2020-01-012024-05-16https://scholars.lib.ntu.edu.tw/handle/123456789/669993摘要：本計畫之目的在於瞭解我國兒童，青少年與成人疫苗可預防疾病血清抗體流行病學之狀況。我國幼兒A型肝炎疫苗全面施打剛剛開始，瞭解我國目前A型肝炎流行狀況等於是建立106年1月1日以前及以後出生的幼兒A型肝炎的血清流行病學狀況。其次，我國實施多年的全面B型肝炎預防注射之政策下，一般兒童、青少年、以及成人的B型肝炎血清流行病學概況亦須持續追蹤，包括HBsAg、Anti-HBc及Anti-HBs，以了解全面B型肝炎預防注射後我國國民B型肝炎免疫力之流行病學狀況。 此外，C型肝炎目前仍無疫苗可供預防，過去僅有成人族群感染的盛行率資料，欠缺年輕族群的相關資訊。由於近年來發展出可治癒C型肝炎的口服抗病毒用藥，C型肝炎在台灣盛行率調查不但提供研究者重要公衛資訊，並且也為感染者提供可能的治癒機會。 本次計畫將探討全台灣A型肝炎與B型肝炎C型肝炎感染盛行率；男女比例約 1:1。預算及人力時間等因素考量之下，共計收案至少4200位，並規畫年齡層如下：1歲至4歲一年齡層，1至<2歲至少100人，2至4歲至少250人，小計至少350人；5至59歲年齡層，每5歲一年齡組距，分11組，每組至少350人。大約依照人口比例分布為北部約2160人, 中部與南部各約850人, 以及東部約340人。這些研究對象均偵測A型肝炎與B型肝炎、C型肝炎血清流行病學標記。並發問卷調查、審閱兒童健康手冊，蒐集研究對象之性別、出生日期、抽血日期、居住鄉鎮與包括A型肝炎、B型肝炎、麻疹、日本腦炎、水痘與德國麻疹之疫苗接種史藉以瞭解其預防接種狀況。 由台灣地區A型肝炎與B型肝炎、C型肝炎血清抗體流行病學的狀況的了解，可以探討防疫死角是否存在，發掘未來全面施打A型肝炎與B型肝炎疫苗之後可能面臨的新問題，並且了解C型肝炎在台灣感染比率的概況。依據上述研究的結果，得以重新檢視檢討我國A型肝炎與B型肝炎疫苗接種的政策、、與C型肝炎預防感染的策略。同時藉由檢測疫苗可預防疾病之年齡別血清盛行率，階段性評估不同疫苗之政策執行成效，並找出抗體衰退世代評估其罹病風險與疫苗政策調整之必要性。 透過本研究之國人血清收集，同時提供血清供疾病管制署檢測及建立國人1至59歲年齡層之其他重要疫苗可預防疾病(如麻疹、日本腦炎、水痘與德國麻疹)抗體盛行率，以為我國預防接種政策制定、修訂及幼兒與成人預防接種建議研訂之參考依據，發揮疫苗接種與疾病防治的最大成效。 <br> Abstract: This project aimed to investigate the prevalences of antibodies to hepatitis B surface antigen (anti-HBs), hepatitis A (anti-HAV), and to hepatitis C (anti-HCV) in Taiwan. This study is going to cover the whole population and the seromarkers to be checked will be mainly for hepatitis A, hepatitis B, and hepatitis C. Hopefully, we can prove that the anti-HBs is prevalent enough after the launch of universal vaccination program in infancy. We expect those who age >35 years of age will have a much higher hepatitis B surface antigen positive rate than those <35 years of age since we started the universal vaccination program 35 years ago. While the anti-HBs will be more prevalent in those <35 years of age. In terms of anti-HAV, we just started the universal HAV vaccination program this year and this study can found the baseline data of anti-HAV prevalence in Taiwan’s population. In the future, we can learn if this is a successful universal vaccination program or not based on the baseline data. Furthermore, the epidemiologic data regarding HCV infection in Taiwan is also important. Since curative, direct-acting antiviral regimens were proposed in recent years, the accurate estimate of HCV infection burden in Taiwan will not only provide the critical information, but also the treatment opportunity. In the past, we had performed several hepatitis B seroprevalence studies in Taiwan. This project will extend to the whole Taiwan. The recruited subjects will be male: female= 1:1。Because of the restraint of budge and manpower, we plan to enroll the subjects as below: 1 to <2y/o will be at least 100 persons, 2-4y/o will be at least 250 persons, as for 5-59 y/o，we will divide them by 5 years; that is , 5-10, 10-15, 15-20, and so on, totally 11 groups, at least 350 persons for each group, and subtotally 3850 persons。If we divide these subjects according to the geographic area, approximately northen Taiwan will be 2160 persons, middle and southern Taiwan will be 850 cases each and finally the eastern Taiwan is expected to recruit about 340 cases. All these cases will be tested for HBsAg, Anti-HBs, Anti-HBc, and Anti-HAV. and Anti-HCV. They will also be inquired about their vaccination histories and confirmed by the database in National Health Bureau if available. From these data, we can understand the seroprevalence of HBsAg, Anti-HBs, Anti-HBc, and Anti-HAV, and Anti-HCV in Taiwan in different age groups. We may learn the problems and difficulties of universal vaccination program. and the strategies to prevent infection. We will try to tease out if the antibody prevalence good enough or not. Based on these data, we may revisit our vaccination policy and the immunity conferred by vaccination in different age group. and provide better health promoting policies. We will take advantage of these field study to study the other vaccine-preventable diseases, such as measles, rubella, chickenpox, and Japanese encephalitis, in the meantime by providing serum samples to Taiwan CDC for the check of antibodies for those vaccine preventable diseases. The serum samples can be utilized to study the sero-epidemiology and the herd immunity of these abovementioned diseases. The data generated from this study will be very important for making the future prevention policy for these diseasesA型肝炎B型肝炎C型肝炎重要疫苗可預防疾病流行病學Anti-HAVAnti-HBsAnti-HCV