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坦桑尼亚多多马地区慢性肝病患者中乙型和丙型肝炎病毒感染的血清流行率及预测因素:一项横断面研究

Seroprevalence and Predictors of Hepatitis B and C Virus Infections Among Patients with Chronic Liver Diseases in Dodoma Region, Tanzania: A Cross-Sectional Study.

作者信息

Gyunda Daudi J, Yahaya James J, Sindato Emmanuel M, Meremo Alfred J

机构信息

Department of Internal Medicine, School of Medicine and Dentistry, University of Dodoma, Dodoma, Tanzania.

Department of Pathology, School of Health Sciences, Soroti University, Soroti, Uganda.

出版信息

Hepat Med. 2025 Sep 23;17:125-140. doi: 10.2147/HMER.S533485. eCollection 2025.

Abstract

BACKGROUND

The known major causes of chronic liver diseases (CLDs) include, hepatitis B virus (HBV) and hepatitis C virus (HCV); however, there is scarcity of data regarding their seroprevalence in Tanzania. We aimed to evaluate the seroprevalence of HBsAg and anti-HCV and their predictors among patients with CLDs. Additionally, we also described the clinical patterns of the patients.

METHODS

A cross-sectional analytical study design was carried at the two referral public hospitals in Dodoma region; Dodoma referral regional hospital (DRRH) and Benjamin Mkapa hospital (BMH) among 118 patients with CLDs. Rapid test immunochromatography was used to test for HBsAg whereas anti-HCV antibody positivity was tested using lateral flow chromatographic immunoassay. Multivariable binary logistic regression was used to evaluate the predictors of HbsAg positive results, and statistical significance was set at p˂0.05.

RESULTS

The seroprevalence of HBsAg and anti-HCV antibody was 28% (33/118) and 3.4% (4/118), respectively. Having a chronic illness (AOR = 2.3, 95% CI = 1.76-7.19, p = 0.041), raised level of alanine transaminase (ALT) (AOR = 3.6, 95% CI = 1.74-8.21, p = 0.025), increased AST/ALT ratio (AOR = 2.9, 95% CI = 2.57-11.57, p = 0.039), and increased level of total bilirubin (AOR = 5.1, 95% CI = 1.09-24.39, p = 0.039) remained the predictors of HBsAg positivity.

CONCLUSION

This study reports that almost one-third of the study subjects had positive HbsAg, and the positivity of anti-HCV antibody was quite low. The positivity of HbsAg was associated with having chronic illness, increased levels of ALT, total bilirubin, and AST/ALT ratio. Therefore, emphasis should be made to maximize the screening practices for individuals with such predictors due to high possibility of being infected with HBV.

摘要

背景

慢性肝病(CLD)的已知主要病因包括乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV);然而,关于它们在坦桑尼亚的血清流行率的数据却很匮乏。我们旨在评估慢性肝病患者中HBsAg和抗-HCV的血清流行率及其预测因素。此外,我们还描述了患者的临床特征。

方法

在多多马地区的两家转诊公立医院——多多马转诊地区医院(DRRH)和本杰明·姆卡帕医院(BMH),对118例慢性肝病患者进行了一项横断面分析研究。采用快速检测免疫层析法检测HBsAg,而抗-HCV抗体阳性则采用侧向流动层析免疫测定法检测。使用多变量二元逻辑回归来评估HBsAg阳性结果的预测因素,统计学显著性设定为p˂0.05。

结果

HBsAg和抗-HCV抗体的血清流行率分别为28%(33/118)和3.4%(4/118)。患有慢性病(调整后比值比[AOR]=2.3,95%置信区间[CI]=1.76-7.19,p=0.041)、丙氨酸转氨酶(ALT)水平升高(AOR=3.6,95%CI=1.74-8.21,p=0.025)、天冬氨酸转氨酶/ALT比值升高(AOR=2.9,95%CI=2.57-11.57,p=0.039)以及总胆红素水平升高(AOR=5.1,95%CI=1.09-24.39,p=0.039)仍然是HBsAg阳性的预测因素。

结论

本研究报告称,几乎三分之一的研究对象HBsAg呈阳性,而抗-HCV抗体的阳性率相当低。HBsAg阳性与患有慢性病、ALT、总胆红素水平升高以及AST/ALT比值升高有关。因此,鉴于感染HBV的可能性很高,应重视对具有此类预测因素的个体加强筛查措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2333/12476176/12ba1bcb93ed/HMER-17-125-g0001.jpg

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