Department of Medicine, Alameda Health System - Highland Hospital, Oakland, California, USA.
Toronto Centre for Liver Disease, University Health Network, Toronto General Hospital, University of Toronto, Toronto, Canada.
Eur J Gastroenterol Hepatol. 2021 Dec 1;33(1S Suppl 1):e610-e614. doi: 10.1097/MEG.0000000000002180.
To evaluate the prevalence of hepatitis B surface antigen (HBsAg) positive or hepatitis B core antibody total (anti-HBc) among adults with latent tuberculosis infection (LTBI) in the USA.
Using data from the National Health and Nutrition Examination Survey 1999-2000 and 2011-2012 cycles, US adults with LTBI (identified by positive tuberculin skin test or positive QuantiFERON-TB Gold In-Tube test) were evaluated to determine prevalence HBsAg and anti-HBc. Survey-weighted data was used to determine prevalence estimates of HBsAg or anti-HBc, which were further stratified by sex, race/ethnicity, country of birth and age. Trends were analyzed by regressing the outcome over time. Between-group comparisons used chi-squared testing.
Overall prevalence of LTBI was 4.2% [95% confidence interval (CI), 3.5-5.1]. Among individuals with LTBI, HBsAg prevalence was 0.9% (95% CI, 0.4-2.1) and anti-HBc prevalence was 12.9% (95% CI, 9.8-16.8), both of which remained stable between 1999-2000 and 2011-2012. While no significant differences in HBsAg prevalence were observed by sex, race/ethnicity, country of birth, age, anti-HBc prevalence was significantly higher in men vs. women (16.8 vs. 7.9%, P < 0.05), blacks vs. non-Hispanic whites (22.9 vs. 5.9%, P < 0.05), non-US born vs. US-born (15.9 vs. 7.2%, P = 0.01) and highest in the oldest age group (age ≥65 years: 17.5%, 95% CI, 10.5-27.8).
Among US adults with LTBI, overall prevalence of HBsAg was 0.9%. One in eight individuals with LTBI had prior HBV exposure. Effective HBV screening among individuals with LTBI may allow changes in clinical practice to prevent drug-induced liver injury from anti-TB therapies.
评估美国潜伏性结核感染（LTBI）成人中乙型肝炎表面抗原（HBsAg）阳性或乙型肝炎核心抗体总（抗-HBc）的流行率。
利用 1999-2000 年和 2011-2012 年全国健康和营养调查的数据，对 LTBI （通过结核菌素皮肤试验或 QuantiFERON-TB Gold In-Tube 试验阳性确定）的美国成年人进行评估，以确定 HBsAg 和抗-HBc 的流行率。使用调查加权数据确定 HBsAg 或抗-HBc 的流行率估计值，并进一步按性别、种族/族裔、出生国和年龄进行分层。通过回归分析随时间推移的结果来分析趋势。使用卡方检验进行组间比较。
LTBI 的总体流行率为 4.2%（95%置信区间[CI]，3.5-5.1）。在 LTBI 个体中，HBsAg 的流行率为 0.9%（95%CI，0.4-2.1），抗-HBc 的流行率为 12.9%（95%CI，9.8-16.8），两者在 1999-2000 年和 2011-2012 年之间均保持稳定。尽管 HBsAg 的流行率在性别、种族/族裔、出生国、年龄方面没有显著差异，但男性的抗-HBc 流行率明显高于女性（16.8% vs. 7.9%，P <0.05），黑人高于非西班牙裔白人（22.9% vs. 5.9%，P <0.05），非美国出生者高于美国出生者（15.9% vs. 7.2%，P=0.01），年龄最大组（年龄≥65 岁：17.5%，95%CI，10.5-27.8）最高。
在美国 LTBI 成人中，HBsAg 的总体流行率为 0.9%。每 8 名 LTBI 患者中就有 1 人有过 HBV 暴露。LTBI 患者的有效 HBV 筛查可能会改变临床实践，以防止抗结核治疗引起的药物性肝损伤。
