Department of Infectious Diseases, Public Health Service (GGD) Amsterdam, Nieuwe Achtergracht 100, 1000 CE Amsterdam, The Netherlands.
Vaccine. 2012 Aug 17;30(38):5651-5. doi: 10.1016/j.vaccine.2012.06.080. Epub 2012 Jul 11.
The Netherlands is a low-incidence country for acute hepatitis B (HBV) infection (1.2/100,000 in 2010), where it is typically acquired in adulthood through injecting drug use or homosexual exposure. Recently, the number of heterosexually acquired acute infections in the Netherlands has increased. Ethnicity may be a risk factor. We describe trends in the incidence of acute HBV among heterosexual adults in ethnic groups in Amsterdam from 1992 to 2009 and discuss future control of HBV in the Netherlands.
We studied all cases of acute HBV acquired in heterosexuals aged ≥15 years in the Amsterdam region (1992-2009, n=238) by ethnic group. Incidence rates were estimated as the average number of cases per 100,000 per year. Using Poisson regression, we calculated univariable and multivariable incidence rate ratios (IRR) by ethnic group over calendar year, by age and gender.
The incidence in first generation migrants from HBV-endemic countries (FGM) was 4.1/100,000 showing no trend over time. Since 1999, incidence in Dutch-born cases in Amsterdam has increased by 13% annually from 0.2/100,000 in 1999 to 2.1/100,000 in 2009 (annual IRR 1.13, 95% CI:1.0-1.22). From 2004 to 2009, the incidence in native Dutch/Western in Amsterdam was 1.6/100,000 (reference for IRR), in FGM was 4.3/100,000 (IRR of 2.7, 95% CI:1.8-4.2) and in Dutch-born second generation migrants (SGM) was 3.7/100,000 (IRR:2.4, 95% CI:1.2-4.7).
Incidence of acute hepatitis B in Amsterdam in FGM and SGM is higher than in the native Dutch population. Low-endemic countries with migrant populations from HBV-endemic areas should consider offering screening and vaccination to both FGM and SGM.
荷兰是急性乙型肝炎（HBV）感染的低发国家（2010 年为 1.2/100,000），其感染通常通过注射毒品或同性恋暴露发生在成年期。最近，荷兰异性恋获得的急性感染数量有所增加。种族可能是一个危险因素。我们描述了 1992 年至 2009 年阿姆斯特丹不同种族组中异性恋成年人中急性 HBV 发病率的趋势，并讨论了荷兰 HBV 的未来控制。
我们按种族研究了阿姆斯特丹地区≥15 岁的异性恋获得的所有急性 HBV 病例（1992-2009 年，n=238）。发病率估计为每年每 10 万人中的平均病例数。使用泊松回归，我们按日历年度、年龄和性别计算了各种族的单变量和多变量发病率比（IRR）。
来自乙型肝炎流行地区的第一代移民（FGM）的发病率为 4.1/100,000，且随时间无变化趋势。自 1999 年以来，阿姆斯特丹出生的荷兰人病例的发病率每年增加 13%，从 1999 年的 0.2/100,000 增加到 2009 年的 2.1/100,000（年 IRR 为 1.13，95%CI：1.0-1.22）。2004 年至 2009 年，阿姆斯特丹本地荷兰/西方人的发病率为 1.6/100,000（IRR 的参考值），FGM 为 4.3/100,000（IRR 为 2.7，95%CI：1.8-4.2），而第二代移民（SGM）的发病率为 3.7/100,000（IRR：2.4，95%CI：1.2-4.7）。
阿姆斯特丹的 FGM 和 SGM 急性乙型肝炎发病率高于本地荷兰人。来自乙型肝炎流行地区移民人口的低流行国家应考虑为 FGM 和 SGM 提供筛查和疫苗接种。
