台灣B型肝炎疫苗接種世代急性B型肝炎發生率及風險因子分析

本研究目的在於分析台灣1998-2017年間急性B型肝炎確定病例發生率趨勢，及B肝疫苗接種世代感染急性B型肝炎之風險因子。研究結果顯示，研究期間台灣各年齡層急性B型肝炎發生率皆呈下降趨勢，尤其以15-29歲年齡層之發生率降幅最高，達85.5％，B肝疫苗接種世代且有接種記錄之急性B型肝炎確定病例，主要發生於1歲以下及15-29歲年齡層，兩者合計佔88％，感染風險因子含括母嬰垂直感染、醫療暴露風險及不安全性行為等。台灣B肝疫苗接種政策有效降低國人急性B型肝炎之發生；基於國內急性B型肝炎發生率持續下降，6歲幼童B型肝炎帶原率已下降至0.8％，且B型肝炎疫苗維持95％以上接種完成率，建議尚無須針對疫苗接種世代全面進行追加接種，惟仍須持續監測並落實各項公共衞生防治策略，以降低B型肝炎病毒傳播。

關鍵字

急性B型肝炎；發生率； B肝疫苗接種；風險因子

並列摘要

The study aimed to analyze the incidence of acute hepatitis B (AHB) and the risk factors of hepatitis B virus (HBV) infection in HBV vaccinated birth cohorts from 1998 to 2017 in Taiwan. The results showed that the continuing downward trend of AHB incidence were in all age groups, especially the age between 15 and 29 years old (85.5%). In HBV vaccinated birth cohorts the majority AHB confirmed cases were 88% for age less than 1 year and age between 15 and 29 years. The risk factors might include perinatal HBV infection, iatrogenic infection risk, unprotected sex, etc. The universal hepatitis B vaccination program has effectively reduced the occurrence of AHB in Taiwan. A previous study demonstrated the surface antigen carriage rate at age six decreased to around 0.8% in Taiwan. However, we observed the continuing downward trend of AHB incidence. In addition, the vaccine coverage rate was reached to 95%. In conclusion, this study suggested that there may not be urgent to consider booster HBV vaccination campaign for the HBV vaccinated birth cohorts. In order to reduce the HBV transmission, it still needs to keep surveillance of the trend of AHB and ensure the implementation of public health interventions.

並列關鍵字

acute hepatitis B ； incidence ； HBV vaccination ； risk factor

參考文獻

WHO_Hepatitis B, 2017: http://www.who.int/ news-room/fact-sheets/detail/hepatitis-b./ Accessed May 30, 2018. doi: 10.1007/s12480-017-0116-x

Chang MH, Chen CJ, Lai MS, et al: Universal hepatitis B vaccination in Taiwan and the incidence of hepatocellular carcinoma in children. N Engl J Med 1997;336:1855-9. doi: 10.1056/NEJM199706263362602

Chen CY, Hsu HY, Liu CC, et al: Stable seroepidemiology of hepatitis B after universal immunization in Taiwan: A 3-year study of national surveillance of primary school students. Vaccine 2010;28:5605-8. doi: 10.1016/j.vaccine.2010.06.029

Ni YH, Chang MH, Jan CF, et al: Continuing Decrease in Hepatitis B Virus Infection 30 Years after Initiation of Infant Vaccination Program in Taiwan. Clin Gastroenterol Hepatol 2016;14: 1324-30. doi: 10.1016/j.cgh.2016.04.030

Chiang CJ, Yang YW, You SL, et al: Thirty-Year Outcomes of the National Hepatitis B Immunization Program in Taiwan. JAMA 2013;310:974-6. doi: 10.1001/jama.2013.276701

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台灣B型肝炎疫苗接種世代急性B型肝炎發生率及風險因子分析

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