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巴西一个非洲裔社区中乙型肝炎病毒感染的血清流行率。

Seroprevalence of Hepatitis B virus infection among an Afro-descendant community in Brazil.

作者信息

Motta-Castro Ana R C, Yoshida Clara F T, Lemos Elba R S, Oliveira Jaqueline M, Cunha Rivaldo V, Lewis-Ximenez Lia L, Cabello Pedro H, Lima Kátia M B, Martins Regina M B

机构信息

Hospital Universitário, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil.

出版信息

Mem Inst Oswaldo Cruz. 2003 Jan;98(1):13-7. doi: 10.1590/s0074-02762003000100002. Epub 2003 Apr 9.

Abstract

Furnas dos Dionísios is an Afro-Brazilian black community whose descendants were mainly fugitive slaves that established themselves in the State of Mato Grosso do Sul (MS), Brazil. The population is comprised mainly of low socioeconomic individuals who are engaged in agricultural activities. The objective of this study was to investigate the prevalence of hepatitis B (HB) and its correlation with epidemiological data obtained from the community. The studied population totaled 260 individuals with ages varying from 1 to 79 years (median 20). One hundred thirty-three (51.2%) were females and 127 (48.8%) were males. A high prevalence for anti-HBc was observed (42.7%), with present infection detected in 9.2% of the subjects who were also HB surface antigens (HBs Ag) positive; 27.3% were anti-HBc and anti-HBs reactive, and 6.2% had anti-HBc as only marker. The prevalence for anti-HBc was proportional to age, reaching its highest peak in age categories greater than 50. No serological marker was detected in children under the age of 2 years, however anti-HBc was present in 12 subjects with ages between 2 and 14 years, of these 8 (7.4%) were HBsAg positive. Among individuals over the age of 15 years, 99 were anti-HBc reactive, of these 16 (10.5%) were also HBsAg positive, thus suggesting an increased prevalence of HBV carriers among children and adolescents. The risk factors observed in this community that were significantly associated with anti-HBc positivity were age (over 20 years) and having an anti-HBc positive mother. Both HBeAg and anti-HBe were detected in 44.4% of the samples tested. HBsAg subtypes found in the studied population were adw2 (77.7%) and ayw2 (23.3%). While intrafamilial transmission was most likely responsible for HBV infection among children, other routes such as sexual contact might be considered for individuals with ages over 15 years.

摘要

弗尔纳斯·多斯·迪奥尼西奥斯是一个非裔巴西黑人社区,其后代主要是逃亡奴隶,他们在巴西南马托格罗索州(MS)定居下来。该社区人口主要由从事农业活动的社会经济地位较低的个体组成。本研究的目的是调查乙型肝炎(HB)的患病率及其与从该社区获得的流行病学数据的相关性。研究人群共有260人,年龄从1岁到79岁不等(中位数为20岁)。其中133人(51.2%)为女性,127人(48.8%)为男性。观察到抗-HBc的高患病率(42.7%),在9.2%的同时也是乙肝表面抗原(HBs Ag)阳性的受试者中检测到现症感染;27.3%的受试者抗-HBc和抗-HBs呈反应性,6.2%的受试者仅以抗-HBc作为标志物。抗-HBc的患病率与年龄成正比,在50岁以上年龄组达到最高峰。2岁以下儿童未检测到任何血清学标志物,但在2至14岁的12名受试者中存在抗-HBc,其中8人(7.4%)HBsAg阳性。在15岁以上的个体中,99人抗-HBc呈反应性,其中16人(10.5%)也HBsAg阳性,因此表明儿童和青少年中乙肝病毒携带者的患病率增加。在该社区观察到的与抗-HBc阳性显著相关的危险因素是年龄(20岁以上)和母亲抗-HBc阳性。在检测的样本中,44.4%同时检测到HBeAg和抗-HBe。在研究人群中发现的HBsAg亚型为adw2(77.7%)和ayw2(23.3%)。虽然家庭内传播最有可能是儿童感染乙肝病毒的原因,但对于15岁以上的个体,可能还应考虑其他传播途径,如性接触。

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