Michault A, Faulques B, Sevadjan B, Troalen D, Marais A, Barau G
Laboratoire de bactériologie-parasitologie-virologie, Centre hospitalier Sud Réunion, Saint Pierre.
Bull Soc Pathol Exot. 2000 Feb;93(1):34-40.
We studied the prevalence of Hepatitis A, B, C in different groups in the population of the South of Reunion Island. The aims of this study were the following: to estimate the prevalence of Hepatitis C virus (HCV) (anti-HCV antibodies) and Hepatitis B virus (HBV) (anti-HBc, HBs Ag and anti-HBs) in a population of 1455 women, who delivered in the Centre hospitalier Sud Reunion (CHSR), to estimate the prevalence of these two viruses in a population selected for risk factors (100 prisoners), to estimate the prevalence of Hepatitis A in a group of 400 persons (aged 0 to 19) hospitalised in CHSR since 1st January 1998 (100 for each 5-year age bracket), to research risks factors in these populations and immunity. The overall prevalence of anti-HCV was 0.14% in pregnant women and risk factor associated was found in 28.9% of this population (2.9% history of transfusion, 0.21% drug users). In the group of prisoners seroprevalence was 2%, far below that of prisoners in France. Anti-HCV seroprevalence is weak in Reunion Island and very inferior to seroprevalence in the French population as in other Indian Ocean islands. This is due to the low risk of parenteral transmission. Anti-HBc was found in 90 serum samples from women (overall prevalence 6.35%) and of these 90 positive samples, 9 were positive for HBs Ag (overall prevalence 0.63%), 68 were positive for anti-HBs (4.81%) and 22 (1.54%) were anti-HBc isolated (without HBs Ag and anti-HBs). The overall prevalence of anti-HBs was 62.8%. In the population of 100 prisoners, 2 were HBs Ag positive, 10 anti-HBc positive (2 anti-HBc isolated, 2 associated with HBs Ag, 6 with anti-HBs). The prevalence of anti-HBs was 22%. The major risk factor observed in this population of prisoners was tattooing and/or piercing (46%). These results show that: Reunion island is an area of low endemicity for HBV virus. The measure of protective inoculation is well followed. i.v. drug abuse and previous transfusion are weak routes of transmission. In the group aged 0 to 19, overall prevalence of anti-HAV was 11.9% with the highest rate found among 15 to 19 year-olds (25%). Seroprevalence falls with socio-economic progress. At the present time, the endemic is intermediate in Reunion Island. Given immunity levels within the young population, there is a risk of outbreak. This risk is due to the conditions in Reunion Island, but also to people who travel to other Indian Ocean countries where endemicity is high. It is thus very important that a vaccination strategy be determined.
我们研究了留尼汪岛南部人群中不同群体甲型、乙型和丙型肝炎的流行情况。本研究的目的如下：估计在南留尼汪中心医院（CHSR）分娩的1455名妇女中丙型肝炎病毒（HCV）（抗-HCV抗体）和乙型肝炎病毒（HBV）（抗-HBc、HBs Ag和抗-HBs）的流行情况；估计在一组有危险因素的人群（100名囚犯）中这两种病毒的流行情况；估计自1998年1月1日以来在CHSR住院的400名（0至19岁）患者（每5岁年龄组100人）中甲型肝炎的流行情况；研究这些人群中的危险因素和免疫力。孕妇中抗-HCV的总体流行率为0.14%，该人群中28.9%发现有相关危险因素（2.9%有输血史，0.21%为吸毒者）。在囚犯组中，血清阳性率为2%，远低于法国囚犯。留尼汪岛抗-HCV血清阳性率较低，与法国人群以及其他印度洋岛屿相比非常低。这是由于经肠外传播的风险较低。在90份女性血清样本中发现抗-HBc（总体流行率6.35%），在这90份阳性样本中，9份HBs Ag阳性（总体流行率0.63%），68份抗-HBs阳性（4.81%），22份（1.54%）为单独抗-HBc阳性（无HBs Ag和抗-HBs）。抗-HBs的总体流行率为62.8%。在100名囚犯人群中，2人HBs Ag阳性，10人抗-HBc阳性（2人单独抗-HBc阳性，2人与HBs Ag相关，6人与抗-HBs相关）。抗-HBs的流行率为22%。在该囚犯人群中观察到的主要危险因素是纹身和/或穿孔（46%）。这些结果表明：留尼汪岛是HBV病毒低流行地区。保护性接种措施执行良好。静脉吸毒和既往输血是较弱的传播途径。在0至19岁年龄组中，抗-HAV总体流行率为11.9%，15至19岁年龄组中流行率最高（25%）。血清阳性率随社会经济发展而下降。目前，留尼汪岛的流行情况处于中等水平。鉴于年轻人群中的免疫水平，存在暴发风险。这种风险既归因于留尼汪岛的情况，也归因于前往其他高流行的印度洋国家旅行的人群。因此，确定疫苗接种策略非常重要。
