Dinsmoor M J, Gibbs R S
Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio.
Obstet Gynecol. 1990 Aug;76(2):239-40.
Recent reports document high rates of asymptomatic hepatitis B virus infection in pregnant Hispanic women of Caribbean and Latin American origin, frequently in the absence of identifiable risk factors. We hypothesized that the prevalence of asymptomatic hepatitis B virus infection in Mexican-American women was much lower and that most belonged to established risk groups. Three thousand seven hundred eight-nine pregnant women, 77% of whom had Hispanic surnames, were screened for hepatitis B surface antigen upon admission in labor to Medical Center Hospital in San Antonio. Twelve women, six of whom had Hispanic surnames, were found to have asymptomatic hepatitis B infections. The prevalence of asymptomatic infections was 3.2 per 1000 (95% confidence interval 1.6-5.5) in the total population, 2.0 per 1000 (95% confidence interval 0.7-4.5) in those with Hispanic surnames, and 7.0 per 1000 (95% confidence interval 2.5-15.0) in those with non-Hispanic surnames. Risk factors, as defined by the Centers for Disease Control, were found in five (42%) of the positive patients overall and in only one (17%) of the positive patients with an Hispanic surname. We conclude that, although asymptomatic hepatitis B infection is uncommon in these pregnant Mexican-American women, the absence of identifiable risk factors in the majority of those infected suggests that routine screening in this population is justified.
近期报告显示,加勒比和拉丁美洲裔的西班牙裔孕妇中无症状乙肝病毒感染率很高,且往往不存在可识别的风险因素。我们推测,墨西哥裔美国女性中无症状乙肝病毒感染的患病率要低得多,且大多数属于既定风险群体。3789名孕妇在进入圣安东尼奥医疗中心医院待产时接受了乙肝表面抗原筛查,其中77%的孕妇有西班牙裔姓氏。12名女性被发现患有无症状乙肝感染,其中6名有西班牙裔姓氏。无症状感染在总人群中的患病率为每1000人中有3.2例(95%置信区间1.6 - 5.5),有西班牙裔姓氏者中为每1000人中有2.0例(95%置信区间0.7 - 4.5),非西班牙裔姓氏者中为每1000人中有7.0例(95%置信区间2.5 - 15.0)。总体而言,在所有阳性患者中有5名(42%)发现了疾病控制中心定义的风险因素,而在有西班牙裔姓氏的阳性患者中只有1名(17%)发现了风险因素。我们得出结论,尽管无症状乙肝感染在这些墨西哥裔美国孕妇中并不常见,但大多数感染者缺乏可识别的风险因素,这表明对该人群进行常规筛查是合理的。