河南省18岁及以下住院患者HBV血清流行病学特征分析

李威; 康艳红; 张江峰; 殷辉; 刘俊平; 李玉魁; 康谊

doi:10.3969/j.issn.1001-5256.2023.05.009

河南省18岁及以下住院患者HBV血清流行病学特征分析

DOI: 10.3969/j.issn.1001-5256.2023.05.009

李威^a,
康艳红^a,
张江峰^b,
殷辉^a,
刘俊平^a,
李玉魁^a,
康谊^a, , ,

a.
河南省人民医院感染科，郑州 450003
b.
河南省人民医院检验科，郑州 450003

基金项目:

河南省医学科技攻关计划项目 (LHGJ20190609);

河南省自然科学基金项目 (162300410294)

伦理学声明：本研究方案于2021年12月24日经由河南省人民医院伦理委员会审批，批号：184号。

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：李威负责课题设计，资料分析，撰写论文；康艳红、张江峰、殷辉、刘俊平参与收集数据，修改论文；康谊、李玉魁负责指导撰写文章并最后定稿。

详细信息

通信作者:
康谊，wwhhslek@126.com (ORCID: 0000-0002-4150-5270)

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出版历程
- 收稿日期: 2023-01-27
- 录用日期: 2023-02-28
- 出版日期: 2023-05-20

Seroepidemiological characteristics of hepatitis B virus among hospitalized patients aged 18 years or below in Henan Province of China

a.
Department of Infectious Diseases, Henan Provincial People's Hospital, Zhengzhou 450003, China
b.
Department of Clinical Laboratory, Henan Provincial People's Hospital, Zhengzhou 450003, China

Research funding:

Henan Medical Science and Technology Research Program (LHGJ20190609);

Henan Natural Science Foundation Project (162300410294)

More Information

Corresponding author: KANG Yi, wwhhslek@126.com (ORCID: 0000-0002-4150-5270)

摘要

摘要: 目的调查1~18岁住院患者HBV感染现状，分析乙型肝炎疫苗接种后免疫情况。方法收集2020年7月—2021年7月1~18岁河南省人民医院住院患者的乙型肝炎血清学标志物(HBsAg、抗-HBs、HBeAg、抗-HBe和抗-HBc)以及乙型肝炎疫苗接种等信息，分析HBV感染流行现状和疫苗接种后的免疫效果。趋势分析采用趋势χ²检验。结果共收集住院患者10 658例，男6 372例(59.79%)，女4 286例(40.21%)。人群整体HBsAg阳性占比为0.28%(30/10 658)，17、18岁年龄组HBsAg阳性占比较高，分别为0.68%和0.62%；抗-HBs阳性占比为51.82%(5 523/10 658)，其中1~4岁年龄组抗-HBs阳性占比处于较高水平，均在63%以上，5~18岁年龄组抗-HBs阳性占比下降，波动在40%左右。随着年龄增长，无论男性还是女性，抗-HBs阳性均有下降趋势(男性：χ²=8.217, P=0.004，女性：χ²=10.048, P=0.002)。结论基于住院患者数据，河南省1~18岁人群HBV感染呈现低水平流行、高免疫特点，本地区计划免疫5年以上抗-HBs阳性占比下降的现象需要关注。
- 乙型肝炎病毒 /
- 生物标记 /
- 儿童
Abstract: Objective To investigate the current status of hepatitis B virus (HBV) infection among hospitalized patients aged 1-18 years, as well as the status of immunity after hepatitis B vaccination. Methods Related data were collected from the patients aged 1-18 years who were hospitalized in Henan Provincial People's Hospital from July 2020 to July 2021, including serological markers for hepatitis B (HBsAg, anti-HBs, HBeAg, anti-HBe, and anti-HBc) and hepatitis B vaccination. The epidemiological situation of HBV infection was analyzed, as well as the immune effect after vaccination. The trend chi-square test was used for trend analysis. Results A total of 10 658 hospitalized patients were collected, among whom there were 6 372 male patients (59.79%) and 4 286 female patients (40.21%). In this population, the patients with positive HBsAg accounted for 0.28% (30/10 658), with a relatively high proportion of 0.68% and 0.62%, respectively, in the 17-and 18-year age groups; the patients with positive anti-HBs accounted for 51.82% (5 523/10 658), with a relatively high proportion of > 63% in the 1-4 years age groups, and there was a reduction in the proportion of patients with positive anti-HBs (fluctuating around 40%) in the 5-18 years age groups. With the increase in age, the positive rate of anti-HBs tended to decrease in both male and female patients (male: χ²=8.217, P=0.004; female: χ²=10.048, P=0.002). Conclusion Based on the data of hospitalized patients, HBV infection in the population aged 1-18 years in Henan Province has the characteristics of low prevalence rate and high immunity, and the reduction in the proportion of patients with positive anti-HBs at more than five years after vaccination should be taken seriously in this region.
- Hepatitis B Virus /
- Biomarkers /
- Child

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图 1 抗-HBs阳性分布和趋势

Figure 1. The distribution and trend of HBsAb positive rate

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表 1 1~18岁10 658例人群HBV血清学标志物特点

Table 1. Characteristics of HBV serological markers in 10 658 people aged 1-18 years

HBsAg	抗-HBs	HBeAg	抗-HBe	抗-HBc	人数 (例)	构成比(%)
-	+	-	-	-	5 523	51.82
-	-	-	-	-	5 071	47.58
+	-	+	-	+	24	0.23
-	+	-	-	+	23	0.22
-	-	-	-	+	6	0.06
-	+	-	+	+	4	0.04
+	-	-	+	+	4	0.04
+	+	-	-	-	1	0.01
+	-	+	-	-	1	0.01
-	-	-	+	+	1	0.01
注：-表示阴性，+表示阳性。

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表 2 不同年龄组HBsAg阳性分布

Table 2. The distribution of HBsAg prevalence in different age groups

年龄	总数 (例)	HBsAg阳性 [例(%)]	HBeAg 阳性(例)	抗-HBe 阳性(例)	抗-HBc 阳性(例)
1岁	584	2(0.34)	2	0	3
2岁	547	1(0.18)	1	0	2
3岁	626	1(0.16)	0	1	4
4岁	640	2(0.31)	3	0	6
5岁	602	1(0.17)	1	0	2
6岁	605	2(0.33)	0	2	3
7岁	544	1(0.18)	1	0	3
8岁	527	2(0.38)	2	0	3
9岁	542	1(0.18)	0	0	0
10岁	564	1(0.17)	2	1	3
11岁	570	1(0.18)	0	0	3
12岁	595	2(0.34)	2	0	3
13岁	629	1(0.16)	1	0	4
14岁	586	1(0.17)	1	0	3
15岁	656	1(0.15)	1	1	2
16岁	607	2(0.33)	2	0	2
17岁	586	4(0.68)	4	2	10
18岁	648	4(0.62)	3	2	6
合计	10 658	30(0.28)	26	9	62

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表 3 1~18岁人群血清抗-HBs阳性分布

Table 3. The distribution of HBsAb prevalence in population aged 1-18

年龄	总数 (男/女，例)	总抗-HBs阳性		男性抗-HBs阳性		女性抗-HBs阳性
年龄	总数 (男/女，例)	例数	百分比(%)	例数	百分比(%)	例数	百分比(%)
1岁	584(335/249)	551	94.35	320	95.52	231	92.77
2岁	547(316/231)	466	85.19	272	86.08	194	83.98
3岁	626(361/265)	465	74.28	273	75.62	192	72.45
4岁	640(364/276)	407	63.59	232	63.74	175	63.41
5岁	602(350/252)	295	49.00	172	49.14	123	48.81
6岁	605(342/263)	270	44.63	144	42.11	126	47.91
7岁	544(332/212)	281	51.65	165	49.70	116	54.72
8岁	527(336/191)	216	40.99	138	41.07	78	40.84
9岁	542(359/183)	242	44.65	159	44.29	83	45.36
10岁	564(341/223)	250	44.33	158	46.33	92	41.26
11岁	570(357/213)	249	43.68	154	43.14	95	44.60
12岁	595(344/251)	239	40.17	143	41.57	96	38.25
13岁	629(379/250)	245	38.95	143	37.73	102	40.80
14岁	586(346/240)	226	38.57	136	39.31	90	37.50
15岁	656(372/284)	269	41.01	162	43.55	107	37.68
16岁	607(374/233)	256	42.17	163	43.58	93	39.91
17岁	586(382/204)	272	46.42	177	46.34	95	46.57
18岁	648(382/266)	324	50.00	200	52.36	124	46.62
合计	10 658 (6 372/4 286)	5 523	51.82	3 311	51.96	2 212	51.61

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