Suárez A, Viejo G, Navascués C A, García R, Díaz G, Saro C, Román F J
Seccion de Aparato Digestivo, Hospital de Cabueñes, Gijón.
Gastroenterol Hepatol. 1997 Aug-Sep;20(7):347-52.
The aim of this study was to know the prevalence of hepatitis A, B and C markers in an adult population in Gijón, Spain. A randomized, transversal sample according to the census was made in a population between 26 and 65 years of age in Gijón, analyzing demographic, epidemiologic and clinical variables, liver function tests, anti-HAV IgG, anti-HBcore and anti-HCV. Of the 476 individuals included a census error was detected in 26 (5.5%) and 340 (71.4%) were studied. Of these anti-HAV IgG was positive in 210 (61.8%) with prevalences of 17.9% from 26 to 30 years (CI: 95%, 11.1%-27.4%), 54.7% from 31 to 35 years (CI: 95%, 41.8%-67%), 73.6% from 36 to 40 years (CI: 95%, 59.4%-84.3%) and 93% (CI: 95%, 86.7%-96.5%) above 40 years of age (p < 0.001). No other significant variables were found adjusted by age groups. With regard to HBV, of the 331 unvaccinated cases, 35 (10.6, CI 95%, 7.6%-14.5%) presented immune markers and 4 (1.2% CI: 95%, 0.4%-3.3%) HBsAg positivity, with all having normal ALT and no viral replication. Anti-HCV was positive in 1.7% (CI: 95%, 0.7-3.9%), being significantly related to IVDA or tattoos. Hypertransaminasemias were detected in 18 (5.3%) being attributed to virus C (27.8%), alcoholism (27.8%) or obesity (44.4%). History of clinical manifestations of acute hepatitis was collected in 9.7% of the cases with no memory of the episode in 84.3% of the anti-HAV IgG positive cases, 79.5% of the anti-HBcore positive cases and 83.3% of the anti-HCV positive cases. The current curve of prevalence of anti-HAV IgG in the Gijón population varies in the decade from 30 to 40 years in age ranging from values discarding prevaccination screening under the age of 30 to levels of minimum susceptibility to infection above the age of 40. The low prevalence of anti-HBcore underestimates its use as prevaccination screening versus HBV in the population of Gijón. The prevalences of HBsAg or anti-HCV thereby make this area a zone of intermediate endemicity, with around 3% of the population being chronically infected by one of these viruses.
本研究旨在了解西班牙希洪市成年人群中甲、乙、丙型肝炎标志物的流行情况。根据人口普查，在希洪市26至65岁的人群中进行了随机横断面抽样，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、抗乙肝核心抗体和抗丙型肝炎病毒。在纳入的476名个体中，检测到26例（5.5%）存在人口普查误差，对340例（71.4%）进行了研究。其中，抗甲型肝炎病毒IgG呈阳性的有210例（61.8%），26至30岁人群的流行率为17.9%（95%置信区间：11.1%-27.4%），31至35岁人群为54.7%（95%置信区间：41.8%-67%），36至40岁人群为73.6%（95%置信区间：59.4%-84.3%），40岁以上人群为93%（95%置信区间：86.7%-96.5%）（p<0.001）。按年龄组调整后未发现其他显著变量。关于乙肝，在331例未接种疫苗的病例中，35例（10.6%，95%置信区间：7.6%-14.5%）呈现免疫标志物，4例（1.2%，95%置信区间：0.4%-3.3%）乙肝表面抗原呈阳性，所有这些病例的谷丙转氨酶均正常且无病毒复制。抗丙型肝炎病毒呈阳性的比例为1.7%（95%置信区间：0.7%-3.9%），与静脉注射毒品或纹身显著相关。检测到18例（5.3%）存在转氨酶升高，原因是丙型病毒感染（27.8%）、酗酒（27.8%）或肥胖（44.4%）。9.7%的病例有急性肝炎临床表现史，在抗甲型肝炎病毒IgG阳性病例中，84.3%的人对该发作无记忆，抗乙肝核心抗体阳性病例中这一比例为79.5%，抗丙型肝炎病毒阳性病例中为83.3%。希洪市人群中抗甲型肝炎病毒IgG的当前流行曲线在30至40岁这十年间有所不同，从30岁以下不进行疫苗接种前筛查的水平，到40岁以上对感染最低易感性的水平。抗乙肝核心抗体的低流行率低估了其在希洪市人群中作为乙肝疫苗接种前筛查指标的作用。乙肝表面抗原或抗丙型肝炎病毒的流行率使该地区成为中度流行区，约3%的人口被这些病毒之一慢性感染。
