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埃塞俄比亚亚的斯亚贝巴资源有限的高流行地区孕妇中乙型肝炎和人类免疫缺陷病毒合并感染:对预防和控制措施的影响

Hepatitis B and human immunodeficiency virus co-infection among pregnant women in resource-limited high endemic setting, Addis Ababa, Ethiopia: implications for prevention and control measures.

作者信息

Desalegn Zelalem, Wassie Liya, Beyene Habtamu Bedimo, Mihret Adane, Ebstie Yehenew A

机构信息

Department of Microbiology, Immunology and Parasitology, School of Medicine, Addis Ababa University, P. O. Box: 9086, Addis Ababa, Ethiopia.

Armauer Hansen Research Institute (AHRI), Jimma Road, ALERT Campus, Addis Ababa, Ethiopia.

出版信息

Eur J Med Res. 2016 Apr 14;21:16. doi: 10.1186/s40001-016-0211-3.

Abstract

BACKGROUND

Hepatitis, a highly contagious viral infection, is one of the leading killer diseases globally caused by hepatitis virus. Among the existing viral causes for hepatic failure, hepatitis B virus (HBV) plays a significant role with devastating implications, especially when combined with other viral infections such as human immunodeficiency virus (HIV). Co-infection with hepatitis B virus and HIV leads to increased morbidity and mortality as compared to independent HIV and HBV infections. In this study, we aimed to assess the seroprevalence of HBV and HIV coinfection and associated risk factors among pregnant women in a selected hospital facility around Addis Ababa, Ethiopia.

METHODS

A total of 215 pregnant women were recruited between July and October 2014 from Tirunesh Beijing General Hospital. A pretested and structured questionnaire was used to collect socio-demographic characteristics and possible risk factors. In addition, 5 ml venous blood was collected and centrifuged to estimate the seroprevalence of HBV and HIV. Descriptive statistics and logistic regression analysis were done and a P value less than 0.05 was considered statistically significant.

RESULTS

The overall prevalence of hepatitis B virus infection was 13 (6%). This positivity was different across different age categories: 1 (11.1%), 3 (4.5%), 6 (6%), 1 (3.2%), and 2 (25%) among those between 15-19, 20-24, 25-29, 30-34, and 35-39 years, respectively. However, a statistically significant association was not established between age and HBV. Among the total, 9 (4.2%) of the positive cases were detected among primary school completed. Multivariate analyses indicated that history of abortion (p = 0.003), history of surgery (p = 0.0.022), and tattooing (p = 0.033) were significantly associated with HBV infection. A total of 9 (4.2%) women were found to be HIV seropositive, of whom 2 (22.2%) were co-infected with HBV.

CONCLUSIONS

We observed a relatively higher seroprevalence of HBV infection among pregnant women in the study area, in which majority of the cases had underlying risk factors for acquiring the infection. Since none of the mothers were vaccinated for HBV, the possibility of perinatal transmission is inevitable. Hence, routine screening and immunization against HBV during pregnancy and health education are highly warranted to alleviate the situation.

摘要

背景

肝炎是一种具有高度传染性的病毒感染,是全球由肝炎病毒引起的主要致命疾病之一。在现有的导致肝衰竭的病毒病因中,乙型肝炎病毒(HBV)起着重要作用,具有毁灭性影响,尤其是与其他病毒感染如人类免疫缺陷病毒(HIV)合并感染时。与单独的HIV和HBV感染相比,HBV与HIV合并感染会导致发病率和死亡率增加。在本研究中,我们旨在评估埃塞俄比亚亚的斯亚贝巴附近一家选定医院设施中孕妇HBV与HIV合并感染的血清流行率及相关危险因素。

方法

2014年7月至10月期间,从提鲁内什·北京综合医院招募了215名孕妇。使用预先测试和结构化的问卷收集社会人口统计学特征和可能的危险因素。此外,采集5毫升静脉血并离心,以估计HBV和HIV的血清流行率。进行描述性统计和逻辑回归分析,P值小于0.05被认为具有统计学意义。

结果

乙型肝炎病毒感染的总体患病率为13例(6%)。不同年龄组的阳性率不同:15 - 19岁组中有1例(11.1%),20 - 24岁组中有3例(4.5%),25 - 29岁组中有6例(6%),30 - 34岁组中有1例(3.2%),35 - 39岁组中有2例(25%)。然而,年龄与HBV之间未建立统计学上的显著关联。在总计中,小学毕业人群中有9例(4.2%)检测为阳性。多变量分析表明,流产史(p = 0.003)、手术史(p = 0.022)和纹身史(p = 0.033)与HBV感染显著相关。共有9名(4.2%)女性被检测出HIV血清阳性,其中2名(22.2%)同时感染了HBV。

结论

我们观察到研究区域内孕妇中HBV感染的血清流行率相对较高,其中大多数病例有感染的潜在危险因素。由于没有一位母亲接种过HBV疫苗,围产期传播的可能性不可避免。因此,孕期常规筛查和HBV免疫接种以及健康教育非常有必要,以缓解这种情况。

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