Jung Molly, Kuniholm Mark H, Ho Gloria Y F, Cotler Scott, Strickler Howard D, Thyagarajan Bharat, Youngblood Marston, Kaplan Robert C, Del Amo Julia
Albert Einstein College of Medicine, Bronx, NY.
Loyola University Medical Center, Chicago, IL.
Hepatology. 2016 Feb;63(2):445-52. doi: 10.1002/hep.28328. Epub 2015 Dec 9.
Little is known regarding the prevalence and distribution of hepatitis B virus (HBV) infection in U.S. Hispanics/Latinos. We sought to determine the prevalence of HBV exposure (serum HBV core antibody; anti-HBc), active HBV infection (serum HBV surface antigen; HBsAg), and vaccine-induced HBV immunity (antibody against HBV surface antigen; anti-HBs) in U.S. Hispanics/Latinos and consider how these data inform clinical screening recommendations. Our analysis included 11,999 women and men of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a population-based, household survey in four urban communities (Bronx, NY; Miami, FL; Chicago, IL; and San Diego, CA) of U.S. civilian, noninstitutionalized self-identifying Hispanic/Latino adults ages 18-74. Vaccine-induced immunity was defined as detection of anti-HBs, but not anti-HBc. However, if anti-HBc were present, it was considered evidence of exposure to HBV, with detection of HBsAg used to distinguish those with active HBV infection. Mean age was 45.7 years, and 7,153 were women. Vaccine-induced immunity was greatest among those ages 18-29 years (60.2% in women, 54% in men) and decreased with increasing age, regardless of country of birth. The prevalence of active HBV infection was 0.29% (95% confidence interval: 0.19-0.43), but varied by country of birth. Those born in the Dominican Republic had the highest prevalence of HBV exposure (20.3% in women, 29.7% in men) and active HBV infection (0.95%).
The overall age-standardized prevalence of active HBV infection in Hispanic/Latino adults (0.29%) was no different from the general U.S. population estimate (0.27%) and did not exceed 2%, regardless of country of birth. These data do not support targeting HBV screening to US Hispanic/Latino adults based upon background.
关于美国西班牙裔/拉丁裔人群中乙肝病毒（HBV）感染的患病率和分布情况，人们了解甚少。我们试图确定美国西班牙裔/拉丁裔人群中HBV暴露（血清HBV核心抗体；抗-HBc）、HBV活动性感染（血清HBV表面抗原；HBsAg）以及疫苗诱导的HBV免疫力（抗HBV表面抗原抗体；抗-HBs）的患病率，并思考这些数据如何为临床筛查建议提供依据。我们的分析纳入了西班牙裔社区健康研究/拉丁裔研究（HCHS/SOL）中的11999名男性和女性，这是一项基于人群的家庭调查，涉及美国四个城市社区（纽约州布朗克斯区、佛罗里达州迈阿密、伊利诺伊州芝加哥和加利福尼亚州圣地亚哥）年龄在18 - 74岁的非机构化、自我认定为西班牙裔/拉丁裔的美国平民成年人。疫苗诱导的免疫力定义为检测到抗-HBs，但未检测到抗-HBc。然而，如果存在抗-HBc，则被视为HBV暴露的证据，检测到HBsAg用于区分那些患有HBV活动性感染的人。平均年龄为45.7岁，其中7153人为女性。疫苗诱导的免疫力在18 - 29岁人群中最高（女性为60.2%，男性为54%），且随年龄增长而下降，与出生国家无关。HBV活动性感染的患病率为0.29%（95%置信区间：0.19 - 0.43），但因出生国家而异。出生在多米尼加共和国的人HBV暴露患病率最高（女性为20.3%，男性为29.7%），HBV活动性感染患病率为0.95%。
西班牙裔/拉丁裔成年人中HBV活动性感染的总体年龄标准化患病率（0.29%）与美国总体人群估计值（0.27%）无差异，且无论出生国家如何，均不超过2%。这些数据不支持基于背景因素对美国西班牙裔/拉丁裔成年人进行HBV筛查。
