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以色列布哈拉犹太移民中乙型和丙型肝炎的患病率极高。

Very high prevalence of hepatitis B and C in Bukharian Jewish immigrants to Israel.

作者信息

Glikberg F, Brawer-Ostrovsky J, Ackerman Z

机构信息

Department of Family Medicine, Hadassah University Hospital, Mount Scopus, Jerusalem, Israel.

出版信息

J Clin Gastroenterol. 1997 Jan;24(1):30-3. doi: 10.1097/00004836-199701000-00006.

Abstract

In Israel, the reported prevalence of hepatitis-C virus (HCV) infection among blood donors is 0.44%. As we found a high prevalence of chronic hepatitis-B virus (HBV) and HCV infection in Jewish immigrants from Uzbekistan and Tajikistan (Bukharian Jews) among our general patient population, we determined the prevalence of HBV and HCV infection among "healthy" Bukharian Jewish immigrants by screening for HBV and HCV markers and risk factors in a population of Bukharian Jews in north Jerusalem. A total of 27 (26.5%) of 102 patients were anti-HCV positive (by ELISA and confirmation tests). The HCV positive patients were older and had a higher rate of liver enzyme abnormalities than were the HCV-negative patients (56.5 +/- 2.3 versus 47.6 +/- 1.8, p = 0.003; and 14 of 27 versus 7 of 75, p < 0.01, respectively). HCV-positive patients with liver enzyme abnormalities were younger than HCV-positive patients without liver enzyme abnormalities (52.5 +/- 3.0 versus 62.8 +/- 2.8, p = 0.02). Sixteen patients (15.7%) were hepatitis-B surface antigen (HBsAg) carriers, and only two of these HBsAg carriers had liver enzyme abnormalities. None of the HCV-positive patients were HBsAg carriers (0 of 27 among HCV-positive patients versus 16 of 75 among HCV-negative patients, p = 0.0055). Past infection with HBV was found in 67 examinees (66%) (45 of 75 HCV-negative patients and 22 of 27 HCV-positive patients, p = 0.058). However, similar proportions of patients from both groups had past and present exposure to HBV [61 (81.3%) of 75 among HCV-negative patients versus 22 (81.5%) of 27 among HCV-positive patients]. Only 14 patients (13.7%) had no exposure to either HCV or HBV. Possible risk factors were use of nondisposable needles during mass vaccination in the U.S.S.R. or possible intrafamilial spread. The study concluded that immigrant Jews from former Asiatic U.S.S.R. republics have the highest rate of HCV positivity ever reported, and many of them have past and present HBV infection. Measures to prevent intrafamilial transmission of both viruses should be instituted.

摘要

在以色列,据报告献血者中丙型肝炎病毒(HCV)感染率为0.44%。由于我们在普通患者群体中发现来自乌兹别克斯坦和塔吉克斯坦的犹太移民(布哈拉犹太人)中慢性乙型肝炎病毒(HBV)和HCV感染率很高,我们通过在耶路撒冷北部的布哈拉犹太人群体中筛查HBV和HCV标志物及危险因素,确定了“健康”布哈拉犹太移民中HBV和HCV感染率。102例患者中共有27例(26.5%)抗-HCV阳性(通过酶联免疫吸附测定法及确认试验)。HCV阳性患者比HCV阴性患者年龄更大,肝酶异常率更高(分别为56.5±2.3对47.6±1.8,p = 0.003;27例中的14例对75例中的7例,p < 0.01)。有肝酶异常的HCV阳性患者比无肝酶异常的HCV阳性患者年龄更小(52.5±3.0对62.8±2.8,p = 0.02)。16例患者(15.7%)为乙型肝炎表面抗原(HBsAg)携带者,其中只有2例HBsAg携带者有肝酶异常。HCV阳性患者中无HBsAg携带者(HCV阳性患者中27例为0例,HCV阴性患者中75例为16例,p = 0.0055)。67例受检者(66%)有HBV既往感染(75例HCV阴性患者中的45例和27例HCV阳性患者中的22例,p = 0.058)。然而,两组中既往和目前接触HBV的患者比例相似[HCV阴性患者中75例的61例(81.3%)对HCV阳性患者中27例的22例(81.5%)]。只有14例患者(13.7%)未接触过HCV或HBV。可能的危险因素是在苏联大规模疫苗接种期间使用非一次性针头或可能的家庭内传播。该研究得出结论,来自前苏联亚洲共和国的犹太移民的HCV阳性率是有报告以来最高的,其中许多人有HBV既往和目前感染。应采取措施预防这两种病毒的家庭内传播。

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