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喀麦隆西南部地区乙肝病毒感染患者的医护人员、家庭成员及性接触者的乙肝病毒传播风险评估

HBV Transmission Risk Assessment in Healthcare Workers, Household and Sexual Contacts of HBV Infected Patients in the Southwest Region of Cameroon.

作者信息

Tufon Kukwah Anthony, Meriki Henry Dilonga, Kwenti Tebit Emmanuel, Tony Nyeke James, Malika Ekeme, Bolimo Ayah Flora, Kouanou Youmbi Sylvain, Nkuo-Akenji Theresa, Anong Damian Nota

机构信息

Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.

Diagnostic Laboratory, Buea Regional Hospital, Buea, Cameroon.

出版信息

Oman Med J. 2019 Jul;34(4):313-321. doi: 10.5001/omj.2019.62.

Abstract

OBJECTIVES

Hepatitis B virus (HBV) is known to be highly transmissible via the body fluids of an infected person. We investigated the transmission risks, awareness, and prevalence among healthcare workers (HCWs), household contacts (HHCs), and sexual partners (SPs) of HBV infected individuals.

METHODS

We conducted a cross-sectional study of HCWs, HBV infected individuals as well as their corresponding HHCs and SPs. Data related to some transmission risks and HBV awareness was obtained from each participant using a questionnaire. Blood samples were collected from each participant and tested for hepatitis B surface antigen (HBsAg), hepatitis B e-antigen, and anti-hepatitis B core (anti-HBc). HBV viral load measurement was done for the HBV infected participants.

RESULTS

A total of 596 participants were enrolled (127 HCWs, 128 HHCs, 138 SPs, and 203 HBV infected participants). HHCs (odds ratio (OR): 3.85, confidence interval (CI): 1.89-7.81), and SPs (OR: 3.04, CI: 1.51-6.17) were more associated with HBsAg/anti-HBc positivity compared to HCWs. Age, years spent with HBV infected partner, unprotected sex, and marriage were not identified as risk factors for HBV sexual transmission but cohabiting with an HBV infected SP was significantly ( 0.005) associated with transmission (OR: 3.56, CI: 1.46-8.72). Female HHCs (OR: 2.48, CI: 1.06-5.80) and SPs (OR: 2.64, CI: 0.95-7.30) were more associated with HBsAg/anti-HBc positivity. The mean viral load (log IU) of HBV infected individuals (3.9±2.0) with HBsAg positive SPs was significantly higher than that of HBV infected individuals (2.8±1.0) with HBsAg negative SPs ( < 0.001).

CONCLUSIONS

HHCs and SPs of HBV infected patients are more associated with HBV infection compared to HCWs. Horizontal transmission can as well be implicated among SPs since unprotected sex was not identified as a risk factor for transmission, but cohabitation was. Prompt management and preventive measures could be implemented if HHCs and SPs of HBV infected patients are identified, sensitized, and screened.

摘要

目的

已知乙型肝炎病毒(HBV)可通过感染者的体液高效传播。我们调查了医护人员(HCWs)、家庭接触者(HHCs)以及HBV感染者的性伴侣(SPs)中的传播风险、认知情况和感染率。

方法

我们对医护人员、HBV感染者及其相应的家庭接触者和性伴侣进行了一项横断面研究。使用问卷从每位参与者获取与一些传播风险和HBV认知相关的数据。采集每位参与者的血样,检测乙肝表面抗原(HBsAg)、乙肝e抗原和抗乙肝核心抗体(抗-HBc)。对HBV感染的参与者进行HBV病毒载量检测。

结果

共纳入596名参与者(127名医护人员、128名家庭接触者、138名性伴侣和203名HBV感染者)。与医护人员相比,家庭接触者(优势比(OR):3.85,置信区间(CI):1.89 - 7.81)和性伴侣(OR:3.04,CI:1.51 - 6.17)与HBsAg/抗-HBc阳性的关联更强。年龄、与HBV感染伴侣相处的年限、无保护性行为和婚姻未被确定为HBV性传播的风险因素,但与HBV感染的性伴侣同居与传播显著相关(P = 0.005)(OR:3.56,CI:1.46 - 8.72)。女性家庭接触者(OR:2.48,CI:1.06 - 5.80)和性伴侣(OR:2.64,CI:0.95 - 7.30)与HBsAg/抗-HBc阳性的关联更强。HBsAg阳性性伴侣的HBV感染者的平均病毒载量(log IU)(3.9±2.0)显著高于HBsAg阴性性伴侣的HBV感染者(2.8±1.0)(P < 0.001)。

结论

与医护人员相比,HBV感染患者的家庭接触者和性伴侣与HBV感染的关联更强。由于未将无保护性行为确定为传播风险因素,而同居是,所以性伴侣之间也可能存在水平传播。如果识别、提高认识并筛查HBV感染患者的家庭接触者和性伴侣,可实施及时的管理和预防措施。

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