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在门诊就诊的叙利亚难民儿童中甲型、乙型、丙型肝炎及艾滋病毒的血清流行率

Hepatitis A, B, C and HIV seroprevalence among Syrian refugee children admitted to outpatient clinics.

作者信息

Köse Şükran, Ödemiş Ilker, Çelik Didem, Gireniz Tatar Bengü, Akbulut Ilkay, Çiftdoğan Dilek Yilmaz

机构信息

Division of Infectious Diseases and Clinical Microbiology, Tepecik Training and Research Hospital, Izmir, Turkey.

Division of Paediatric Infectious Diseases, Tepecik Training and Research Hospital, Izmir, Turkey.

出版信息

Infez Med. 2017 Dec 1;25(4):339-343.

Abstract

Viral hepatitis is the most common cause of serious health problems such as liver cirrhosis and hepatocellular carcinoma (HCC). Leading to immunodeficiency disorders through different mechanisms, Human Immunodeficiency Virus (HIV) causes the development of severe secondary infections. Hepatitis A (HAV) is thought to spread by the faecal-oral route, while Hepatitis B (HBV), Hepatitis C (HCV) and HIV are mostly transmitted vertically during childhood. In our study, we aimed to determine the seroprevalence of HAV, HBV, HCV and HIV among Syrian refugee children who were admitted to outpatient clinics. We conducted a retrospective review of data concerning 171 Syrian children aged between 0-18 years admitted between April 2014 and December 2015 to the outpatient infectious disease clinic of ?zmir Tepecik Training and Research Hospital and the social welfare outpatient clinic for Syrian refugees for reasons other than jaundice. Serum samples from patients were studied for HAV antibody IgG (anti-HAV IgG), HBV surface antigen (HBsAg), antibodies against HBV surface antigen (anti-HBs), antibodies against HBV core antigen (anti-HBc total), HCV antibody (anti-HCV) (anti-HIV) with the ELISA (Enzyme-Linked Immunosorbent Assay) method. In this study 51% of patients were female, with a mean age of 6.52 years among all patients. Six of the 140 patients (4.2%) scanned for HBV among the patients enrolled in the study were HBsAg and anti-HBc total positive and anti-HBs negative. Three patients (2.1%) were HBsAg negative, and anti-HBc total and anti-HBs positive, which indicated they had previously recovered from an HBV infection. HBsAg, anti-HBs, anti-HBc total data for 140 patients (81.9%), anti-HCV data for 109 patients (63.8%), anti-HIV data for 88 patients (51.5%) and HAV IgG data for 86 patients (50.3%) were obtained. Due to migration from regions in Syria where there is no regular follow-up of HBV vaccination in children, HBsAg seroprevalence of refugee children is thought to be higher than in other children in Turkey and anti-HBs positivity is thought to be lower. We expected to see a higher seroprevalence of anti-HCV and anti-HIV in Syria due to the lack of health facilities such as non-regular anti-HCV and anti-HIV screening before blood transfusions and during pregnancy in all regions of Syria. Yet in this study, the anti-HCV, anti-HIV seroprevalence of Syrian refugee children was similar to that in Turkey. According to the results, if the children of asylum seekers are admitted to the national HAV and HBV vaccination schedule, hepatitis infections and their complications may be prevented.

摘要

病毒性肝炎是导致肝硬化和肝细胞癌(HCC)等严重健康问题的最常见原因。人类免疫缺陷病毒(HIV)通过不同机制导致免疫缺陷疾病,引发严重的继发感染。甲型肝炎(HAV)被认为是通过粪口途径传播,而乙型肝炎(HBV)、丙型肝炎(HCV)和HIV大多在儿童时期垂直传播。在我们的研究中,我们旨在确定在门诊就诊的叙利亚难民儿童中HAV、HBV、HCV和HIV的血清流行率。我们对2014年4月至2015年12月期间因黄疸以外的原因入住伊兹密尔泰佩奇克培训与研究医院门诊传染病科以及叙利亚难民社会福利门诊的171名0至18岁叙利亚儿童的数据进行了回顾性分析。采用酶联免疫吸附测定(ELISA)法对患者的血清样本进行HAV抗体IgG(抗-HAV IgG)、HBV表面抗原(HBsAg)、抗HBV表面抗原抗体(抗-HBs)、抗HBV核心抗原抗体(抗-HBc总抗体)、HCV抗体(抗-HCV)、HIV抗体(抗-HIV)检测。在本研究中,51%的患者为女性,所有患者的平均年龄为6.52岁。在纳入研究的患者中,对140名患者进行了HBV检测,其中6名(4.2%)患者HBsAg和抗-HBc总抗体阳性,抗-HBs阴性。3名患者(2.1%)HBsAg阴性,抗-HBc总抗体和抗-HBs阳性,这表明他们曾感染过HBV且已康复。获得了140名患者(81.9%)的HBsAg、抗-HBs、抗-HBc总抗体数据,109名患者(63.8%)的抗-HCV数据,88名患者(51.5%)的抗-HIV数据,以及86名患者(50.3%)的HAV IgG数据。由于来自叙利亚儿童未定期进行HBV疫苗接种随访的地区,难民儿童的HBsAg血清流行率被认为高于土耳其其他儿童,而抗-HBs阳性率被认为较低。由于叙利亚所有地区在输血前和孕期缺乏如不定期进行抗-HCV和抗-HIV筛查等卫生设施,我们预计叙利亚抗-HCV和抗-HIV的血清流行率会更高。然而在本研究中,叙利亚难民儿童的抗-HCV、抗-HIV血清流行率与土耳其相似。根据研究结果,如果寻求庇护者的儿童被纳入国家HAV和HBV疫苗接种计划,肝炎感染及其并发症可能会得到预防。

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