School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.
PLoS One. 2011;6(9):e24721. doi: 10.1371/journal.pone.0024721. Epub 2011 Sep 13.
Data on hepatitis B virus (HBV) prevalence are limited in developing countries. There is also limited information of consistent condom use efficacy for reducing HBV transmission at the population level. The study goal was to evaluate the prevalence and factors associated with HBV infection in Peru, and the relationship between anti-HBc positivity and consistent condom use.
Data from two different surveys performed in 28 mid-sized Peruvian cities were analyzed. Participants aged 18-29 years were selected using a multistage cluster sampling. Information was collected through a validated two-part questionnaire. The first part (face-to-face) concerned demographic data, while the second part (self-administered using handheld computers) concerned sexual behavior. Hepatitis B core antibody (anti-HBc) was tested in 7,000 blood samples. Prevalences and associations were adjusted for sample strata, primary sampling units and population weights. Anti-HBc prevalence was 5.0% (95%CI 4.1%-5.9%), with the highest prevalence among jungle cities: 16.3% (95%CI 13.8%-19.1%). In the multivariable analysis, Anti-HBc positivity was directly associated with geographic region (highlands OR = 2.05; 95%CI 1.28-3.27, and jungle OR = 4.86; 95%CI 3.05-7.74; compared to coastal region); and inversely associated with age at sexual debut (OR = 0.90; 95%CI 0.85-0.97). Consistent condom use, evaluated in about 40% of participants, was associated with reduced prevalence (OR = 0.34; 95%CI 0.15-0.79) after adjusting for gender, geographic region, education level, lifetime number of sex partners, age at sexual debut and year of survey.
Residence in highlands or jungle cities is associated with higher anti-HBc prevalences, whereas increasing age at sexual debut were associated with lower prevalences. Consistent condom use was associated with decreased risk of anti-HBc. Findings from this study emphasize the need of primary prevention programs (vaccination) especially in the jungle population, and imply that condom use promotion might be a potential strategy to prevent HBV infection.
发展中国家的乙型肝炎病毒 (HBV) 流行数据有限。关于一致性使用安全套在人群层面降低 HBV 传播的效果也存在有限的信息。本研究旨在评估秘鲁的 HBV 感染流行情况及其相关因素，以及抗 HBc 阳性与一致性使用安全套之间的关系。
对在秘鲁 28 个中等城市进行的两项不同调查的数据进行了分析。使用多阶段聚类抽样选择了 18-29 岁的参与者。通过经验证的两部分问卷收集信息。第一部分（面对面）涉及人口统计数据，第二部分（使用手持计算机进行自我管理）涉及性行为。对 7000 份血样进行了乙型肝炎核心抗体 (抗 HBc) 检测。对样本层、初级抽样单位和人口权重进行了调整，以评估流行率和关联。抗 HBc 的流行率为 5.0%（95%CI 4.1%-5.9%），其中丛林城市的流行率最高：16.3%（95%CI 13.8%-19.1%）。在多变量分析中，抗 HBc 阳性与地理区域（高原地区 OR=2.05；95%CI 1.28-3.27，丛林地区 OR=4.86；95%CI 3.05-7.74；与沿海地区相比）直接相关；与性初现年龄呈负相关（OR=0.90；95%CI 0.85-0.97）。在大约 40%的参与者中评估了一致性使用安全套，在调整了性别、地理区域、教育程度、性伴侣终生数量、性初现年龄和调查年份后，一致性使用安全套与降低抗 HBc 的流行率（OR=0.34；95%CI 0.15-0.79）相关。
居住在高原或丛林城市与较高的抗 HBc 流行率相关，而性初现年龄的增加与较低的流行率相关。一致性使用安全套与降低抗 HBc 风险相关。本研究的结果强调了初级预防计划（疫苗接种）的必要性，特别是在丛林地区，这意味着推广安全套使用可能是预防 HBV 感染的一种潜在策略。
