新加坡患有性传播疾病和艾滋病毒感染的男性中乙肝病毒（HBV）感染的患病率：在乙肝病毒中度流行的城市国家中，性传播的作用

Prevalence of hepatitis B virus (HBV) infection in Singapore men with sexually transmitted diseases and HIV infection: role of sexual transmission in a city state with intermediate HBV endemicity.

作者信息

Heng B H, Goh K T, Chan R, Chew S K, Doraisingham S, Quek G H

机构信息

Quarantine and Epidemiology Department, Ministry of the Environment, Singapore.

出版信息

J Epidemiol Community Health. 1995 Jun;49(3):309-13. doi: 10.1136/jech.49.3.309.

DOI:10.1136/jech.49.3.309

PMID:7629470

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1060804/

Abstract

STUDY OBJECTIVES

To describe the prevalence of hepatitis B virus (HBV) infection in patients with sexually transmitted diseases (STD) and human immunodeficiency virus (HIV) infection, and to determine the role of sexual transmission of HBV infection in Singapore.

DESIGN

A cross sectional study of all consecutive men presenting with a new episode of STD at a government outpatient clinic and all men with HIV infection on routine follow up at a government hospital. The prevalence of various HBV markers was compared with that of healthy males aged 15 years and above (controls).

SETTING

Singapore, a city state of intermediate HBV endemicity.

SUBJECTS

These comprised 497 STD patients, 47 HIV infected patients, and 418 controls.

MAIN RESULTS

The overall seroprevalences of HBV infection in STD patients, HIV infected patients, and control subjects were 41.2%, 61.7%, and 33.3%, respectively (p < 0.001). The seroprevalences of hepatitis B surface antigen (6.2%, 8.5%, and 4.5%, respectively) were comparable in the three groups. Using stepwise logistic regression analysis, the adjusted seroprevalences of HBV infection in STD and HIV infected patients were respectively 2.4 times (95% confidence interval (CI), 1.7, 3.3) and 3.3 times (95% CI 1.7, 6.3) higher than in controls. HBV infection rates were higher among Chinese (odds ratio (OR), 1.9; 95% CI 1.6, 3.4) than non-Chinese, and among those aged 25-34 years (OR 2.4; 95% CI 1.6, 3.4), 35-44 years (OR 3.9; 95% CI 2.5, 5.9), and 45+ years (OR 6.2; 95% CI 3.8, 10.2) than in those aged 15-24 years. Sex related factors significantly associated with higher infection rates, independent of age and ethnic group, were reactive VDRL test (OR 2.4; 95% CI 1.2, 4.7), participation in anal intercourse (OR 2.3; 95% CI 1.2, 4.3), and having 10 or more lifetime sexual partners (OR 1.5; 95% CI, 1.0, 2.1).

CONCLUSION

The importance of sexual transmission of HBV in an area of intermediate HBV endemicity was confirmed. Patients attending STD clinics should be routinely screened for HBV markers and those found to be seronegative should be strongly advised to be immunised against this virus.

摘要

研究目的

描述性传播疾病（STD）患者及人类免疫缺陷病毒（HIV）感染者中乙型肝炎病毒（HBV）感染的流行情况，并确定新加坡HBV感染性传播的作用。

设计

对一家政府门诊新诊断为STD的所有连续男性患者以及一家政府医院常规随访的所有HIV感染男性患者进行横断面研究。将各种HBV标志物的流行率与15岁及以上健康男性（对照组）的流行率进行比较。

研究地点

新加坡，一个HBV中度流行的城市国家。

研究对象

包括497例STD患者、47例HIV感染患者和418例对照。

主要结果

STD患者、HIV感染患者和对照人群中HBV感染的总体血清流行率分别为41.2%、61.7%和33.3%（p<0.001）。三组中乙型肝炎表面抗原的血清流行率（分别为6.2%、8.5%和4.5%）相当。采用逐步逻辑回归分析，STD患者和HIV感染患者中HBV感染的校正血清流行率分别比对照组高2.4倍（95%置信区间（CI），1.7，3.3）和3.3倍（95%CI 1.7，6.3）。华裔人群中的HBV感染率（优势比（OR），1.9；95%CI 1.6，3.4）高于非华裔人群，25 - 34岁（OR 2.4；95%CI 1.6，3.4）、35 - 44岁（OR 3.9；95%CI 2.5，5.9）和45岁及以上（OR 6.2；95%CI 3.8，10.2）人群中的感染率高于15 - 24岁人群。与较高感染率显著相关的性别相关因素，独立于年龄和种族群体，是性病研究实验室玻片试验反应性（OR 2.4；95%CI 1.2，4.7）、参与肛交（OR 2.3；95%CI 1.2，4.3）以及终身有10个或更多性伴侣（OR 1.5；95%CI，1.0，2.1）。