosed as acute hepatitis B while 112 cases were as non-acute hepatitis B.The consistent rate of acute hepatitis B was 37.43% (67/179).Among the 112 cases that were diagnosed as non-acute hepatitis B,proportions of chronic hepatitis B and cirrhosis were 49.11%(55/112) and 16.07%(18/112) respectively.Conclusion Consistency between the reported type of acute hepatitis B inpatients and the types diagnosed by clinicians was poor.Our results suggested that clinicians should make the accurate diagnosis at first place and then report to the Network in accordance with the clinical diagnosis classification criterfia,set by the government.
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Objective To analyze the sero-epidemiological features of hepatitis B among children aged 1-14 years old who were born to HBsAg positive mothers.Methods Based on the results from the hepatitis B national sero-survey in 2014,children aged 1-14 years old born to HBsAg positive mother were involved in this study.Positive rates on HBsAg,anti-HBs,anti-HBc by gender,age,nationality,birth place,residency (urban/rural),region (eastern/central/western) and related factors of HBsAg and anti-HBs for children under research,were analyzed by SPSS 18.0 statistical software.Results A total of 645 children aged 1-14 years old that born to HBsAg positive mothers were analyzed in the study.Positive rates on HBsAg,anti-HBs,anti-HBc among these children were 3.41% (22/645),71.94% (464/645) and 7.60% (49/645),respectively.HBsAg positive rates for children aged 1-2 years,3-4 years,5-9 years,10-14 years appeared 1.27% (3/236),3.23% (6/186),5.71% (8/140) and 6.02% (5/83),respectively.The anti-HBs positive rates were 85.17% (201/236),69.35% (129/186),56.43% (79/140),66.27% (55/83) while the anti-HBc positive rates were 4.66% (11/236),5.38% (10/186),11.43% (16/140) and 14.46% (12/83),respectively.Results from the multifactor logistic analysis showed that birth place,time of the first dose of HepB inoculation were major influencing factors on the positive rates among children with HBsAg.HBsAg positive rate for the children born outside the hospital was higher than those born in the hospital (OR=7.47,95% CI:1.50-37.25).HBsAg positive rate for children with the first dose of HepB inoculation>24 h after birth,was higher than that inoculation within 24 h after birth (OR=6.21,95% CI:2.15-17.99).Conclusions Some achievements in preventing mother-to-child transmission of hepatitis B had been seen in China.Hospital delivery for pregnant women and timely HepB vaccination with birth-dose for the neonates,remained the key strategy on prevention of HBV vertical transmission.
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Objective To evaluate the effects on Hepatitis B surveillance models at the surveillance pilot points in China.Methods Hepatitis B related records kept at the surveillance pilot points were downloaded from NNDRS.Data concerning proportion of unclassified Hepatitis B cases,consistency of additional records and the accuracy of reported acute Hepatitis B cases were evaluated.Results The proportion of unclassified Hepatitis B cases was decreasing year by year (P<0.05),from 32.07% in 2012 to 4.26% in 2015,with Kappa as 0.768,0.821 and 0.836 respectively in 2013-2015.The accuracy of reported acute Hepatitis B was improving (P<0.05),from 55.77% in 2013 to 74.49% in 2015.Conclusions Additional records and blood testings on acute Hepatitis B cases seemed to be effective in improving the accuracy of Hepatitis B reporting system and decreasing the proportion of unclassified Hepatitis B cases.We suggested that this model of surveillance could be applied elsewhere in the nation to improve the quality of report system on Hepatitis B.
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Objective@#To evaluate the effect of hepatitis B prevention and control by comparative analysis on the results of HBsAg, anti-HBs and anti-HBc prevalence from national hepatitis B seroepidemiological surveys in 1992 and 2014 in different epidemic regions of China.@*Methods@#Data was from the national seroepidemiological surveys of hepatitis B conducted in 1992 and 2014. The survey in 1992 was conducted in 145 disease surveillance points of 30 provinces (excluding Hong Kong, Macao Special Administrative Region and Taiwan province) in China. The survey in 2016 was conducted in 160 disease surveillance points of 31 provinces (excluding Hong Kong, Macao Special Administrative Region and Taiwan province) in China. In the two surveys, face-to-face interviews with the subject by door to door or on the investigation site were conducted by trained staff using standard questionnaires to obtain basic information including birth date, gender, ethnicity, resident place and so on. And then 5 ml venous blood was collected to test the sero-markers of HBsAg, anti-HBs and anti-HBc. We analyzed unweighted point prevalence and 95% CI of HBsAg, anti-HBs and anti-HBc in 1992 which had no design weighting, and analyzed weighted point prevalence and 95%CI of HBsAg, anti-HBs and anti-HBc in 2014 which had design weighting.@*Results@#34 291 and 31 713 people aged 1-29 years were involved in 1992 and 2014 national serosurveys of China, respectively. For the people aged 1-29 years, HBsAg prevalence was 2.64% (95%CI: 2.28%-3.06%) in 2014 and decreased by 73.92% as compared with the rate 10.13% (95% CI: 9.81%-10.45%) in 1992. Anti-HBc prevalence was 13.01% (95%CI: 12.09%-14.00%) in 2014 and decreased by 71.61% as compared with the rate 45.84% (95% CI: 45.31%-46.37%) in 1992. Anti-HBs prevalence was 57.79% (95%CI: 56.33%-59.25%) in 2014 and ascended by 127.41% as compared with the rate 25.41% (95% CI: 24.95%-25.87%) in 1992. In high, medium and low epidemic region, for the people who born during 1992-2001 when hepatitis B vaccine was introduced in routine immunization management, HBsAg prevalence was 4.74% (95%CI: 3.79%-5.69%), 1.59% (95%CI: 1.09%-2.10%) and 2.53% (95%CI: 1.66%-3.39%), respectively, and anti-HBs prevalence was 64.25% (95% CI: 62.11%-66.39%), 56.34% (95% CI: 54.50%-58.57%), 54.49% (95%CI: 51.75%-57.23%), respectively, and anti-HBc prevalence was 15.16% (95%CI: 13.56%-16.76%), 11.07% (95%CI: 9.80%-12.33%), 7.61% (95%CI: 6.15%-9.07%), respectively. In high, medium and low epidemic region, for the people who born during 2002-2013 the duration which hepatitis B vaccine was integrated in expanded immunization program born during when HBsAg prevalence was 0.88% (95%CI: 0.66%-1.11%), 0.37% (95%CI: 0.24%-0.49%)and 0.71% (95%CI: 0.48%-0.94%), respectively, and anti-HBs prevalence was 60.74% (95%CI: 59.57%-61.90%), 59.46% (95%CI: 58.44%-60.49%), 52.56% (95% CI: 51.20%-53.92%), respectively, and anti-HBc prevalence was 3.30% (95% CI: 2.87%-3.72%), 1.91% (95%CI: 1.63%-2.20%), 2.25% (95%CI: 1.85%-2.66%), respectively.@*Conclusion@#China had made great achievement in hepatitis B prevention and control. HBsAg prevalence among people aged 1-29 years old in 2014 decreased dramatically as compared with that in 1992. Since hepatitis B vaccine was integrated into expanded immunization program, China reduced HBsAg prevalence to less than 1% among people aged 1-12 years in 2014 in different epidemic region.
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Objective@#To analyze the sero-epidemiological characteristics of hepatitis B virus among people born during 1994-2001, conducted by the national hepatitis B sero-epidemiological surveys in 2006 and 2014.@*Methods@#Based on the data of the two national hepatitis B sero-epidemiological surveys in 2006 and 2014, people born during 1994-2001 were included into our analysis as this study subjects. The two surveys were conducted in 160 disease surveillance points of 31 provinces (not including Hong Kong, Macao and Taiwan) in China. Face-to-face interviews with the subject by door to door or on the investigation site were conducted by trained staff using standard questionnaires to obtain basic information including birth date, sex, ethnicity, resident place and so on. And then 5 ml venous blood was collected. Enzyme-linked immunosorbent assay (ELISA) reagents were used for HBsAg, anti-HBs and anti-HBc measurements and Abbott micro-particle enzyme immunoassay (MEIA) reagents was used to confirm test. We analyzed HBsAg, anti-HBs and anti-HBc positive rate by gender, ethnicity, urban/rural, eastern/central/western region, birth years and compared the distribution of serum epidemiological characteristics in 2006 and 2014.@*Results@#19 821 and 4 712 people born during 1994-2001 were involved in 2006 and 2014 national serosurveys of China, respectively. For the people born during 1994-2001, HBsAg positive rate were 2.02% (95% CI: 1.82%-2.21%) in 2014 and 1.95% (95% CI: 1.56%-2.35%) in 2006. Anti-HBc positive rate were 7.94% (95%CI: 7.17%-8.71%) in 2014 and higher than that in 2006 (6.49%, 95%CI: 6.15%-6.83%), especially for the female (8.31%, 95% CI: 7.20%-9.43%), urban (7.45%, 95% CI: 6.38%-8.52%), western region (11.25%, 95%CI: 9.79%-12.71%), minority people (16.02%, 95%CI: 13.47%-18.57%) in 2014 were higher than that of the female (6.29%, 95% CI: 5.81%-6.78%), urban (4.82%, 95% CI: 4.40%-5.24%), western region (7.97%, 95% CI: 7.31%-8.63%), minority people (11.88%, 95% CI: 10.66%-13.00%) in 2006 respectively. Anti-HBs positive rate were 57.80% (95%CI: 57.11%-58.48%) in 2014 and 59.13% (95%CI: 57.72%-60.53%) in 2006. Anti-HBs positive rate of rural (58.80%, 95% CI: 56.83%-60.78%),western region (58.50%, 95% CI: 56.23%-60.78%), minority people (57.20%, 95% CI: 53.76%-60.63%) in 2014 was higher than of rural (52.62%, 95% CI: 51.64%-53.61%),western region (51.73%, 95% CI: 50.54%-52.96%),minority people (41.14%, 95%CI: 39.28%-43.00%) in 2006.@*Conclusion@#Anti-HBc positive rate among people born during 1994-2001 in 2014 survey showed a rising tendency than in 2006. The risk of HBV infection was existed. Hepatitis B vaccine catch-up in childhood was necessary.
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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 49 849 and 31 713, respectively. And compared with 2006, the proportion of HBV susceptible people with HepB among 1-29 in 2014 increased from 20.87% (10 401) to 28.55% (9 055) (χ2=630.69, P<0.001); and the proportion of susceptible people without HepB decreasing from 15.02% (7 485) to 7.66% (2 460) (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%, 1 047/2 460) was higher than the proportion in eastern (6.30%, 657/2 460) and middle area (7.30%, 756/2 460) (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.
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Objective@#To analyze the epidemiological characteristics of hepatitis A cases in China from 2004 to 2015.@*Methods@#Data of hepatitis A were reported through national notifiable disease information reporting system, which covered the 31 provinces (Hong Kong, Macau and Taiwan excluded). The inclusion criteria was: date of illness onset was between January 1st 2004 and December 31st 2015, the status of reported card was confirmed, the case was classified as laboratory confirmed or clinical diagnosed, the disease was Hepatitis A. The information such as sex, date of birth, date of illness onset, place of residence was collected. The data was divided into three phases, 2004-2007, 2008-2011, 2012-2015, which represented the phase before expanded program on immunization (EPI), first 4 years after EPI, second 4 years after EPI.@*Results@#From 2004 to 2015, there were totally 574 697 hepatitis A cases in China, the mean annual incidence was 3.62/100 000. The risk ratio of hepatitis A in 2015 was 0.23 when compared with 2004. Sichuan, Xinjiang and Yunnan contributed to 27.27% of the total cases in China. In 2012-2015, the incidence of western (3.46/100 000) region was significantly higher than that in central (1.21/100 000) and eastern (1.08/100 000) regions. From 2004-2015, number of cases in each age group declined greatly, with number of cases declining from 43 711 to 5 938 in the age group of 5-9 years, from 29 722 to 3 438 in 10-14, from 23 212 to 3 646 in 15-19. The number of cases declined from 24 079 to 10 304 in the age group of 0-4 (declined by 57.21%), but in 2012-2015, the incidence of 0-4 age group was still the highest, with 77.72% cases in Xinjiang and Sichuan. Famers, students and scattered children accounted for 69.95% of total cases, with student cases declined from 24.08% (2004-2007) to 8.67% (2012-2015).@*Conclusion@#The incidence of hepatitis A in China is decreasing year by year, the risk has been decreasing to a relatively low level. However, in western regions and children under age five, the risk is still high. Precision intervention is needed for further prevention and control of hepatitis A.
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Objective To analyze the duplicated reporting of hepatitis B in the national notifiable communicable disease report system (NNDRS) in China during 2011-2013.Methods The data of hepatitis B reported from January 1,2011 to December 31,2013 were collected from NNDRS,the duplicated reporting were searched with software SAS 9.1.3 according to the cases' ID number,name,gender,birth data and current address code.Results During 2011-2013,a total of 3 389 374 hepatitis B cases were reported through NNDRS,but the duplicated reporting rate was 7.35% (249 047).According to 6 protocols,the duplicated reporting rate ranged from 0.88% to 6.38%.If using the data in 2011 as the baseline,the duplicated reporting rate in the three years was 2.91%,8.11% and 11.72%,respectively.In the duplicated repeating,33.04% (71 709) occurred in the same year,and 66.96% (145 329) occurred in other year.Without the duplicated repeating,the hepatitis B incidence in Xinjiang and Qinghai provinces in 2013 could decreased by 30.80/100 000 and 26.26/ 100 000,respectively.Conclusions The analysis indicated that the duplicated repeating rate of hepatitis B was 7.36% in NNDRS during 2011-2013,and the duplicated reporting mainly occurred in other years.The duplicated reporting of hepatitis B in NNDRS had greatly affected the accuracy of surveillance data in some provinces,such as Xinjiang and Qinghai.