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中国高流行地区育龄妇女乙肝病毒感染的流行病学

The epidemiology of hepatitis B virus infection in women of reproductive age in highly endemic areas in China.

作者信息

Zheng H, Cui F Q, Wang F Z, Huang L F, Shao X P, Du J F, Li J, Zhou Y, Zheng H Z, Zhuo J T, Zeng X X, Zhang G M, Miao N, Sun X J, Liang X F, Luo H M

机构信息

Chinese Center for Disease Control and Prevention, Beijing, China.

Fujian Center for Disease Control and Prevention, Fuzhou, China.

出版信息

J Viral Hepat. 2018 Jan;25(1):88-96. doi: 10.1111/jvh.12757. Epub 2017 Aug 23.

Abstract

We describe the epidemiology of hepatitis B virus (HBV) infection among women of reproductive age residing in areas of China that are highly endemic for chronic HBV, and provide evidence useful for decision-makers to guide strategies for preventing mother-to-child transmission of HBV, and assess the impact of perinatal transmission PMTCT by projecting HBsAg prevalence trends without interventions. We conducted a cross-sectional HBV serological survey of women, 15-49 years of age, residing in Fujian, Guangdong, Guangxi and Hainan provinces. Demographic and other subject-level data were collected in face-to-face interviews, after which we obtain blood specimens. Specimens were tested for HBV sero-markers by ELISA (Beijing Wantai Biological Pharmacy), and HBV DNA was tested with PCR (Hunan Sansure Biotech). Weighted HBsAg and HBV (either HBsAg+ or anti-HBc+ indicating either present or past infection) prevalences were 11.82% and 57.16%, respectively. Among the HBsAg-positive women, 27% were also HBeAg positive. The proportion of individuals with HBV DNA loads >10 IU/mL declined with increasing age. Among HBsAg-negative women, 0.9% had occult HBV infection. The prevalence of chronic HBV infection among reproductive women in these highly endemic provinces is high, posing a threat to maternal health and risk of mother-to-child transmission. Prevention of mother-to-child transmission remains critically important.

摘要

我们描述了居住在中国慢性乙肝高流行地区的育龄妇女中乙肝病毒(HBV)感染的流行病学情况,并提供了有助于决策者制定预防HBV母婴传播策略的证据,还通过预测无干预措施情况下HBsAg流行趋势来评估围产期传播(PMTCT)的影响。我们对居住在福建、广东、广西和海南省的15至49岁女性进行了一项横断面HBV血清学调查。通过面对面访谈收集人口统计学和其他个体层面的数据,之后采集血液样本。采用酶联免疫吸附测定法(北京万泰生物药业)检测样本中的HBV血清标志物,采用聚合酶链反应(湖南圣湘生物科技)检测HBV DNA。加权后的HBsAg和HBV(HBsAg阳性或抗-HBc阳性表明现感染或既往感染)流行率分别为11.82%和57.16%。在HBsAg阳性女性中,27%同时HBeAg阳性。HBV DNA载量>10 IU/mL的个体比例随年龄增长而下降。在HBsAg阴性女性中,0.9%存在隐匿性HBV感染。这些高流行省份育龄妇女中慢性HBV感染的流行率很高,对孕产妇健康和母婴传播风险构成威胁。预防母婴传播仍然至关重要。

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