Jing Wenzhan, Yuan Yanling, Liu Min, Ye Hanfeng, Kong Cai, Liu Jue, Wu Yu
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
Reproductive Epidemiology Laboratory, Yunnan Population and Family Planning Research Institute, Kunming, China.
Front Med (Lausanne). 2022 Jan 26;8:799873. doi: 10.3389/fmed.2021.799873. eCollection 2021.
Hepatitis B is a potentially life-threatening liver infection caused by hepatitis B virus (HBV) and China has the largest disease burden. We aim to understand the ethnic disparities in HBV infection among the married reproductive-age couples planning for pregnancy in Yunnan, a multiethnic province in Southwest China, to increase the health equities within the hepatitis response in China.
A population-based cross-sectional study was performed. Couples aged 20-49 years in rural Yunnan were enrolled through the National Free Preconception Health Examination Project from Jan 2014 to Dec 2019. HBsAg-positive couples were defined as couples in which one or both were HBsAg-positive, and HBsAg- and HBeAg-positive couples were defined as couples in which one or both were HBsAg- and HBeAg-positive. The HBV prevalence of positive couples was estimated by ethnicity. Multivariate logistic regression analyses were used to assess the association between ethnicity and HBsAg status.
Overall, 63,513 of 1,060,643 couples (5.99%, 95% CI, 5.94%-6.03%) were HBsAg-positive, and 15,898 of 63,513 HBsAg-positive couples (25.03%, 95% CI 24.69%-25.37%) were HBsAg- and HBeAg-positive couples in rural Yunnan. The highest prevalence of HBsAg-positive couples was in the Miao and Miao ethnicity (12.04%) and Zhuang and Zhuang ethnicity (9.76%), and the risk of HBV infection of wives/husbands in these ethnic groups was significantly higher than that in the Han and Han ethnicity. Additionally, the HBsAg prevalence in wives/husbands has increased with the positive status of HBsAg and HBeAg of their spouses.
The HBV prevalence in reproductive-age couples was intermediate (6% of 1 million couples) in rural Yunnan, China, with the highest in the Miao and Zhuang ethnicities. There are still large ethnic disparities in HBV infection in China. Therefore, China should make great efforts, especially giving priority to ethnic minorities and taking positive couples as an important unit of care, to equitably eliminate the HBV intrafamilial transmission.
乙型肝炎是一种由乙型肝炎病毒（HBV）引起的潜在威胁生命的肝脏感染，中国的疾病负担最为沉重。我们旨在了解中国西南部多民族省份云南计划怀孕的已婚育龄夫妇中HBV感染的种族差异，以提高中国肝炎应对中的健康公平性。
开展了一项基于人群的横断面研究。2014年1月至2019年12月，通过国家免费孕前健康检查项目招募了云南农村地区年龄在20 - 49岁的夫妇。HBsAg阳性夫妇定义为一方或双方HBsAg呈阳性的夫妇，HBsAg和HBeAg阳性夫妇定义为一方或双方HBsAg和HBeAg呈阳性的夫妇。按种族估计阳性夫妇的HBV流行率。采用多因素logistic回归分析评估种族与HBsAg状态之间的关联。
总体而言，在云南农村地区的1,060,643对夫妇中，有63,513对（5.99%，95%CI，5.94% - 6.03%）为HBsAg阳性，在63,513对HBsAg阳性夫妇中有15,898对（25.03%，95%CI 24.69% - 25.37%）为HBsAg和HBeAg阳性夫妇。HBsAg阳性夫妇患病率最高的是苗族和苗族（12.04%）以及壮族和壮族（9.76%），这些民族中妻子/丈夫的HBV感染风险显著高于汉族和汉族。此外，妻子/丈夫的HBsAg患病率随着其配偶HBsAg和HBeAg阳性状态而增加。
中国云南农村地区育龄夫妇的HBV患病率处于中等水平（每百万对夫妇中有6%），苗族和壮族的患病率最高。中国HBV感染仍存在较大的种族差异。因此，中国应做出巨大努力，特别是优先关注少数民族，并将阳性夫妇作为重要的护理单位，以公平地消除HBV家庭内传播。
