title: Effectiveness of HBV vaccination in infants and prediction of HBV prevalence trend under new vaccination plan: findings of a large-scale investigation.
abstract: 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.
authors.affiliation: The State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Province, Hangzhou, China.
authors.forename: Shi-gui
authors.initials: SG
authors.lastname: Yang
authors.forename: Bing
authors.initials: B
authors.lastname: Wang
authors.forename: Ping
authors.initials: P
authors.lastname: Chen
authors.forename: Cheng-bo
authors.initials: CB
authors.lastname: Yu
authors.forename: Min
authors.initials: M
authors.lastname: Deng
authors.forename: Jun
authors.initials: J
authors.lastname: Yao
authors.forename: Chun-xia
authors.initials: CX
authors.lastname: Zhu
authors.forename: Jing-jing
authors.initials: JJ
authors.lastname: Ren
authors.forename: Wei
authors.initials: W
authors.lastname: Wu
authors.forename: Bin
authors.initials: B
authors.lastname: Ju
authors.forename: Jian-feng
authors.initials: JF
authors.lastname: Shen
authors.forename: Yu
authors.initials: Y
authors.lastname: Chen
authors.forename: Ming D
authors.initials: MD
authors.lastname: Li
authors.forename: Bing
authors.initials: B
authors.lastname: Ruan
authors.forename: Lanjuan
authors.initials: L
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002353:Carrier State / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D005544:Forecasting; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage / Q000276:immunology*; D006515:Hepatitis B virus / Q000187:drug effects* / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012737:Sex Factors; D014611:Vaccination
chemical_list: D015415:Biomarkers; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines; D000410:Alanine Transaminase