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4 000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7 500万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3 000万人尚未确诊，而在已确诊的感染者中，38.25%（约1 700万人）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.
邓优,孟彤彤,尤红,等. 中国乙型肝炎最新流行病学及防治进展[J]. 中华肝脏病杂志,2025,33(02)：115-120.
DOI:10.3760/cma.j.cn501113-20250127-00046版权归中华医学会所有。
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注：HBsAg：乙型肝炎表面抗原
邓优、孟彤彤：综述框架设计与文献筛选；尤红、王宇：文献收集与数据整理；孟彤彤、王宇：数据分析与结果解读；邓优、孟彤彤：初稿撰写；贾继东、王宇：综述内容的指导、批注性审阅及关键修订
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