| Objective:To analyze the incidence of hepatitis B in monitor pilot projects and provide information for the prevention and control of the epidemic situation.Understanding the epidemic status of hepatitis B virus is to analyze subgenotypes and serotypes in Henan Province.To find out the problems existing in the process of hepatitis B monitoring,and evaluate the effect of pilot implementation of hepatitis B monitoring,so as to provide data support for the follow-up expansion of hepatitis B monitoring points..Methods:The data of hepatitis B cases reported from six hepatitis B surveillance sites were analyzed in Henan Province from 2012 to 2017.The indicators of regions,years and occupations of the attached card information were described.Samples suspected of acute hepatitis B were re-examined by ELISA(enzyme-linked immunosorbent assay)for HBsAg,HBeAg and anti-HBc IgM.The S gene of HBV was amplified by nested polymerase chain reaction.The amplified products were detected by electrophoresis and sent to the biological company for sequencing.The sequencing results were spliced,edited and corrected by ContigExpress software.Clustal X software in Mega 6.0,which was used to cluster and compare the spliced S gene sequence,the reference strain sequence.It also analyze the genotype,gene subtype and serotype of HBV.The MHR region of HBV was aligned with the reference sequence to analyze the amino acid mutation sites.Results:Epidemiological distribution of reported cases in surveillance pilot: From 2012 to 2017,a total of 28582 cases of hepatitis B were reported in six pilot hepatitis B surveillance projects,including 25386 cases of CHB(88.8%,25386/28582),1455 cases of acute hepatitis B(5.1%,1455/28582),and 1741 cases of unclassified hepatitis B(6.1%,1741/28582).There were 18686 males(65.4%,18686/28582)and 9896 females(34.6%,9896/28582).The sex ratio was 1.9:1.During 2012 and 2017,the total reported incidence rates in Henan Province were 150.5/lakh,88.8/lakh,76.4/lakh,73.2/lakh,74.0/lakh and 80.2/lakh respectively.The reported morbidity in all monitoring sites decreased from 2012 to 2013,and stabilized from 2014 to 2017.The report showed that the incidence of chronic hepatitis B is much higher than that of acute hepatitis B in the monitoring pilot project from 2012 to 2017.The highest reported incidence was in the 25-30 age group.The reported incidence in males was higher than that in females.The top five reported cases were included farmers,housework and their unemployment,workers,retirees and commercial services.Besides,63.7% were farmers.Molecular epidemiology: 126 samples were successfully amplified and sequenced,of which 17(13.5%)were genotype B and 109(86.5%)were genotype C.B1 subtype accounted for 0.8%,B2 subtype 12.7%,C1 11.9%,C2 74.6%.There were 105 adrq + serotypes,accounting for 83.3%;and 21 were adw2 serotypes accounting for 16.7%.The mutation rate of MHR region was 50.8% in 64 of 126 strains.The mutation sites of HBV were relatively large,including 113,117,122,123,124,126,131,133,147,160,163,164,168 and 169 amino acids.The highest mutation rate of 126 amino acids was 35.7%.Evaluation of the effect of monitoring pilot implementation:(1)Compared with 2011,the unfilled rate of "HBsAg positive time" decreased year by year from 2012 to 2017,which were 97.8%,2.8%,0.3%,0.2%,0.1% and 0 respectively.The undetermined rate of anti-HBc IgM 1:1000 test results was 81.1%,and the undetermined rate of serum HBsAg negative and anti-HBs positive in recovery period was 99.1%.In 2017,the unfilled rate of ALT(U/L)and anti-HBc IgM 1:1000 test results decreased to 0 year by year.(2)There were 6775 unreported cases in 2011,accounting for 39.0% of the total reported cases in 2011.There were 1741 cases,accounting for 13.9% of the total reported cases in 2012,and the proportion of unclassified cases in 2012 decreased by 25.1% compared with that in 2011.There have been no unclassified cases since 2013.(3)From 2013 to 2017,the coincidence rate of acute hepatitis B was more than 80.0%.Conclusion:1.Hepatitis B surveillance pilot report that the incidence of hepatitis B is gradually decreasing.The incidence of chronic hepatitis B is higher than that of acute hepatitis B.The reported incidence in males was higher than that in females.The highest reported incidence was in the 25-30 age group.2.The serotype of HBV in Henan Province is mainly adrq +,which is followed by adw2.The genotype of HBV is C,followed by B.The gene subtype of HBV: B1,B2,C1,C2,of which B2 and C2 are predominant.Mutations occurred in several HBV MHR regions,and the highest mutation rate at 126 amino acids.3.The completeness rate of report card filling is improved.It is necessary to improve the ability of hepatitis B laboratory detection. |
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