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[希洪市6至25岁人群中甲肝和乙肝病毒标志物的流行情况]

[The prevalence of markers for the hepatitis A and B viruses in the population of Gijón between 6 and 25 years old].

作者信息

Suárez A, Navascués C A, García R, Peredo B, Miguel D, Menéndez M T, Saro C, Román F

机构信息

Sección de Aparato Digestivo, MIR Hospital de Cabueñes, Gijón.

出版信息

Med Clin (Barc). 1996 Apr 6;106(13):491-4.

PMID:8992130
Abstract

BACKGROUND

The aim of this study was to know the prevalence of previous infection markers for hepatitis A and B viruses in a pediatric-juvenile population from Gijón, Spain.

PATIENTS AND METHODS

A representative (according to the census) transversal randomized sample of a population from 6 to 25 years in age from Gijón, Spain, was included in the study analyzing demographic, epidemiologic and clinical variables, liver tests, anti-HAV IgG and anti-HBc.

RESULTS

Of the 630 individuals selected a demographic error was detected in 28 (4.4%) and 453 subjects were studied (71.9%) in whom the anti-HAV IgG was positive in 37 cases (8.75% of prevalence adjusted for age), with 4.4% (12/271) (CI 95% 2.3%-7.6%) for the younger cases and 13.7% (25/182) (CI 95% 9.1%-19.6%) in the group ranging from 18 to 25 years in age (p < 0.001). No anti-HAV IgG positive case was detected in the population under the age of 10 years. Among the young adults the prevalence of anti-HAV IgG positive cases was higher in those born in the south of Spain (2/6, 33.3%) (CI 95% 4.3%-77.7%) with respect to those from the northern regions of Spain (9/259, 3.5%) (CI 95% 1.6%-6.4%). (p = 0.02). With respect to HBV markers, of the 433 unvaccinated cases, 6 (1.4%) presented markers of past infection and 2 (0.46%) HBsAg positivity. Both had normal serum ALT without viral replication. Six cases of hypertransaminasemia levels (1.3%) were detected all being related with obesity or alcoholism. All the cases with previous acute clinical hepatitis were found to be anti-HAV IgG positive and anti-HBc negative.

CONCLUSIONS

The current prevalence of anti-HAV IgG in the population from 6 to 25 years from Gijón, Spain is very low and given the high degree of susceptibility (86%) for HAV infection in the young adult population (18-25 years) the implementation of vaccination programs is recommended even without previous serologic screening. The low prevalence of anti-Hbc would also undervalue its use as prevaccination screening against HB in this geographical area.

摘要

背景

本研究旨在了解西班牙希洪市儿童及青少年人群中甲型和乙型肝炎病毒既往感染标志物的流行情况。

患者与方法

本研究纳入了西班牙希洪市6至25岁人群的一个具有代表性(根据人口普查)的横向随机样本,分析人口统计学、流行病学和临床变量、肝功能检查、抗甲型肝炎病毒IgG和抗乙型肝炎核心抗体。

结果

在选取的630名个体中,检测到28例(4.4%)存在人口统计学误差,共研究了453名受试者(71.9%),其中37例抗甲型肝炎病毒IgG呈阳性(年龄校正后的流行率为8.75%),年龄较小的病例中为4.4%(12/271)(95%置信区间2.3%-7.6%),18至25岁年龄组中为13.7%(25/182)(95%置信区间9.1%-19.6%)(p<0.001)。10岁以下人群未检测到抗甲型肝炎病毒IgG阳性病例。在年轻成年人中,出生于西班牙南部的人群抗甲型肝炎病毒IgG阳性病例的流行率较高(2/6,33.3%)(95%置信区间4.3%-77.7%),而来自西班牙北部地区的人群为(9/259,3.5%)(95%置信区间1.6%-6.4%)(p = 0.02)。关于乙型肝炎病毒标志物,在433例未接种疫苗的病例中,6例(1.4%)呈现既往感染标志物,2例(0.46%)乙肝表面抗原呈阳性。两者血清谷丙转氨酶均正常,无病毒复制。检测到6例转氨酶水平升高(1.3%),均与肥胖或酗酒有关。所有既往有急性临床肝炎的病例抗甲型肝炎病毒IgG均为阳性,抗乙型肝炎核心抗体均为阴性。

结论

西班牙希洪市6至25岁人群中抗甲型肝炎病毒IgG的当前流行率非常低,鉴于年轻成年人(18 - 25岁)对甲型肝炎病毒感染的易感性较高(86%),即使没有先前的血清学筛查,也建议实施疫苗接种计划。抗乙型肝炎核心抗体的低流行率也会低估其在该地理区域作为乙肝疫苗接种前筛查指标的作用。

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