Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Quest Diagnostics, Secaucus, New Jersey, USA.
Clin Infect Dis. 2020 Jul 27;71(3):586-592. doi: 10.1093/cid/ciz841.
The current opioid injection drug use epidemic has been associated with an increase in hepatitis C virus infections among women of childbearing age in the United States, but changes in hepatitis B virus (HBV) infections have not been studied.
A retrospective analysis of HBV statuses among women of childbearing age nationally and by state was conducted, utilizing the Quest Diagnostics database. Rates of HBV in women born before and after the implementation of universal HBV vaccination recommendations were determined.
We identified 8 871 965 women tested for HBV from 2011-2017. Nationally, the annual rate of acute HBV infections was stable, but rates increased in Kentucky, Alabama, and Indiana (P < .03). The national prevalence of new, chronic HBV diagnoses decreased significantly, from 0.83% in 2011 to 0.19% in 2017 (P < .0001), but increased in Mississippi, Kentucky, and West Virginia (P ≤ .05). A declining prevalence of HBV seroprotection was evident over time, especially within the birth-dose cohort (which dropped from 48.5% to 38.5%; P < .0001).
National rates of newly diagnosed acute and chronic HBV infections declined or were stable overall, but increased significantly in specific Appalachian states. The HBV vaccine is effective in decreasing infections, but seroprotection wanes over time. These trends in new infections may be related to increased injection drug use and highlight potential gaps in HBV vaccine protection.
目前，在美国，阿片类药物注射吸毒的流行与育龄妇女丙型肝炎病毒感染的增加有关，但乙型肝炎病毒（HBV）感染的变化尚未得到研究。
利用 Quest Diagnostics 数据库，对全国和各州育龄妇女的 HBV 状况进行了回顾性分析。确定了在实施普遍 HBV 疫苗接种建议之前和之后出生的妇女的 HBV 感染率。
我们从 2011 年至 2017 年确定了 8871965 名接受 HBV 检测的妇女。从全国范围来看，急性 HBV 感染的年发生率保持稳定，但在肯塔基州、阿拉巴马州和印第安纳州有所上升（P<0.03）。新的慢性 HBV 诊断的全国患病率显著下降，从 2011 年的 0.83%降至 2017 年的 0.19%（P<0.0001），但在密西西比州、肯塔基州和西弗吉尼亚州有所上升（P≤0.05）。随着时间的推移，HBV 血清保护的流行率呈下降趋势，尤其是在出生剂量组（从 48.5%降至 38.5%；P<0.0001）。
总的来说，全国新诊断的急性和慢性 HBV 感染率下降或保持稳定，但在某些阿巴拉契亚州显著上升。HBV 疫苗可有效降低感染率，但血清保护随时间推移而减弱。这些新感染的趋势可能与注射吸毒的增加有关，并突出了 HBV 疫苗保护的潜在差距。
