Liu J, Zhang S, Wang Q, Shen H, Zhang M, Zhang Y, Yan D, Liu M
Department of Child, Adolescent and Women's Health, School of Public Health, Peking University, Beijing, China.
Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing, China.
J Viral Hepat. 2017 Aug;24(8):679-686. doi: 10.1111/jvh.12693. Epub 2017 Mar 27.
There are few extant studies on the prevalence of HBV infection in couples preparing for pregnancy. We assessed the prevalence of hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) in couples preparing for pregnancy in rural China, and the association between HBV prevalence and the statuses of HBsAg/HBeAg and ALT in the spouses. We performed a nationwide cross-sectional study, using data from a health check-up program for 1 936 801 rural couples from 31 provinces preparing for pregnancy between 2010 and 2012. ELISA was used to test serologic samples, and we defined couples who were either discordant or both positive for HBsAg as "POSITIVE COUPLES" (PC). Amongst the 1 936 801 couples, 202 816 (10.47%; 95% CI, 10.43%-10.51%) were PC. HBeAg (high infectiousness) was detected in 56 474 (27.84%; 95% CI, 27.65%-28.04%) of 202 816 HBsAg-positive couples. Multivariate models showed that the prevalence of HBV infection in wives increased along with the positive statuses for HBsAg/HBeAg and alanine aminotransferase (ALT) of their husbands (adjusted odds ratio increased from 2.31 to 4.98), after adjustment for potential confounders. Similarly, the prevalence of HBV infection in husbands was associated with the positive statuses of HBsAg/HBeAg and ALT of their wives (adjusted odds ratio increased from 2.04 to 4.93). The prevalence of POSITIVE COUPLES in couples preparing for pregnancy in rural China was high, and the prevalence of HBV infection was independently associated with the positive statuses of HBsAg/HBeAg and ALT of the spouses. Instead of solely focussing on mothers prior to becoming pregnant, POSITIVE COUPLES should be taken as an important unit of care.
目前关于备孕夫妇中乙肝病毒（HBV）感染率的现存研究较少。我们评估了中国农村备孕夫妇中乙肝表面抗原（HBsAg）和乙肝e抗原（HBeAg）的感染率，以及HBV感染率与配偶的HBsAg/HBeAg状态和丙氨酸氨基转移酶（ALT）之间的关联。我们进行了一项全国性横断面研究，使用了2010年至2012年期间来自31个省份的1936801对农村备孕夫妇的健康检查项目数据。采用酶联免疫吸附测定（ELISA）检测血清学样本，我们将HBsAg不一致或均为阳性的夫妇定义为“阳性夫妇”（PC）。在这1936801对夫妇中，有202816对（10.47%；95%置信区间，10.43%-10.51%）为阳性夫妇。在202816对HBsAg阳性夫妇中，检测到56474对（27.84%；95%置信区间，27.65%-28.04%）存在HBeAg（高传染性）。多变量模型显示，在调整潜在混杂因素后，妻子的HBV感染率随着丈夫的HBsAg/HBeAg和丙氨酸氨基转移酶（ALT）阳性状态而增加（调整后的优势比从2.31增加到4.98）。同样，丈夫的HBV感染率与妻子的HBsAg/HBeAg和ALT阳性状态相关（调整后的优势比从2.04增加到4.93）。中国农村备孕夫妇中阳性夫妇的比例较高，HBV感染率与配偶的HBsAg/HBeAg和ALT阳性状态独立相关。不应仅在孕前关注母亲，而应将阳性夫妇作为重要的护理单元。
