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预防母婴传播项目中乙型肝炎病毒伴侣感染的模式及危险因素

Pattern and risk factors for partner infection with hepatitis B virus in a prevention of mother-to-child transmission programme.

作者信息

Onakewhor J U, Olagbuji B N, Okpere E E

机构信息

Materno-fetal Unit, Department of Obstetrics and Gynaecology, University of Benin Teaching Hospital, Benin City.

出版信息

West Afr J Med. 2013 Apr-Jun;32(2):110-4.

Abstract

BACKGROUND

Hepatitis B virus (HBV) infection is horizontally and vertically transmitted. It is associated with high morbidity and mortality but is preventable with vaccine. There is paucity of data on pattern and risk factors for partner infection in prevention of mother-to-child transmission (PMTCT) programmes.

OBJECTIVE

To determine the pattern and risk factors for partner infection with HBV in a PMTCT Programme.

METHODS

This cross-sectional study evaluated the hepatitis B surface antigen (HBsAg) serostatus of partners of HBV-infected pregnant women in a PMTCT programme using rapid, third generation immunochromatographic test. Repeatedly reactive samples were confirmed using enzyme-linked immunosorbent assay. Patients' sociodemographic characteristics and behavioral risk factors were evaluated against their HBsAg-serostatus. The seropositive and seronegative subjects had liver function tests HBV vaccination respectively.

RESULTS

Out of 3,907 pregnant women seen, 3,762(96.3%) and 73 (45.3%) partners of 161 HBV-infected women were screened. The HBsAg seroprevalence among the women and partners were 161(4.3%) and 5(6.8%) respectively; p<0.43. The sero-concordance and discordance were 6.8% and 93.2% respectively. Nulliparity (60.9%) associated with non-protective pre-marital sex and induced abortions (58.4%), history of blood transfusion (6.7%) and lack of vaccination (93.6%) were risk factors for HBV-infection.

CONCLUSION

This study has revealed high prevalence of HBV infection among the couples and high serodiscordance rate. The risk factors for HBV infection were preventable. We recommend integration of couple counseling and testing backed with vaccination into antennal care services nationwide. Further study is required to assess the serostatus of female partners' of HBV-infected males to determine HBV feminization.

摘要

背景

乙型肝炎病毒(HBV)通过水平和垂直传播。它与高发病率和死亡率相关,但可通过疫苗预防。在预防母婴传播(PMTCT)项目中,关于性伴侣感染模式和危险因素的数据匮乏。

目的

确定PMTCT项目中HBV性伴侣感染的模式和危险因素。

方法

这项横断面研究使用快速第三代免疫层析试验评估了PMTCT项目中HBV感染孕妇性伴侣的乙肝表面抗原(HBsAg)血清学状态。反复反应性样本用酶联免疫吸附试验进行确认。根据患者的HBsAg血清学状态评估其社会人口学特征和行为危险因素。血清阳性和血清阴性受试者分别进行肝功能检查和HBV疫苗接种。

结果

在3907名就诊孕妇中,对161名HBV感染女性的3762名(96.3%)和73名(45.3%)性伴侣进行了筛查。女性和性伴侣中的HBsAg血清流行率分别为161例(4.3%)和5例(6.8%);p<0.43。血清一致性和不一致性分别为6.8%和93.2%。未生育(60.9%)与无保护性婚前性行为和人工流产(58.4%)、输血史(6.7%)和未接种疫苗(93.6%)是HBV感染的危险因素。

结论

本研究揭示了夫妇中HBV感染的高流行率和高血清不一致率。HBV感染的危险因素是可以预防的。我们建议在全国范围内将夫妇咨询和检测以及疫苗接种纳入产前保健服务。需要进一步研究以评估HBV感染男性女性伴侣的血清学状态,以确定HBV女性化情况。

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