Whether a booster dose of hepatitis B vaccine is necessary for adolescents remains controversial. We conducted a retrospective cohort study from the Immunization Information System and The National Notifiable Disease Reporting System to evaluate the impact of hepatitis B virus (HBV) vaccination programs (universal infant hepatitis B immunization and adolescent booster) on HBV infection. The vaccine effectiveness (VE) of hepatitis B vaccine is 64.43

ObjectiveTo understand the current status and influencing factors of the first-dose and full-course vaccination for human papillomavirus (HPV) among girls born in Beijing from 2009 to 2015, thus providing evidence for formulating HPV vaccination strategies for girls. MethodsData related to HPV vaccination for 691 632 girls born between January 1, 2009 and December 31, 2015 and registered in the Beijing Immunization Information System were collected. The current status and influencing factors of the first-dose and full-course vaccination for HPV were analyzed. ResultsAmong the 691 632 girls born in Beijing from 2009 to 2015, 27 011 girls received the first dose of HPV vaccine, with the first-dose vaccination rate of 3.91%; 12 534 girls received the full course of HPV vaccines, with the full-course vaccination rate of 1.81%. Multivariate unconditional logistic regression analysis results showed that girls born in Beijing between 2010 and 2011, as well as those in areas covered by the HPV vaccination program, had higher first-dose vaccination rates for HPV. In contrast, girls born in Beijing between 2012 and 2015, those with non-local or unknown household registration, and those living in suburban and outer suburban areas had lower first-dose vaccination rates. Among the girls born in Beijing, those residing in areas covered by the HPV vaccination program had a high full-course vaccination rate, while those born between 2011 and 2015, those with unknown household registration, and those living in outer suburban areas had lower full-course vaccination rates. ConclusionsThe girls born in Beijing between 2009 and 2015 had lower first-dose and full-course vaccination rates for HPV, especially those born between 2012 and 2015, living in outer suburban areas, and in areas not covered by the HPV vaccination program.

The pneumococcal conjugate vaccine (PCV), Haemophilus influenzae type b (Hib) vaccine, rotavirus vaccine (RV), and varicella vaccine (VarV) have been recommended by WHO for inclusion in National Immunization Program (NIP). However, their vaccination rate is low in China as self-funded vaccines. This study aimed to investigate the coverage of these four vaccines and to identify their influencing factors. Selected via multi-stage stratified sampling, 4,182 guardians participated in a February-March 2025 study. Guardians completed an online questionnaire capturing sociodemographic characteristics, attitudes toward vaccination, and indicators of immunization service accessibility. Individual-level vaccination histories for children were extracted from the Beijing Immunization Information System and linked to survey responses. The vaccination coverage of PCV, Hib vaccine, RV and VarV were 48.5%, 47.4%, 43.5% and 89.3%, respectively. Older age, residence outside urban areas (suburban, outer suburban), and greater number of children in the household were associated with lower coverage of PCV, Hib vaccine, and RV, with adjusted ORs ranging from 0.160 to 0.929 (all p values < .05). Conversely, higher household income (200,000-499,999 CNY and ≥500,000 CNY), guardians' perceived vaccination necessity, and receipt of vaccination notifications were associated with higher coverage of PCV, Hib vaccine, and RV, with adjusted ORs ranging from 1.018 to 6.521 (all p values < .05). The results indicated the vaccination coverage of PCV, Hib vaccine, and RV remains suboptimal in Beijing, with evident regional disparities. Free vaccination policies for PCV, Hib vaccine, RV, and VarV, together with strengthened reminder systems and targeted health education interventions, may help improve vaccine coverage among children.

Background: Various factors influence the immunologic responses to HBV vaccines in adults, including unchangeable individual characteristics. Personalized vaccination regimens accounting for host factors can enhance immune efficiency, particularly for adults at higher risk. Methods: In this two-center controlled trial, HBV vaccine-naïve participants aged 25–55 were randomly administered the two types of HBV vaccines (yeast cell-derived (YDV) or Chinese hamster ovary (CHO) cell-derived) at 0–1–6 months. Antibody titers were measured eight weeks after the final dose. Results: Overall, 289 participants with YDV and 293 participants with CHO completed the three-dose series and antibody testing. The seroprotection rates (SPRs) were comparable (97.23% vs. 98.98%; p = 0.1398), but the geometric mean concentration (GMC) was significantly higher for the CHO (1627.83 mIU/mL vs. 600.76 mIU/mL; p < 0.0001). The GMC of both regimens declined significantly in individuals aged ≥45 years and males. Unlike the YDV, the GMC of CHO was minimally affected by BMI or smoking or drinking status. Conclusion: The CHO regimen may be advantageous for HBV vaccine-naïve adults aged 25–55 with BMI ≥ 25 or those who smoke or drink, in terms of immunogenicity and durability, providing insights for personalized immunization strategies.

The 20 μg (0–1–6 month) hepatitis B virus (HBV) vaccination is widely recommended for HBV vaccine-naïve immune adults in China. However, suboptimal protective responses may occur due to dose-series incompletion. We aim to investigate the immunogenicity of a 60 μg HB vaccine with a 0–2 month series among HBV vaccine-naïve immune adults aged 25–55 to assess potential alternative approaches for HB immunization. A two-center randomized controlled trial was carried out. Participants were randomly allocated to either the 20 μg (0–1–6 month) or the 60 μg (0–2 month) regimen. Blood samples were collected eight weeks after the final injection to measure the antibodies. A total of 583 adults (289 in the 20 μg regimen and 294 in the 60 μg regimen) were included. The seroprotection rates (SPRs) were 97.23% and 93.54% in the 20 μg and 60 μg regimens, respectively (p = 0.0261), and the geometric mean concentrations were 600.76 mIU/mL and 265.68 mIU/mL, respectively (p < 0.0001). The immunogenicity of the 60 μg regimen decreased significantly with age, particularly in adults aged 40 and older. The 60 μg regimen may be beneficial for adults under 40, especially those with poor compliance or in urgent need of immunization.

目的 获得北京市市区居民及医务人员对丙型肝炎(丙肝)知识的知晓及诊治和报告情况,为开展不同人群的丙肝知识宣教和提高丙肝诊断报告质量提供依据.方法 2021年在北京市开展现场调查,社区居民调查采用横断面调查方法,选取北京市东城和通州区作为调查点,每个区按照容量比例抽样原则(PPS)各选取4个社区,每社区随机抽取100名15～65岁居民进行调查.医务人员调查根据2018-2020年丙肝报告病例数和医院级别,选择报告病例数前7家医院的临床医生进行调查.结果 社区居民调查收集有效问卷893份,丙肝基本知识知晓率仅为37.40％;婚姻状况(x2=11.03,P＜0.05)和文化程度(x2=39.98,P＜0.05)是社区人群丙肝基本知识的知晓的影响因素.医务人员调查收集有效问卷498份,丙肝基本知识知晓率达95.98％,但专业知识知晓率为20.08％,对于"丙肝病例的诊断分类"和"丙肝临床诊断病例的诊断依据"的知晓率不足10.00％;文化程度(OR=3.35,95％CI:1.82～6.17)、医院科室(OR=0.40,95％CI:0.20～0.78)和近1年是否接受过丙肝专业培训(OR=10.33,95％CI:1.34～79.79)是医务人员丙肝专业知识知晓的影响因素.结论 社区居民对丙肝知识知晓率较低,尤其是对丙肝临床表现认知存在误区.医务人员丙肝基本知识知晓率较高,但专业知识知晓率较低,尤其是对丙肝临床诊断和分类掌握较差.今后应在不同人群开展差异化健康宣教,对医务人员加强丙肝专业知识培训.

Background The incidence of hepatitis A virus (HAV) infection is low in Beijing, China, but the risk of outbreaks still exists. It is difficult to identify possible sources of infection among sporadic cases based on a routine surveillance system. Therefore, a more effective surveillance system needs to be established. Methods The epidemiological data of hepatitis A were obtained from a routine surveillance system. Patients with HAV confirmed at the local hospitals were asked to complete a questionnaire that included additional case information and possible sources of infection. Serum and fecal specimens were also collected for testing HAV RNA by polymerase chain reaction. In addition, the 321-nucleotide segment of the VP1/2A junction region was sequenced to determine the HAV genotype. Results In 2019, 110 HAV cases were reported in Beijing, with an incidence rate of 0.51/100,000. 61(55.5%) of these patients were male. The greatest proportion of these patients were aged from 30 to 60 years. The rate was lower in suburban and rural areas compared to urban areas. Contaminated food consumption, particularly seafood consumption, was the primary potential source of infection. Among the 16 specimens of confirmed HAV cases that could be sequenced, 93.8% were HAV IA, and 6.3% were HAV IB. In addition, the samples collected from all HAV sequences in this investigation showed 89.4–100% nucleotide homology. Two groups (each with three sporadic cases) showed 100% nucleotide homology. The three sporadic cases in one group had the same possible source of infection: contaminated salad with raw vegetables and seafood. In the other group, the three sporadic cases did not have an epidemiological connection. Conclusions In a low HAV prevalent area, such as in Beijing, incorporating molecular epidemiology into the routine surveillance system could help inform possible clusters of outbreaks and provide support for earlier control of HAV transmission. Nevertheless, increased sampling from detected cases and improved specimen quality are needed to implement such a system.

Chronic hepatitis B virus (HBV) infection is a major global public health problem. Approximately 887,000 people die of HBV infection-related diseases annually, with cirrhosis and hepatocellular carcinoma (HCC) being the principal causes of mortality.[1] Timely antiviral therapy greatly reduces the risks of cirrhosis and HCC. However, unfortunately, of those patients who are eligible for antiviral treatment, only 25% of patients in clinic settings and 12% of those in community settings obtain timely antiviral therapy.[2] Therefore, reliable means of identifying patients with chronic HBV infection that require antiviral therapy are necessary, particularly for use in the community. Liver biopsy has long been considered the gold-standard method for evaluating liver inflammation and fibrosis, but its routine use for diagnosis and community surveillance is limited because of its invasiveness. Golgi protein 73 (GP73) is a type II transmembrane protein that is located in the Golgi membrane and is recognized and cleaved by proprotein convertases, releasing it into the circulation.[3] Previous clinical studies had shown that serum GP73 concentration is high in patients with obvious liver lesions, including inflammation, fibrosis, and cirrhosis, which suggests that serum GP73 may represent a useful biomarker for the assessment of liver injury.[4] However, it is unclear whether the measurement of serum GP73 concentration would be an effective means of identifying patients with chronic HBV infection in the community who require antiviral therapy. Therefore, in the present study, we aimed to evaluate the use of serum GP73 for the identification of chronic HBV infection requiring antiviral therapy in a community setting. We performed a cross-sectional study of serum Hepatitis B surface antigen (HBsAg) positive community-dwelling patients who had accepted the health examination from July 2017 to September 2019 in the Beijing Center for Disease Prevention and Control (Beijing, China). The inclusion criteria were as follows: (1) age ≥18 years; (2) HBsAg-positivity (HBsAg ≥0.05 IU/mL) for ≥6 months; (3) availability of blood samples. The exclusion criteria were as follows: (1) history of hepatitis virus infection other than HBV; (2) history of antiviral treatment during the preceding 6 months; (3) pregnancy or other non-viral liver diseases, such as alcohol-related, autoimmune, or drug-induced liver disease. The study was conducted in accordance with the Declaration of Helsinki and its amendments and was approved by the Biomedical Ethics Committee of Peking University (No. IRB00001052-19081). Written informed consent was obtained from all the participants. At present, the latest Chinese guidelines for the prevention and treatment of chronic hepatitis B (CHB) state that the decision to start antiviral therapy should depend on a comprehensive analysis of serum HBV deoxyribonucleic acid (DNA) levels, alanine aminotransferase (ALT) levels, the severity of liver disease, as well as their age, family history, and concomitant diseases.[5] Therefore, the indications for antiviral therapy in this study include the following: (1) serum HBV DNA is positive, ALT levels are persistently abnormal (>upper limit of normal [ULN]), and other causes have been excluded; (2) HBV-related compensated cirrhosis patients with positive serum HBV DNA and HBV-related decompensated cirrhosis patients with positive HBsAg; (3) noninvasive tests or liver biopsy revealing obvious liver inflammation or fibrosis in those with persistently normal ALT levels and age >30 years old.[5] Liver fibrosis and cirrhosis were evaluated by liver stiffness measurement (LSM) using transient elastography. And the participants were allocated to three groups according to the expert consensus[6]: no/mild fibrosis, significant/advanced fibrosis, and cirrhosis [Supplementary Figure 1, https://links.lww.com/CM9/A979]. A total of 1529 patients with a mean age of 48.1 ± 13.13 years were included in this study, of whom 782 (51.1%) were men. The fibrosis/cirrhosis status of each patient was evaluated following the recommended diagnosis work-flow,[6] which showed that 1246 patients had no/mild fibrosis, 205 patients had significant/advanced fibrosis, and 68 patients had cirrhosis. The remaining 10 individuals were not assessed for liver fibrosis due to ALT ≥200 U/L or total bilirubin (TBil) ≥51 μmol/L, but still required antiviral therapy. A total of 422 (27.6%) patients met the recommended criteria for antiviral therapy, with abnormal ALT (>ULN) and/or significant or severe fibrosis/cirrhosis. To determine whether serum GP73 could reflect the severity of liver fibrosis, the concentrations in patients at different stages of fibrosis were compared. This showed that the serum GP73 levels of the non/mild fibrosis group were significantly lower than those of the significant/advanced fibrosis and cirrhosis groups (54.57 ng/mL vs. 67.79 ng/mL vs. 67.70 ng/mL, respectively; P < 0.001), implying that the measurement of serum GP73 may represent a means of identifying patients with significant/advanced fibrosis or cirrhosis. The potential utility of serum GP73 for the identification of patients with significant/advanced liver fibrosis and cirrhosis was further evaluated using receiver operating characteristic (ROC) analysis. The area under the ROC curve of serum GP73 for the identification of significant/advanced liver fibrosis and cirrhosis was 0.605 (95% confidence interval: 0.58–0.64, P < 0.001), and the sensitivity and specificity were 62.6% and 56.6%, respectively. There were no significant differences in the screening efficiencies of serum GP73 vs. the aspartate aminotransferase-to-platelet ratio index and fibrosis-4 index, two established non-invasive diagnostic indices of liver fibrosis (P = 0.338 and 0.925, respectively). The findings of community screening were also consistent with serum GP73 concentration reflecting liver inflammation. The participants were allocated to three groups, using ALT levels of >40 U/L and >80 U/L as cutoff values, and the serum GP73 concentrations of each group were compared. The serum GP73 concentration increased significantly with increases in ALT levels (60.63 ng/mL vs. 78.46 ng/mL vs. 103.1 ng/mL, respectively; P < 0.001). Further correlation analysis also showed that serum GP73 positively correlated with ALT serum concentrations, albeit relatively weakly (r = 0.275, P < 0.001). Serum GP73 could not only be used as a serum marker of significant fibrosis and cirrhosis but also for the evaluation of the severity of liver inflammation in patients with CHB. In this community-based study, we also evaluated the utility of serum GP73 for the screening of a population to identify patients who require antiviral therapy. The results showed that patients that needed antiviral therapy had significantly higher serum GP73 concentrations than those who did not (68.99 ng/mL vs. 53.17 ng/mL; P < 0.001). In addition, the ROC curve yielded a cut-off value of serum GP73 for the screening of patients for a requirement for antiviral therapy was 59.08 ng/mL, with a true-positive rate (TPR) and false-negative rate (FNR) of 62.8% and 37.2%, respectively. When ALT >40 U/L alone was used to screen such patients, the TPR and FNR were only 50.2% and 49.8%, and the screening efficacy slightly lower than that of serum GP73 (62.8% vs. 50.2%). When serum GP73 was combined with ALT for the screening of the patients, the TPR increased to 78.9%, the FNR decreased to 21.1%, and the patient detection rate was further improved [Table 1]. Table 1 - Use of serum GP73 concentration, ALT activity, and a combination for the screening of patients with CHB for a requirement for antiviral therapy. Needing antiviral therapy, n (%) Indicators Yes No Serum GP73 alone (+) 265 (62.8) 452 (40.8) Serum GP73 alone (−) 157 (37.2) 655 (59.2) ALT alone (+) 212 (50.2) 10 (0.9) ALT alone (−) 210 (49.8) 1097 (99.1) GP73 (+) and/or ALT (+) 333 (78.9) 458 (41.4) GP73 (−) and ALT (−) 89 (21.1) 649 (58.6) Total 422 (100) 1107 (100) Serum GP73 (+): GP73 > 59.08 ng/mL; serum GP73 (−): GP73 ≤ 59.08 ng/mL; ALT (+): ALT > 40 U/L; ALT (−): ALT ≤ 40 U/L. ALT: Alanine aminotransferase; CHB: Chronic hepatitis B; GP73: Golgi protein 73. Timely detection and the administration of antivirals are important ways of delaying the development of end-stage liver disease in and improving the quality of life of patients with CHB. In 2015, the World Health Organization produced its first set of guidelines regarding the prevention, care, and management of chronic HBV infection, in which it advocated the use of simple, non-invasive diagnostic tests to assess the stage of liver disease and eligibility for treatment. The current mainstream guidelines for CHB state that HBV DNA and abnormal ALT levels should be used to evaluate liver injury and serve as the marker to start antiviral treatment. However, previous studies have shown that 13.8% to 47.5% of HBsAg-positive individuals have ongoing liver damage but normal ALT levels,[7] which implies that the conventional means of identifying patients that require antiviral therapy is inadequate. Thus, new non-invasive biomarkers of liver injury are still required to identify patients who need antiviral treatment. Serum GP73 is an emerging serological marker in recent years, but its biological significance and clinical application value remain to be further investigated. In this community screening study, although limited by the availability of trials using LSM and ALT as criteria to identify patients requiring antiviral therapy, the results confirm serum GP73 not only reflects the severity of liver injury but also identifies more patients in need of antiviral treatment than ALT. In particular, a combination of serum GP73 and ALT significantly improved the efficacy of screening, which should help clinicians identify more patients with CHB who require antiviral treatment, improve the antiviral treatment rate, and contribute to achieving the goal of eliminating HBV infection by 2030. Funding This work was supported by the National Natural Science Foundation of China (No. 81902115), the National Key Research and Development Program of China (No. SQ2020YFF0426358), and the National S and T Major Project for Infectious Diseases (No. 2017ZX10201201). Conflicts of interest None.

Background The alcohol consumption pattern, alcoholic liver disease (ALD) prevalence and related risk factors among alcohol drinkers in Beijing haven’t been fully elucidated. Hence, a cross-sectional study was conducted to investigate potential link among these factors. Methods A two-stage stratified cluster sampling was carried out in Beijing. All participants were 25 years of age or older, possessed with medical insurance, and lived in Beijing for over 6 months. As part for this investigation, participants were asked to answer a questionnaire and undergo physical examination. The questionnaire included demographic information, alcohol intake, and medical history. The physical examination included physical and Fibrotouch tests. Moreover, 10 ml blood sample was collected from each subject to examine liver functions, perform routine blood, Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV). Results Overall, 74,988 residents participated in our study. The proportion of current drinkers among all participants was 46.10%. The differences in gender, region, age group, education, annual household income, and occupation among lifetime abstainers, former drinkers, non-weekly and weekly drinkers were significantly different ( P <0.05). The ethanol intake between men and women, people living in urban and rural regions were significantly different ( P <0.05). Strong spirits were commonly consumed by men, whereas, beers were commonly consumed by women. Drinking strong spirits generally lead to liver steatosis. In addition, ALD prevalence was 1.30% in participants over 25 years old. The differences in ALD prevalence between men and women, and among different age groups, were significant ( P <0.05). Based on our analysis, ALD risk factors in Beijing included: gender (male), age (older than 35 years), high waist circumference, high blood pressure, high BMI, high blood sugar level, and being heavy drinkers. Conclusion Compared with other cities or regions in China, the level of alcohol consumption in Beijing is at an upper middle level. But the ALD prevalence is low likely because ethanol intake is relatively low. Our analysis revealed that heavy drinking is a major risk factor for ALD development. Hence, if alcohol consumption is unavoidable, we caution against heavy drinking.

The prevalence of metabolic-associated fatty liver disease (MAFLD) is rarely reported in Beijing. The goal of this study was to estimate the prevalence and risk factors of MAFLD among Beijing adults aged ≥25 years old. A cross-sectional, community-based survey with multistage stratified cluster sampling was used. Demographic, transient elastography (TE), biochemical and blood examination information was collected in all the subjects in this study. The prevalence of MAFLD was 32.40% (23,832/73,566). Risk factors independently associated with MAFLD included male gender (OR = 1.47, 95%CI, 1.43–1.52), urban residence (OR = 1.06, 95% CI, 1.02–1.10), older age (30–39 years: OR = 1.29; 40–49 years: OR = 1.43; 50–59 years: OR = 1.09; ≥60 years: OR = 1.52) and lower education (middle school: OR = 2.03; high school: OR = 1.89; undergraduate: OR = 1.69). MAFLD was more common in females than in males after 50 years of age. Lean/normal weight MAFLD patients account for approximately 3.04% (724/23,832) of MAFLD. Compared to non-MAFLD subjects, the lean/normal MAFLD patients had a higher prevalence of hypertension and diabetes, and had a higher degree of hepatic steatosis and liver function enzymology parameters (all p < 0.001). MAFLD was highly prevalent among the general population aged ≥25 years old in Beijing. MAFLD was closely associated with male gender, older age, lower education and urban residence. Even lean/normal-weight people were under risk of MAFLD.

Objectives: To assess the prevalence of hepatitis B virus (HBV) infection among married individuals and to analyze the associated risk factors of HBV infection in vaccinated and unvaccinated groups in 2006 and 2014. Methods: Information of married individuals aged over 16 y with a clear HBV vaccination status was extracted from the database constructed by the Beijing Center for Disease Prevention and Control from population-based investigation. A structured questionnaire was employed to collect demographic information, vaccinated history, and other related influence information of HBV of participants. Pearson chi-square test, Fisher's test, and logistic regression were used to explore the risk factors of HBV infection. Results: A total of 2874 individuals in 2006 and 1622 individuals in 2014 were enrolled in our study. The mean age of individuals was 49.30 and 46.68 y in 2006 and 2014, respectively. The overall positive rates of HBsAg, anti-HBc, and single anti-HBs were 4.80%, 43.01%, and 5.78% in 2006, which were 4.69%, 38.22%, and 14.18% in 2014, respectively. For vaccinated individuals, age was significantly correlated with anti-HBc in 2014 (40 < age ≤50 versus age ≤30, relative risk (RR) = 3.03, 95% confidence interval (95%CI) = 1.04–8.84). Gender [male versus female, RR = 0.60, 95%CI = 0.36–1.00 (2006); RR = 0.71, 95%CI = 0.52–0.97 (2014)] and age (in 2006) were found to be significantly associated with single anti-HBs. For unvaccinated individuals, HBsAg positivity was statistically significant correlated with gender [RR = 1.47, 95%CI = 1.04–2.06, in 2006], residence (urban versus rural, RR = 0.40, 95%CI = 0.24–0.67, in 2006; RR = 0.58, 95%CI = 0.34–0.99, in 2014), sharing syringes [RR = 3.75, 95%CI = 1.33–10.63 (in 2006); RR = 2.07, 95%CI = 1.26–3.41 (in 2014)], infected wives (RR = 1.97, 95%CI = 1.28–3.05, in 2006), and infected husbands (RR = 2.19, 95%CI = 1.25–3.82, in 2006). Anti-HBc positivity was significantly associated with gender [RR = 1.19, 95%CI = 1.10–1.30 (in 2006); RR = 1.24, 95%CI = 1.09–1.40 (in 2014)], age (in 2006 and 2014), endoscopic medicine treatment [RR = 1.16, 95%CI = 1.03–1.32 (in 2006), RR = 1.21, 95%CI = 1.01–1.45 (in 2014)], sharing syringes (RR = 1.43, 95%CI = 1.25–1.64, in 2014), body piercing (RR = 0.84, 95%CI = 0.75–0.93, in 2006), infected wives (RR = 1.32, 95%CI = 1.18–1.47, in 2006), and infected husbands (RR = 1.39, 95%CI = 1.22–1.59, in 2006). Anti-HBs positivity was associated with age (in 2006 and 2014). Conclusions: Prevalence of HBV infection was lower in 2014 than in 2006 according to HBsAg and anti-HBc positivity. Unvaccinated individuals faced much more risk of HBV infection than those of vaccinated.

Abstract Background Hepatitis B virus (HBV) infection is a major public health problem in China. Over a decade has passed since the last National Hepatitis Seroepidemiological Survey was conducted in 2006. The lack of updated data on hepatitis B in China makes assessing the current prevalence and burden of the disease inadequate. In response to the above situation, a systematic review and meta-analysis was conducted to provide a better understanding of hepatitis B epidemiology in the general population of China. Methods A systematic search was conducted in international databases (Medline through PubMed, EMBASE, Cochrane, Web of Science) and national databases (CBM, CNKI, WanFang Data) to retrieve primary studies published between January 1, 2013 and December 31, 2017. The pooled prevalence of HBV infection and 95% confidence intervals were calculated. Quality assessment, heterogeneity testing and publication bias assessment were also performed. Results Of the 27 studies included in the meta-analysis, the pooled estimated prevalence of HBV infection in the general population of China from 2013 to 2017 was 6.89% (95% CI:5.84–7.95%), which could be extrapolated to an estimated population of 84 million living with HBsAg in 2018. The prevalence of HBV infection in males was higher than that in females (5.88% vs 5.05%), and rural areas had a higher prevalence than urban areas (5.86% vs 3.29%). The highest prevalence of HBV infection was reported in Western provinces (8.92, 95% CI: 7.19–10.64%). In adults older than 20 years, the prevalence of HBV infection was approximately 7%, which was higher than that in children. Conclusion The prevalence of HBV infection in the general population of China was classified as higher intermediate prevalence (5–7.99%), of which more than 90% of the HBV infection population included adults older than 20 years. The blocking of mother-to-infant hepatitis B transmission and plans involving timely birth dose of hepatitis B vaccine within 24 h should be implemented. Additionally, improving the quality of life and survival rate of the infected population through antiviral therapy and high-risk adult vaccination will be the priority of our future work. Moreover, various control measures should be implemented in different provinces across China.

Backgroud: Beijing was hyper-endemic for hepatitis A until the 1990s and has been vaccinating against hepatitis A since 1994. The objective is to study the epidemiology and changes of antibody level of hepatitis A from 1990 to 2017. Methods: A multistage randomized cluster sampling serological cross-sectional study was conducted in individuals over one year old in 1992, 2006 and 2014 in Beijing. Venous blood samples were collected to test anti-HAV antibody. The incidence data of hepatitis A were obtained from National Notifiable Disease Reporting System (NNDRS) and CDC statistics in Beijing. The vaccination data of hepatitis A immunization were acquired from Beijing Immune Information System. Results: From 1990 to 2017, the reported incidence rate of HAV in Beijing declined from 59.41/100,000 in 1990 to 0.80/100,000 in 2017. The average age of HAV infection was postponed from individuals under 20 years old to individuals over 20 years old. After hepatitis A vaccine was introduced to Beijing, the outbreak of hepatitis A decreased sharply. Adjusted anti-HAV positive rate in general population was 68.23%, 81.73% and 82.47% respectively in 1992, 2006 and 2014. Due to hepatitis A vaccination conducted in children, the anti-HAV positive rate in individuals under 20 years old increased from 1992 to 2014, while in individuals over 20, this rate was barely changed. The coverage rate in target population was higher than 99% after hepatitis A vaccine was integrated into Expanded Program on Immunization (EPI). Conclusion: Incidence rate of hepatitis A in Beijing has decreased dramatically from 1990 to 2017. Hepatitis A vaccine plays an important role in protecting individuals under 20 years old. A higher proportion of adults will be susceptible to hepatitis A virus due to the decay of antibodies as they grow up from childhood to adulthood, which may result in possible outbreak of hepatitis A.

Objective To investigate the anti-HBs level in 15 years after vaccination in adults and newborns in Beijing and provide the suggestion for the adult hepatitis B (HB) immunization plan.Methods A serological survey was conducted in 6 705 subjects aged > 1 year old by multistage randomized cluster sampling in Beijing during August 2013 to February 2014.The subjects who had received a 3-dose recombination HB vaccine when they were newborns or adults aged ≥15 years old and did not undergo revaccination were selected.Antibody to hepatitis B surface antigen (anti-HBs) titers and positive rates in 15 years after vaccination were evaluated.Results A total of 129 and 463 subjects who were vaccinated in adults and newborns were enrolled in the study.Based on the self-limited rate(30%) of HBV infection among the general population aged 15 to 59 years, anti-HBs positive rates for the subjects vaccinated in adults were estimated to be 58.6%,62.5 % and 48.4% during 0-4, 5-9 and 10-15years after vaccination respectively.The corresponding median of anti-HBs titers were 288.8, 120.6 and 62.6 mIU/mL.The anti-HBs positive rates for the subjects vaccinated in newborns during 0-4, 5-9 and 10-15 years after vaccination were 83.3%, 47.3% and 43.5%, respectively.The corresponding anti-HBs titers were 71.8, 8.9 and 6.7 mIU/mL.Conclusions The protection afforded by primary immunization with recombination vaccine in adults and newborns lasts at least 15 years.

Background: The widely recommended standard schedule of hepatitis B vaccine for adults is months 0, 1 and 6, which takes 6 months to complete. Rapid completion of one vaccination schedule is important to adults because of its low compliance with follow-up doses. A new type of 60 mu g Hepatitis B vaccine, made by Shenzhen Kangtai Biological Products Co., LTD., is originally recommended for low or non-responders. The objective of this clinical trial was to test whether this 60 mu g hepatitis B vaccine could be used in primary immune population and what is its level of immunogenicity and safety compared with other hepatitis B vaccines.Methods: This is a 2-center randomized controlled study. A total of 1169 healthy adults aged between 25 and 55 who tested negative for HBsAg, anti-HBs, and anti-HBc were eligible for the study and were enrolled from relatively fixed and stable sites, such as villages, schools and large enterprises et al in Xuanhua county in Hebei province and Huaibei county in Anhui province. They were randomized to group A (20 mu g Engerix-B (R) with 0, 1, 6 month intervals), group B (20 mu g Kangtai hepatitis B vaccine with 0, 1, 6 month intervals), group C (60 mu g Kangtai hepatitis B vaccine with 0, 2 month intervals) and group D (20 mu g Huabei hepatitis B vaccine made by recombinant DNA techniques in CHO cell with 0, 1, 6 month intervals). In group A, B and D, every study object's blood sample was collected in the second month after their final injection to test the anti-HBs levels; while in group C, the blood sample was collected in the second month after the first and the second injection to test the anti-HBs levels. Adverse events were collected after each dose to assess the vaccines' safety.Results: The seroprotection rates were 93.17%, 97.23%, 93.54% and 98.98% respectively and the geometric mean titers (GMTs) were 1033.38 mIU/ml, 600.75 mIU/ml, 265.69 mIU/ml and 1627.05 mIU/ml in group A, B, C and D respectively. The difference of seroprotection rate among the 4 groups was statistically significant (chi(2) = 17.26, P < 0.05). The difference of titers of anti-HBs among the 4 groups was statistically significant (H = 162.42, P < 0.05). BMI, age (older than 40) and smoking were the influence factors of anti-HBs levels on 60 mu g hepatitis B vaccine.Conclusion: 60 mu g hepatitis B vaccine has a satisfactory safety and seroprotection rate in adult, It could be used in rapid adult hepatitis B immunization.

Objective To investigate the risk factors of acute hepatitis B virus through blood and sexual contact transmission in Beijing.Methods A population-based 1∶2 matched case-control study was used in our survey.Three hundred and one acute hepatitis B cases living in Beijing more than one year reported in National Notifiable Disease Reporting System from January 2013 to December 2014 were recruited as cases.Six hundred and two sex-,age- and resident-matched individuals were selected as controls.All cases and controls were interviewed by questionnaires.Categorical variables were compared using chi-square test between groups.Risk factors for acute hepatitis B virus through blood and sexual contact transmission were calculated by Logistic regression model.Results Univariate factor analysis showed that history of drug injection in hospital more than half a year (χ2 =5.45,P =0.03),surgery (χ2 =6.94,P =0.01 ),supragingival scaling (χ2 =4.21 ,P =0.05 ),component blood donation (χ2 =4.43, P =0.04),close household contact (χ2 =8.19,P =0.01),pedicure (χ2 =4.41 ,P =0.04),scraping (χ2 = 6.94,P =0.01 )and cupping (χ2 =8.94,P =0.00 )were the risk factors for acute hepatitis B virus through blood and sexual contact transmission.Multivariate Logistic analysis enrolled risk factors with significance into equation and showed that history of drug injection in hospital more than half a year (OR=3.44,95%CI :1.31 -9.01),surgery (OR=4.03,95%CI :1.44-11.30),close household contact (OR=3.17,95 %CI :1 .32 -7.65 )and cupping (OR =1 .87,95 %CI :1 .03 -3.40 )were the risk factors for acute hepatitis B virus through blood and sexual contact transmission.Multivariate Logistic analysis enrolled all risk factors into equation and showed that history of surgery (OR = 1 .45 ,95 %CI :1 .45 -26.84),traumatic medical cosmetology (OR = 6.83,95 %CI :1 .06 -44.16 )were the risk factors for acute hepatitis B virus through blood and sexual contact transmission.Conclusion History of drug injection in hospital more than half a year,surgery,close household contact,cupping and traumatic medical cosmetology are the risk factors for acute hepatitis B virus through blood and sexual contact transmission in Beijing.

目的 探讨新生儿高、低剂量乙肝疫苗免疫策略的成本效益.方法 以北京市1992年出生新生儿为研究对象,采用成本效益分析方法,对高剂量(10μg×3针)和低剂量(5μg×3针)乙肝疫苗免疫策略的预防效果进行卫生经济学评价.结果 实施高剂量免疫策略,可使上述人群急性乙型肝炎、慢性乙型肝炎、肝硬化、肝癌及乙肝表面抗原携带者分别减少1 392、1 445、365、43和3 220例,由此可节省8 046.61万元,效益成本比(BCR)为10.60;低剂量策略对应减少人数为1 233、1 279、323、38和2 851例,节省费用7 123.49万元,BCR为13.16.不同筛查方案、接种率、贴现率、接种成本、筛查率及疫苗保护率不改变上述结果.结论 高剂量免疫策略可减少更多的乙肝相关疾病的发生和节省更多的费用,但BCR低于低剂量免疫策略.我国现已推行的高剂量免疫策略可以获得更好的乙肝防控效果.