Division of Disease Control, Philadelphia Department of Public Health, Philadelphia, PA; Applied Epidemiology Fellowship Program, Council of State and Territorial Epidemiologists, Atlanta, GA.
Division of Disease Control, Philadelphia Department of Public Health, Philadelphia, PA.
Ann Epidemiol. 2018 Mar;28(3):169-174. doi: 10.1016/j.annepidem.2017.12.006. Epub 2017 Dec 22.
Chronic hepatitis B virus (HBV) affects specific subpopulations in the United States, including individuals born in HBV-endemic countries and persons engaging in high-risk behaviors.
The 2003-2013 HBV registry data and surveillance investigations for Philadelphia, PA were matched to death certificate data to examine demographic, risk factor, and cause of death characteristics among HBV-infected populations. Bivariate analysis compared investigated foreign-born (FB) and US-born chronic HBV individuals. Multivariable logistic regression assessed associations between HBV-status, birth origin, demographic information, and liver-related death.
Of 773 investigated HBV-infected individuals, 159 were US-born and 614 were FB and of primarily non-Hispanic Asian descent. Behavioral risk factors were more often reported by US-born individuals. HBV-infected FB decedents were twice as likely as US-born decedents to have a liver-related cause of death, whereas HIV/AIDS and drug overdose were more likely causes of death among those born in the United States.
There are two HBV-infected populations in Philadelphia: 1) FB individuals most likely infected at birth or during early childhood and 2) US-born individuals with behaviors suggestive of risk-related HBV acquisition. These findings illustrate the need for both FB and US-born individuals with ongoing risk behaviors to receive routine HBV screening, vaccination if indicated, and medical care for outcomes of chronic HBV infection.
慢性乙型肝炎病毒（HBV）在美国的特定人群中流行，包括在 HBV 流行国家出生的个体以及有高危行为的人群。
将 2003 年至 2013 年宾夕法尼亚州费城的 HBV 登记数据和监测调查与死亡证明数据相匹配，以研究 HBV 感染人群的人口统计学、危险因素和死亡原因特征。采用双变量分析比较了调查的外国出生（FB）和美国出生的慢性 HBV 个体。多变量逻辑回归评估了 HBV 状态、出生地点、人口统计学信息与与肝脏相关的死亡之间的关系。
在 773 名调查的 HBV 感染个体中，有 159 名是美国出生的，614 名是 FB，主要是非西班牙裔亚裔。美国出生的个体更常报告行为危险因素。HBV 感染的 FB 死者死于与肝脏相关的原因的可能性是美国出生死者的两倍，而 HIV/AIDS 和药物过量则是美国出生者死亡的更可能原因。
费城有两个 HBV 感染人群：1）FB 个体最有可能在出生或幼儿时期感染，2）美国出生的个体具有与风险相关的 HBV 获得行为。这些发现表明，无论是 FB 还是美国出生的个体，如果有持续的风险行为，都需要接受常规的 HBV 筛查、接种疫苗（如有指征）以及慢性 HBV 感染的医疗护理。
