中国东南部HBsAg阳性感染人群的血清学特征：一项基于社区的研究。
Serolological Profile Among HBsAg-Positive Infections in Southeast China: A Community-Based Study.
作者信息
Chen Ping, Yu Chengbo, Wu Wei, Wang Jinghua, Ruan Bing, Ren Jingjing, Yang Shigui, Xu Kaijin, Yu Liang, Li Lanjuan
机构信息
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
出版信息
Hepat Mon. 2013 Jan;13(1):e7604. doi: 10.5812/hepatmon.7604. Epub 2013 Jan 23.
BACKGROUND
Hepatitis B virus (HBV) infection has remained a significant public health problem. Generating a large-scale, community-based profile of HBV infection in China is essential to prevention of the disease.
OBJECTIVES
The current study was designed to investigate HBV-infected individuals at the community level and determine the age distribution, hepatitis B e antigen (HBeAg) positivity and its related risk factors, relationship among serological markers.
PATIENTS AND METHODS
A cross-sectional, community-based survey was carried out without age restriction, in 12 communities of two counties. The study population was selected by random multistage cluster sampling. Serological samples and demographic information were collected from 8439 HB surface antigen (HBsAg)-positive individuals.
RESULTS
The constituent ratio of individuals with HBsAg-positive infections was lowest among persons aged < 20 years (0.4%) and the highest among persons aged 40-49 years (33.2%). The HBeAg-positive rate among infected individuals was 18.5%, and the constituent ratio decreased with increasing of age. The HBeAg-positive rate in males (21.9%) was significantly higher than in females (14.7%), and was higher among coastland inhabitants (22.9%) than among plains inhabitants (12.9%). Among the 1561 HBeAg-positive individuals, 91.0% were HBV DNA-positive. However, of the 6878 HBeAg-negative individuals, only 45.4% were HBV DNA-positive, and the HBeAg-positive rate was significantly different at different levels of HBV DNA expression. The proportion of detectable HBV DNA levels was significantly higher in individuals with elevated ALT, compared to those with normal ALT, regardless of HBeAg-positivity.
CONCLUSIONS
The HBV prevalence remained high in the > 20 age group. The positivity of HBeAg was related to age, region, and sex. Testing HBeAg and serum ALT levels were effective ways to assess HBV infectiousness in community-level hospitals in China.
背景
乙型肝炎病毒（HBV）感染仍是一个重大的公共卫生问题。在中国开展大规模的基于社区的HBV感染情况分析对于疾病预防至关重要。
目的
本研究旨在调查社区层面的HBV感染者，确定年龄分布、乙肝e抗原（HBeAg）阳性率及其相关危险因素、血清学标志物之间的关系。
患者和方法
在两个县的12个社区开展了一项无年龄限制的基于社区的横断面调查。通过随机多阶段整群抽样选取研究人群。从8439例乙肝表面抗原（HBsAg）阳性个体中收集血清学样本和人口统计学信息。
结果
HBsAg阳性感染个体的构成比在<20岁人群中最低（0.4%），在40 - 49岁人群中最高（33.2%）。感染个体中HBeAg阳性率为18.5%，其构成比随年龄增长而降低。男性的HBeAg阳性率（21.9%）显著高于女性（14.7%），沿海地区居民中的HBeAg阳性率（22.9%）高于平原地区居民（12.9%）。在1561例HBeAg阳性个体中，91.0%的个体HBV DNA呈阳性。然而，在6878例HBeAg阴性个体中，只有45.4%的个体HBV DNA呈阳性，且在不同水平的HBV DNA表达情况下，HBeAg阳性率存在显著差异。无论HBeAg是否阳性，谷丙转氨酶（ALT）升高个体中可检测到的HBV DNA水平比例显著高于ALT正常个体。
结论
20岁以上年龄组HBV流行率仍然很高。HBeAg阳性与年龄、地区和性别有关。检测HBeAg和血清ALT水平是中国社区医院评估HBV传染性的有效方法。
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