Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013
Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013
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DOI：
10.1016/s0140-6736(15)61412-x
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发表时间：
2015-10-17
期刊：
影响因子：
168.9
通讯作者：
Ott, Joerdis J.
中科院分区：
文献类型：
--
作者：
Schweitzer, Aparna;Horn, Johannes;Ott, Joerdis J.
背景：量化可归因于乙肝病毒(HBV)感染的疾病负担和采取预防和控制措施需要了解其在普通人群中的流行情况。对于大多数国家来说，这样的数据并不是例行公事。方法在Medline、Embase、CAB摘要(Global Health)、Popline和Web of Science等数据库中检索1965年1月1日至2013年10月23日发表的有关慢性乙肝感染流行率的数据。我们纳入了在非高危人群中报道慢性乙肝病毒感染的乙肝表面抗原(HBs)血清标志物的研究，并将数据提取到定制的数据库中。对于每个国家，我们计算了乙肝表面抗原流行率估计值和95%的按研究规模加权的CI。我们根据2010年的人口规模外推患病率估计，以获得慢性乙肝病毒感染者的人数。筛选了17 029份记录，其中包括161个国家和地区的1800份关于乙肝表面抗原流行率的报告。世界范围内乙肝表面抗原血清阳性率为3.61%(95%可信区间3.61~3.61)，其中非洲地区国家(总计8.83%，8.82~8.83)和西太平洋地区(总计5.26%，5.26~5.26)流行程度最高。在世卫组织区域内，美洲的流行率为0.20%(0.19-0.21；墨西哥)至13.55%(9.00-19.89；海地)，非洲区域为0.48%(0.12-1.90；塞舌尔)至22.38%(20.10-24.83；南苏丹)。我们估计，2010年，全球约有2.48亿人的乙肝表面抗原呈阳性。解释这项首次对国家层面的慢性乙肝病毒感染人口流行率进行的全球评估发现，各国之间存在很大差异，并强调需要继续采取预防和控制战略，并使用标准化方法收集可靠的流行病学数据。
Background The quantification of the burden of disease attributable to hepatitis B virus (HBV) infection and the adaptation of prevention and control measures requires knowledge on its prevalence in the general population. For most countries such data are not routinely available. We estimated the national, regional, and global prevalence of chronic HBV infection.Methods For this systematic review and pooled analysis, we searched for data on prevalence of chronic HBV infection published between Jan 1, 1965, and Oct 23, 2013, in the databases Medline, Embase, CAB Abstracts (Global health), Popline, and Web of Science. We included studies reporting the hepatitis B surface antigen (HBsAg) serological marker of chronic HBV infection in non-high-risk groups and extracted data into a customised database. For each country, we calculated HBsAg prevalence estimates and 95% CIs weighted by study size. We extrapolated prevalence estimates to population sizes in 2010 to obtain the number of individuals with chronic HBV infection.Findings Of the 17 029 records screened, 1800 report on the prevalence of HBsAg covering 161 countries were included. HBsAg seroprevalence was 3.61% (95% CI 3.61-3.61) worldwide with highest endemicity in countries of the African region (total 8.83%, 8.82-8.83) and Western Pacific region (total 5.26%, 5.26-5.26). Within WHO regions, prevalence ranged from 0.20% (0.19-0.21; Mexico) to 13.55% (9.00-19.89; Haiti) in the Americas, to 0.48% (0.12-1.90; the Seychelles) to 22.38% (20.10-24.83; South Sudan) in the African region. We estimated that in 2010, globally, about 248 million individuals were HBsAg positive.Interpretation This first global assessment of country-level population prevalence of chronic HBV infection found a wide variation between countries and highlights the need for continued prevention and control strategies and the collection of reliable epidemiologic data using standardised methodology.