WHAT'S NEW THIS MONDAY: EFFECTIVENESS OF HBV VACCINATION IN ZHEJIANG PROVINCE, CHINA

Shi-gui Yang¹, Bing Wang¹, Ping Chen¹, Cheng-bo Yu¹, Min Deng¹, Jun Yao², Chun-xia Zhu¹, Jing-jing Ren¹, Wei Wu¹, Bin Ju³, Jian-feng Shen³, Yu Chen¹, Ming D. Li^1*, Bing Ruan^1*, Lanjuan Li^1*

1 The State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, the Key Laboratory of Infectious Diseases, Zhejiang Province, Hangzhou, China, 2 Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China, 3 Zhejiang Province Health Bureau Center of Information, Hangzhou, China

Background

Hepatitis B virus (HBV) infection remains a severe public health problem. Investigating its prevalence and trends is essential to prevention.

Methods

To evaluate the effectiveness of HBV vaccination under the 1992 Intervention Program for infants and predicted HBV prevalence trends under the 2011 Program for all ages. We conducted a community-based investigation of 761,544 residents of 12 counties in Zhejiang Province selected according to their location, population density, and economic development. The HBV prevalence trends were predicted by a time-shifting approach. HBV surface antigen (HBsAg) and alanine amino transferase (ALT) were determined.

Results

Of the 761,544 persons screened for HBsAg, 54,132 were positive (adjusted carrier rate 6.13%); 9,455 had both elevated ALT and a positive HBsAg test (standardized rate 1.18%). The standardized HBsAg carrier rate for persons aged ≤20 years was 1.51%. Key factors influencing HBV infection were sex, age, family history, drinking, smoking, employment as a migrant worker, and occupation. With the vaccination program implemented in 2011, we predict that by 2020, the HBsAg carrier rate will be 5.27% and that for individuals aged ≤34 years will reach the 2% upper limit of low prevalence according to the WHO criteria, with a standardized rate of 1.86%.

Conclusions

The national HBV vaccination program for infants implemented in 1992 has greatly reduced the prevalence of HBV infection. The 2011 program is likely to reduce HBV infection in Zhejiang Province to a low moderate prevalence, and perinatal transmission is expected to be controlled by 2020.