Division of Viral Hepatitis, National Center for HIV, Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
J Viral Hepat. 2010 Dec;17(12):879-86. doi: 10.1111/j.1365-2893.2009.01249.x.
Coinfection with hepatitis B virus (HBV) is an important and preventable cause of chronic liver disease among HIV-infected patients. We calculated the prevalence of chronic HBV infection annually from 1996 to 2007 by age, gender, race/ethnicity, and HIV transmission risk in a multisite observational cohort study of HIV-infected patients. Prevalence of chronic HBV infection was calculated as the number of patients with a positive HBsAg or detectable HBV DNA divided by the number of patients tested using either one of these assays. Among 4467 (59%) patients tested for chronic HBV infection from a total of 7618 patients active during 1996-2007, median age was 38.5 years, 77% were men, 49% were white, 35% were black, 13% were Hispanic, and 53% were men who had sex with men (MSM). Overall, 8.4% tested positive for HBsAg or detectable HBV DNA. Annual chronic HBV prevalence during 1996-2007 ranged from 7.8% to 8.6% without a statistically significant trend. Overall, prevalence was greater among men compared with women; among whites, blacks, and persons of other race compared with Hispanics; among MSM compared with injection drug users and high-risk heterosexuals; and among patients aged 35-44 years compared with younger or older patients. MSM constituted the greatest fraction (63-72%) of all HBV-infected patients in the HIV Outpatient Study (HOPS) over the period. Of eligible patients, 5.8%, 23.4%, and 31.6% had received at least one dose of HBV vaccine by years 1996, 2002, and 2007, respectively. Despite the availability of an effective HBV vaccine for over two decades and long-standing recommendations for immunization of persons (with or without HIV infection) at risk for HBV, the prevalence of chronic HBV infection in this study has been largely unchanged over the past decade among patients in all groups, and overall was 20 times as high as the national population prevalence.
乙肝病毒（HBV）合并感染是 HIV 感染者发生慢性肝病的一个重要且可预防的病因。我们通过对 HIV 感染者进行的多中心观察性队列研究，计算了 1996 年至 2007 年各年龄组、性别、种族和 HIV 传播风险人群中慢性 HBV 感染的年度流行率。慢性 HBV 感染的流行率是通过 HBsAg 阳性或 HBV DNA 可检测患者的数量除以使用上述两种检测方法之一进行检测的患者数量计算得出。在 1996 年至 2007 年期间，共有 7618 例 HIV 活跃患者，其中 4467 例（59%）接受了慢性 HBV 感染检测，患者中位年龄为 38.5 岁，77%为男性，49%为白人，35%为黑人，13%为西班牙裔，53%为男男性接触者（MSM）。总的来说，8.4%的患者 HBsAg 或 HBV DNA 可检测。1996 年至 2007 年期间，慢性 HBV 流行率每年在 7.8%至 8.6%之间，无统计学意义的变化趋势。总的来说，男性患者的流行率高于女性；白人、黑人和其他种族的患者高于西班牙裔；MSM 高于注射吸毒者和高危异性恋者；35-44 岁的患者高于年轻或年长的患者。在 HIV 门诊研究（HOPS）期间，MSM 占所有 HBV 感染患者的比例最大（63-72%）。在符合条件的患者中，分别有 5.8%、23.4%和 31.6%在 1996 年、2002 年和 2007 年至少接种了一剂 HBV 疫苗。尽管有 20 多年的有效 HBV 疫苗和对有 HBV 感染风险的人群（无论是否感染 HIV）进行免疫接种的长期建议，但在过去十年中，所有人群中慢性 HBV 感染的流行率在研究中基本保持不变，总体流行率是全国人口流行率的 20 倍。
