Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, United States Centers for Disease Control and Prevention, Atlanta, GA, United States of America.
Department of Defense HIV/AIDS Prevention Program, United States Naval Health Research Center, San Diego, CA, United States of America.
PLoS One. 2019 Oct 1;14(10):e0222835. doi: 10.1371/journal.pone.0222835. eCollection 2019.
Guyana expanded its HIV response in 2005 but the epidemiology of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections has not been characterized.
The 2011 Seroprevalence and Behavioral Epidemiology Risk Survey for HIV and STIs collected biologic specimens with demographic and behavioral data from a representative sample of Guyana military personnel. Diagnostics included commercial serum: HIV antibody; total antibody to hepatitis B core (anti-HBc); IgM anti-HBc; hepatitis B surface antigen (HBsAg); anti-HBs; antibody to HCV with confirmatory testing; and HBV DNA sequencing with S gene fragment phylogenetic analysis. Chi-square, p-values and prevalence ratios determined statistical significance.
Among 480 participants providing serologic specimens, 176 (36.7%) tested anti-HBc-positive. Overall, 19 (4.0%) participants tested HBsAg-positive; 17 (89.5%) of the HBsAg-positive participants also had detectable anti-HBc, including 1 (5.3%) IgM anti-HBc-positive male. Four (6.8%) females with available HBV testing were HBsAg-positive, all aged 23-29 years. Sixteen (16, 84.2%) HBsAg-positive participants had sufficient specimen for DNA testing. All 16 had detectable HBV DNA, 4 with viral load >2x104IU/ml. Sequencing found: 12 genotype (gt) A1 with 99.9% genetic identity between 1 IgM anti-HBc-positive and 1 anti-HBc-negative; 2 gtD1; and 2 with insufficient specimen. No statistically significant associations between risk factors and HBV infection were identified.
Integrated HIV surveillance identified likely recent adult HBV transmission, current HBV infection among females of reproductive age, moderate HBV infection prevalence (all gtA1 and D1), no HCV infections and low HIV frequency among Guyana military personnel. Integrated HIV surveillance helped characterize HBV and HCV epidemiology, including probable recent transmission, prompting targeted responses to control ongoing HBV transmission and examination of hepatitis B vaccine policies.
圭亚那于 2005 年扩大了其艾滋病毒应对措施，但乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）感染的流行病学尚未确定。
2011 年艾滋病毒和性传播感染的血清流行率和行为流行病学风险调查从圭亚那军事人员的代表性样本中收集了生物标本和人口统计及行为数据。检测包括商业血清：HIV 抗体；乙型肝炎核心总抗体（抗-HBc）；IgM 抗-HBc；乙型肝炎表面抗原（HBsAg）；抗-HBs；HCV 抗体与确认检测；以及 HBV DNA 测序与 S 基因片段系统发育分析。卡方检验，p 值和患病率比确定了统计学意义。
在 480 名提供血清学标本的参与者中，176 名（36.7%）检测抗-HBc 阳性。总体而言，19 名（4.0%）参与者 HBsAg 阳性；17 名（89.5%）HBsAg 阳性者也有可检测到的抗-HBc，其中 1 名（5.3%）男性 IgM 抗-HBc 阳性。有可用 HBV 检测的 4 名女性 HBsAg 阳性，均为 23-29 岁。16 名（16，84.2%）HBsAg 阳性参与者有足够的标本进行 DNA 检测。所有 16 名均有可检测到的 HBV DNA，其中 4 名病毒载量>2x104IU/ml。测序发现：12 种基因型（gt）A1，1 名 IgM 抗-HBc 阳性和 1 名抗-HBc 阴性者之间的遗传同一性为 99.9%；2 种 gtD1；2 种标本不足。未发现危险因素与 HBV 感染之间存在统计学显著关联。
综合艾滋病毒监测发现了可能的近期成人 HBV 传播、生殖年龄女性的当前 HBV 感染、中等 HBV 感染流行率（均为 gtA1 和 D1）、无 HCV 感染和圭亚那军事人员中低 HIV 频率。综合艾滋病毒监测有助于描述 HBV 和 HCV 的流行病学，包括可能的近期传播，促使采取有针对性的措施控制当前的 HBV 传播，并检查乙肝疫苗政策。
