Seroepidemiological Survey Of Hepatitis B Among People Over 30 Years Old In Shunde Of Guangdong Province,2015-2016

BackgroundHepatitis B is a worldwide epidemic.Guangdong Province is a major province of Hepatitis B.The carrier rate of Hepatitis B Surface Antigen（HBsAg）is consistently the highest in the country.Shunde District is a highly endemic area of Hepatitis B.Since the hepatitis B vaccine has been incorporated into immunization program for 25 years,the carrier rate of hepatitis B in children and adolescents decreased significantly,while The prevalence of HBV in adults is unclearObjectiveTo understand the prevalence and infection patterns of HBV in people over the age of 30 in Shunde;To evaluate the consistency of the self-reported history of hepatitis B and the serological test results of chronic hepatitis B virus infection;To investigate the distribution of chronic hepatitis B virus infection among people who are chronically infected with the hepatitis B virus and understand the demographic characteristics of Shunde District.To formulate a scientific basis for formulating hepatitis B prevention and immunization strategies.METHODSThis study was based on a population physical examination project conducted by Shunde Hospital of Southern Medical University in2015-2016 in Shunde District.Participants aged 30 or above participated voluntarily as a research object.A total of 5909 people were investigated and interviewed.The questionnaire survey also collected 5 ml of blood.Enzyme-linked immunosorbent assay（ELISA）was used to detect HBsAg,Hepatitis B surface Antibody（Anti-HBs）,Hepatitis B e Antigen（HBeAg）,and Hepatitis B virus in serum.Hepatitis B e Antibody（Anti-HBe）and Hepatitis B core Antibody（Anti-HBc）.Epidata 3.1 and SAS 9.4 software were applied for data entry and statistical analysis.Results:1.Prevalence and distribution characteristics of hepatitis B serological markers:（1）From 2015 to 2016,the HBsAg carrier rate was 16.71% and the standardization rate was 19.49%in the population over 30 years old in Shunde district.The HBsAg carrier rate decreased with age（P trend<0.001）,male（19.87%）was higher than female（14.80%）,the difference was statistically significant（χ²=28.58,P<0.001）;the positive rate of Anti-HBs was 74.18%,the standardization rate was 72.79%,and the positive rate of Anti-HBs increased with age(P_trend=0.001)The positive rate of Anti-HBs in females（75.67%）was higher than that in males（71.74%）.The difference was statistically significant（χ²=11.16,P=0.001）;the HBV infection rate was 78.54%and the standardized rate was 78.38%.The prevalence of HBV infection was highest in primary and middle school populations（80.22%）,followed by junior high school students（79.91%）,and the lowest in colleges and universities（71.01%）.The difference was statistically significant（χ²=24.94,P<0.001）;HBV self-limiting clearance rate was 39.79%,the standardized rate was 38.01%,the higher the age group self-limiting clearance rate（χ²=17.90,P=0.001）,women with self-limiting clearance rate is higher than Males（χ²=6.26,P=0.012）;HBV chronic infection rate was 15.69%,standardized rate was18.41%,males were higher than Sex（χ²=29.01,P<0.001）;HBV susceptibility was 5.11%,standardized rate was 4.68%,female was higher than male（χ²=6.56,P=0.010）,and the susceptibility rate was highest in50⁵9 age group was 6.10%.2.Hepatitis B serological detection models:（1）A total of 27 hepatitis B serological markers models were detected.Mode 1（only Anti-HBs and Anti-HBc were positive）was the highest detection rate,accounting for 40.08%,Mode 2（Anti-HBs single-positive）followed,accounting for 15.29%;Mode 3（Anti-HBs,Anti-HBe and Anti-HBc were positive）and Mode 4（HBsAg,Anti-HBe and Anti-HBc were positive）ranked 3rd and 4th respectively,accounting for 14.75%and 11.05%;the above four modes accounted for the total81.03%.The hepatitis B serological combination patterns of different ages and gender groups were substantially similar.（2）A total of 22 hepatitis B serological models were detected among women of child-bearing age（30⁴9）,among which mode 1 had the highest detection rate,accounting for 39.13%of all women of child-bearing age（30⁴9）,followed by the higher detection rates of mode2,3,and 4.They accounted for 16.19%,15.37%,and 10.34%of all the detection patterns of women of childbearing age（30⁴9）,and these four models accounted for 81.03%of the total.3.The consistency between the self-reported history of hepatitis B and the chronic hepatitis B infection test results was poor.The Kappa value was 0.28.Among chronic HBV infection,the rate of self-report of male,high age groups,low education levels,and unemployed,retired,or housewives was low.ConclusionThe prevalence of hepatitis B among people over the age of 30 in Shunde District was high.The pattern of HBV infection in this population was mainly the pattern of immunization acquired after infection,but there were still a small number of susceptible individuals in this population,The problem of poor consistency in serological test results for viral infections was exist.It was necessary to strengthen the health education for prevention and treatment of hepatitis B in this population,and to carry out hepatitis B vaccination against susceptible adults in order to reduce the rate of HBV infection and control the spread and spread of hepatitis B.