| Objective:The epidemiological characteristics of acute hepatitis B in Yunnan province and the molecular epidemiology of hepatitis B virus were studied.The molecular epidemiological characteristics of serotypes and genotypes of acute hepatitis B virus in Yunnan province were analyzed,which provided scientific basis for the formulation of targeted prevention and control strategies and measures,and laid a theoretical foundation for effective control of hepatitis B in Yunnan province.Methods:The epidemiological characteristics of 16 721 cases of acute hepatitis B in Yunnan province from 2007 to 2016 were analyzed by descriptive epidemiological method according to the diagnostic criteria for hepatitis B(ws 299-2008).168 samples of acute hepatitis B virus(HBV)were detected by ELISA,s-zone nested PCR and gene sequencing in 2016.The samples were numbered in each prefecture,and 84 samples were collected from 16 prefectures according to the method of systematic sampling.The molecular epidemiology of HBV was studied in 84 samples.Results:1 Epidemiological characteristics of acute hepatitis B from 2007 to 20161.1 General situation of popularityA total of 16721 cases of acute hepatitis B were reported in Yunnan province from 2007 to 2016,with an annual average incidence of 3.62/100,000.The number and incidence of reported cases declined from 2007 to 2012 and increased from 2013.The top three major cities were Banna(9.10/100,000),Baoshan(5.56/100,000)and Wenshan(4.96/100,000).1.2 epidemic characteristics1.2.1 Seasonal distributionThe time distribution of acute hepatitis B cases in Yunnan province from 2007 to 2016 was basically the same,with all cases occurring throughout the year and no obvious seasonal peak.1.2.2 Regional distributionFrom 2007 to 2016,Zhaotong(2363 cases,14.13%),Kunming(2260 cases,13.52%)and Honghe(1862 cases,11.14%)were the top three counties in Yunnan province.The top three counties accounted for 38.78%of the total cases.Xishuangbanna(9.10/100,000),Baoshan(5.56/100,000)and Wenshan(4.96/100,000)were the three cities with the highest incidence.Dehong(1.79/100,000),Yuxi(2.13/100,000)and Qujing(2.44/100,000)were the three cities with the lowest incidence.1.2.3 Population distribution1.2.3.1 Sex distribution In 2007-2016,11160 cases of acute hepatitis B were reported in men,the incidence rate was 4.66/100,000;55 61 cases were female,the incidence rate was 2.50/100 000.The ratio of male to female was 1.84:1,the difference was statistically significant.1.2.3.2 Age distribution Cases of acute hepatitis B occurred in all ages from 2007 to 2016.The peak age was 15-54 years old,accounting for 13 251 cases,accounting for 79.25%of the total population.The 0-14 age group was the low-risk age group,and the incidence rate of each age group showed a decreasing trend from 2007 to 2013.In 2014-2016,the incidence rate increased in all age groups except the 0-14 age group.1.2.3.3 Occupation distribution From 2007 to 2016,the incidence of acute hepatitis B in Yunnan province was mainly concentrated in farmers,students,workers and unemployed population,13741 cases,accounting for 82.18%of the total population,including 11 233 cases of farmers,accounting for 67.18%;1227 students,accounting for 7.34%;690 cases were unemployed,accounting for 4.13%;591 workers,accounting for 3.53%.2 Molecular epidemiological characteristics of acute hepatitis B virus in 20162.1 Basic informationIn 2016,168 cases of acute hepatitis B were classified according to the diagnostic criteria and the quality control requirements of provincial laboratories,and 84 cases of even-numbered samples from 16 prefectures were selected for classification.58 cases were classified successfully,43 cases were male and 15 cases were female.The age group was 1 year old and 82 years old.The average age was 39.30 years old.The majority of the cases were male and middle-aged,10 cases were ethnic minorities and 48 cases were Han nationality.The main symptoms and signs of the case include fatigue,anorexia with or without anaerobic,nausea with or without vomiting,jaundice,etc.The alt values of 58 successful cases were obtained from the cases,56 of 58 cases of acute hepatitis B were abnormal,and the abnormal rate of alt was 96.55%.2.2 Comparison of nucleotide homology of s gene fragmentAccording to the s area,using neighbor-joining,Kimura 2-parameter model method for mapping,bootstrap 1000 times to verify.The results showed that 51 cases(87.93%)were type C,Type B 6 cases(10.34%).Type I 1 case(1.72%).Blast sequence alignment showed that there were 13 cases of Cl subtype,4 cases of C2 subtype,30 cases of C3 subtype,1 case of C5 subtype and 3 cases of C10 subtype.Type B:B2 subtype 3 cases,B3 subtype 1 cases,B4 subtype 2 cases;Type I 1 case was type I1.There was no significant difference in the incidence season,sex,age,nationality and region of HBV genotypes.2.3 Serotype typing resultsThe amino acid sequence of S gene fragment was deduced by mega software.The serotype was determined according to the 122nd amino acid(Lys/arg d/y)and 160th amino acid(Lys/arg r/w)of surface antigen amino acid:adw2 44 cases(75.86%).Adrq +10 cases(17.24%).Ayr serotype 3 cases,accounting for 5.17%;Ayw2 1 cases,accounting for 1.72%,44 cases of ad w2 serum subtypes are C genotype.There was no significant difference in the incidence season,sex,age,nationality and region of HBV serotypes.Conclusion:1.Epidemiological characteristics of acute hepatitis B from 2007 to 20161.1 From 2007 to 2016,the incidence of acute hepatitis B in Yunnan province was 3.62/100,000,which was lower than the national average of 4.70/100,000-7.74/100,000.1.2 Acute hepatitis B occurred throughout the year in 10 years,and there was no obvious seasonal peak.The incidence of acute hepatitis B is higher in men than in women.The incidence of acute hepatitis B is concentrated in the population aged 15-54 years.The occupation of acute hepatitis B is mainly farmers.1.3 The incidence of acute hepatitis B in 16 counties(cities)of Yunnan province is quite different.Xishuangbanna,Baoshan and Wenshan are the key counties with the highest annual incidence.2 Molecular epidemiological characteristics of acute hepatitis B virus in 20162.1 In this study,acute hepatitis B was divided into four serum types,including ayr serotype 3 cases,ayw2 1 cases,adrq +10 cases,adw2 44 cases,serotypes mainly concentrated in adrq+ and adw2.2.2 This study was divided into three genotypes,51 cases of C type,6 cases of B type and 1 case of ? type.The genotype of acute hepatitis B in Yunnan province was mainly C type.2.3 There was no significant difference between the clinical manifestations of sexual hepatitis B and acute attack of chronic hepatitis B and other acute viral hepatitis.The main manifestations were digestive tract symptoms such as asthenia,anorexia,nausea and systemic symptoms,with or without jaundice,and ALT was obviously abnormal.3 Prevention and control advice3.1 Carry out health education for people with high incidence of acute hepatitis B in Yunnan province,and carry out health education for areas with high incidence,and continue to strengthen routine immunization and supplementary vaccination measures for hepatitis B vaccines.3.2 Vaccination against hepatitis B virus is the most effective measure to prevent the spread of hepatitis B virus.People should be encouraged to actively vaccinate against hepatitis B virus. |
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