Seroepidemiology of hepatitis B virus infection in children - Ten years of mass vaccination in Taiwan
Seroepidemiology of hepatitis B virus infection in children - Ten years of mass vaccination in Taiwan
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DOI：
10.1001/jama.276.11.906
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发表时间：
1996-09-18
影响因子：
120.7
通讯作者：
Chen, DS
中科院分区：
文献类型：
--
作者：
Chen, HL;Chang, MH;Chen, DS
目的：研究在台湾开始大规模乙肝疫苗接种计划10年后，儿童中乙肝病毒感染的血清流行病学。设计-横断面血清抗体调查。-1994年，台湾台北市正中/中城区。对象和方法。-对1515名12岁以下健康儿童的血清样本进行了乙肝病毒标志物的检测。这些结果与1984年疫苗接种计划启动前进行的基线血清流行病学研究以及1989年在同一地区进行的后续研究进行了比较。主要结果-87%的儿童至少接种了3剂乙肝疫苗。乙肝表面抗原血症总患病率从1984年的9.8%下降到1994年的1.3%。在1~10岁各年龄组中均有统计学意义的下降。1984年乙肝核心抗体总患病率为26%，为15%，1994年为4.0%。这表明，随着时间的推移，水平感染乙肝病毒的风险已经降低，这不仅是因为疫苗的保护作用，也是因为感染源已经减少。如预期的那样，1994年乙肝表面抗体的高流行率(79%)。结论-台湾的大规模疫苗接种计划保护了大多数10岁以下的儿童不成为携带者，减少了围产期和水平传播的乙肝病毒。在这个高流行地区，大规模接种乙肝疫苗已被证明是控制乙肝感染的一种成功方法。
Objective.-To study the seroepidemiology of hepatitis B virus (HBV) infection in children 10 years after a mass hepatitis B vaccination program was begun in Taiwan.Design.-Cross-sectional seroprevalence survey.Setting.-Cheng-Chung/Chung-Cheng District, Taipei, Taiwan, 1994.Subjects and Methods.-Serum samples from 1515 healthy children younger than 12 years were tested for HBV markers. The results were compared with a baseline seroepidemiologic study conducted just before the vaccination program was launched in 1984 and with a subsequent study in 1989 in the same area.Main Results.-Eighty-seven percent of the children had received at least 3 doses of HBV vaccine. The overall prevalence rate of hepatitis B surface antigenemia decreased from 9.8% in 1984 to 1.3% in 1994. A statistically significant decrease was observed in every age group from 1 to 10 years. The overall prevalence rate of hepatitis B core antibody was 26% in 1984, 15% in 1989, and 4.0% in 1994. This suggests that the risk of horizontal HBV infection has decreased overtime, not only because of the protective effect of the vaccine but also because the infection source has diminished. A high prevalence rate of hepatitis B surface antibody (79%) was noted in 1994 as anticipated.Conclusions.-The Taiwanese mass vaccination program has protected most children younger than 10 years from becoming carriers, reducing both perinatal and horizontal HBV transmission. Mass HBV vaccination has proved to be a successful method to control HBV infection in this hyperendemic area.