| According to the requirements of the plan for prevention and treatment of viral hepatitis,medical institutions should implement the rules of hepatitis B detection for patients undergoing operation,hospitalization,hemodialysis and invasive diagnosis and treatment.This study analyzed the results of hepatitis B detection among inpatients,and mainly grasped the epidemiological characteristics,serum combination patterns and influencing factors of inpatients in our province and many provinces from the aspect of sero-epidemiology.The aim of this study is to find out the key population of hepatitis B infection among hospitalized people,and to understand its distribution through geographical regions,so as to provide basis for prevention and treatment of hepatitis B.At the same time,it evaluated the immune effect of hepatitis B vaccine through the analysis of the results of children’s hepatitis B antibody,and put forward suggestions on screening and replanting the effect of hepatitis B vaccine,which had important guiding significance for the health administrative department to put forward scientific and reasonable immune prevention strategies and make correct decisions.This study consists of three parts:1.Survey of hepatitis B infection in a tertiary grade-A hospital;2.Survey of hepatitis B infection in eight tertiary grade-A hospitals;3.Survey of hepatitis B infection among patients born after 2002 in a tertiary grade-A hospital.Part Ⅰ:Method:In this study,975,257 inpatients were collected from the First Hospital of Jilin University from January 2013 to December 2017.Among them,297,576 people were tested for hepatitis B markers in patients who needed surgeries,invasive diagnosis and treatment,dialysis and pregnancy.Criteria for excluding were missing data,repeated testings(retaining the first test results),acute infections and results from hepatitis B related diseases departments.A total of 234,801 patients were included in the testresults.Chemiluminescence immunoassay was used to detect hepatitis B markers,such as hepatitis B surface antigen,hepatitis B surface antibody,hepatitis B e antigen,hepatitis B e antibody and hepatitis B core antibody.Result:The overall positive rate of HBs Ag was 4.74%.The positive rate of HBs Ag gradually increased with age,reached its peak in 31-50 years old,and then decreased with age.The positive rate of HBs Ag was 4.85% in males and 4.62% in females.There was no significant difference in the positive rate of HBs Ag between males and females under 30 years old.The positive rate of HBs Ag in males over 30 years old was significantly higher than that in females.Most HBe Ag seroconversion occured before the age of 40.The single positive rate of HBs Ab was the highest among1-year-old children,and gradually declined with age,accounting for 34.56% of the total.Previous infection accounted for 19.54% of the total,and the susceptible population with total negative HBs Ag markers accounted for 41.15%.The positive rate of HBs Ag in women of childbearing age(15-49 years old)was 5.97%.Conclusion:The positive rate of HBs Ag in hospitalized patients is still high,and the highest rate of HBs Ag was in 31-50 years old patients.Males are significantly higher than females.Most HBe Ag seroconversion occurs before the age of 40.The positive rate of HBs Ag in women of childbearing age is still high along with a high positive rate of HBe Ag.It is necessary to strengthen the implementation and monitoring of mother and infant prevention.Part Ⅱ:Method:This study collected the results of hepatitis B detection of inpatients from 8hospitals in different geographical locations in China from January to December 2016.These hospitals are located in Gansu,Guangxi,Hebei,Henan,Heilongjiang,Jilin,Shanghai and Chongqing,and all of them are in tertiary grade-A hospitals.The patients who need surgeries,invasive diagnosis and treatment,dialysis,pregnancy and other operations were tested for hepatitis B markers,excluding data loss,repeated detections(retaining the first test results),the results from hepatitis B-related diseases departments and the results of patients under one year old.Finally the results of365,020 patients included.The detection methods include chemiluminescenceimmunoassay,time-resolved fluorescence analysis and enzyme-linked immunosorbent assay.Result:The overall positive rate of HBs Ag was 6.42%.With the increase of age,HBs Ag gradually increased,the highest value was in the age group of 31-50 years old,and then gradually decreased with age.Overall,6.95% of males and 5.87% of females were HBs Ag positive.There was no gender difference in the positive rate of HBs Ag under the age of 20.Males over the age of 20 had higher HBs Ag positive rate than females.The positive rate of HBs Ag in Guangxi and Chongqing was significantly higher than that in other provinces.Most of the HBe Ag serological conversion occured before the age of 40,and Gansu Province has the highest positive rate of HBe Ag,accounting for 25%.The positive rate of HBs Ag and HBe Ag in women of childbearing age was 6.93% and 20.28% respectively.Previous infection(HBs Ag negative HBc Ab positive cases)accounted for 26.36%.HBs Ab single positive cases accounted for 34.03%,which gradually decreased with age,reaching a stable level after 40 years old.The total negative susceptibility rate of hepatitis B was 34.26%.Conclusion:Multicenter results showed that the positive rate of HBs Ag in 8 hospitals was6.42%.The positive rate of HBs Ag in southern provinces was higher,and the serological conversion rate of HBe Ag was higher.Although the positive rate of HBs Ag in northern provinces was lower than that in southern provinces with higher single positive rate of HBs Ab,but the proportion of susceptible population to hepatitis B is also higher.Part Ⅲ:Method:The study included 975,257 patients hospitalized in the First Hospital of Jilin University from January 2013 to December 2017.The inclusion criteria were children born after 2002.The total number for inpatients who met the criteria was 141,037.Among them,4268 patients were tested for hepatitis B markers.The exclusion criteria were incomplete and repetitive results.Finally,38,551 patients were included in the test results,ranging from 1 day to 15 years old.Chemiluminescence method was used in the detection.Result:The positive rate of hepatitis B surface antibody was 63.98%,and the positive rate of was 36.46%.The positive rate of HBs Ab and HBs Ab titer ≥ 100 m IU/ml gradually increased with the increase of month age in children under 1 year old.The positive rate of HBs Ab and HBs Ab titer≥100m IU/ml gradually decreased with the age in children older than 1 year old.After the age of 3,the positive rate maintained at50-60%,and the positive rate of HBs Ab titer≥100m IU/ml maintained at 20-30%.The susceptible population of hepatitis B increased with age,and maintained between35-45% after 3 years of age.There was no difference between genders.The positive rate of susceptible population increased from 9.27% at the age of 1 to 35.31% at the age of 3.The decrease rate of HBs Ab positive patients was basically the same as the increase rate of susceptible population.The geometric mean titers of hepatitis B antibodies in all children changed with age,increased from 152 m IU/ml to 313 m IU/ml within 1 year of age,and dropped rapidly below 20 m IU/ml at 3 years of age.The geometric mean titer of HBs Ab positive patients was calculated and showed that it did not decrease with age.It remained stable until 9 years old,and increased significantly after 9 years old to the range of 300-500 m IU/ml.Conclusion:The positive rate of HBs Ab in hospitalized children born after 2002 was 63.98%.The positive rate and titer of HBs Ab in children under 1 year old increased significantly with the month age and decreased with age over 1 year old.The titers of HBs Ab positive children did not decrease with age,instead it increased significantly after 9 years old. |
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