中国乙型肝炎最新流行病学及防治进展  

Recent advances in epidemiology,prevention and treatment of hepatitis B in China

作　　者：邓优 孟彤彤 尤红[1] 王宇[2] 贾继东[1] Deng You;Meng Tongtong;You Hong;Wang Yu;Jia Jidong(Liver Research Center,Beijing Friendship Hospital,Capital Medical University/The Nation Clinical Research Center for Digestive Diseases/State Key Laboratory of Digestive Health,Beijing 100050,China;Clinical Epidemiology and EBM Unit,Beijing Friondship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院肝病中心、国家消化系统疾病临床研究中心、消化健康国家重点实验室,北京100050 [2]首都医科大学附属北京友谊医院、北京市临床医学研究所临床流行病学与循证医学研究室,北京100050

出　　处：《中华肝脏病杂志》2025年第2期115-120,共6页Chinese Journal of Hepatology

基　　金：“十三五”重大科技专项(2017ZX10105015);国家重点研发计划(20212YFC2303600);首都卫生发展科研专项(CFH 2022-2-1104)。

摘　　要：过去三十年间,我国在控制慢性乙型肝炎病毒感染方面取得了卓越成就。HBsAg总体阳性率从1992年的9.72%降至2020年的5.86%。尤为显著的是,5岁以下儿童的HBsAg阳性率从1992年的9.67%下降至2020年的0.30%。这一转变得益于自1992年起实施的新生儿乙型肝炎疫苗普遍接种,避免4000多万例HBV感染和700多万例乙型肝炎相关死亡。尽管如此,我国目前仍有约7500万例慢性乙型肝炎病毒感染者,其中约59.78%的感染者在调查前已知晓自身感染状态,约有3000万人尚未确诊,而在已确诊的感染者中,38.25%(约1700万人)具有抗病毒治疗指征,但仅17.33%(约300万人)正在接受抗病毒治疗。为加速实现世界卫生组织提出的“2030年消除病毒性肝炎作为公共卫生危害”目标,我国近年来采取了一系列积极措施,包括更新临床指南,扩大治疗适应证以提高诊断和治疗的覆盖率。同时,我国制药企业和学术界在创新乙型肝炎疗法研发方面也取得了显著进展,为实现慢性乙型肝炎的功能性治愈奠定了基础。通过循证公共卫生干预、优化临床管理策略及推动药物创新等综合措施,我国已形成全方位的乙型肝炎管理模式,为全球乙型肝炎的防控与消除提供了宝贵经验。China has made remarkable achievements during the past three decades in controlling chronic hepatitis B virus infection.The overall HBsAg positivity rate dropped from 9.72%in 1992 to 5.86%in 2020.Particularly,the HBsAg positivity rate among children under five years old has dropped from 9.67% in 1992 to 0.30% in 2020.This transition is due to the universal vaccination of newborns with hepatitis B vaccine since 1992,which has averted over 40 million of HBV infections and seven million hepatitis B-related deaths.However,there are still around 75 million cases of chronic hepatitis B virus infection in China,of which about 59.78% of the infected individuals were aware of their infection status before survey,and about 30 million people have not yet been diagnosed.Among the confirmed infected individuals,38.25%(about 17 million people)have indications for antiviral treatment,but only 17.33%(about 3 million people)are receiving antiviral treatment.Therefore,in order to accelerate the actualization of the World Health Organization's goal of eliminating viral hepatitis as a public health threat by 2030,China has taken a series of active measures in recent years,including updating clinical guidelines and expanding treatment indications to improve the coverage of diagnosis and treatment.At the same time,Chinese pharmaceutical companies and academia have made significant progress in the research and development of innovative hepatitis B therapies,laying the foundation for achieving the functional cure of chronic hepatitis B.Furthermore,China has developed a comprehensive management model for the prevention,control,and elimination of hepatitis B through evidence-based public health interventions,optimized clinical management strategies,and promotion of innovative drugs,providing valuable experience for the world.

关 键 词：慢性乙型肝炎 流行病学 治疗 功能性治愈 公共卫生干预 

分 类 号：R51[医药卫生—内科学]