Seroprevalence of hepatitis B, hepatitis C, human immunodeficiency virus, Treponema pallidum, and co-infections among blood donors in Kyrgyzstan: a retrospective analysis (2013-2015).
Seroprevalence of hepatitis B, hepatitis C, human immunodeficiency virus, Treponema pallidum, and co-infections among blood donors in Kyrgyzstan: a retrospective analysis (2013-2015).
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DOI：
10.1186/s40249-017-0255-9
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发表时间：
2017-02-21
影响因子：
8.1
通讯作者：
Akmatov MK
中科院分区：
文献类型：
--
作者：
Karabaev BB;Beisheeva NJ;Satybaldieva AB;Ismailova AD;Pessler F;Akmatov MK
苏联解体后的吉尔吉斯斯坦经历了血液传播感染的大幅增加，但缺乏来自足够有力的最新研究的数据。因此，我们检查了a)吉尔吉斯斯坦献血者中乙型肝炎病毒表面抗原（HBsAg）、HIV-1 p24抗原和抗丙型肝炎病毒（抗hcv）、人类免疫缺陷病毒（抗HIV-1/2、HIV-1 O组）和梅毒梅毒体的血清患病率，并根据性别、年龄和居住省份评估其分布；B)各自血清患病率的趋势；c)所研究病原体之间的共感染率。2013年1月至2015年12月期间，在吉尔吉斯斯坦比什凯克共和国血液中心对37165名献血者进行了血清学筛查。我们应用分层后权重来控制抽样偏差，并使用逻辑回归分析来检验血清阳性和合并感染与性别、年龄、居住省份和献血年份的关系。29,145名（78%）献血者为男性，8,020名（22%）为女性。中位年龄为27岁（范围：18 - 64岁）。HBsAg、抗- hcv、HIV （p24ag和抗-HIV）、抗- t的患病率。螺旋体是3.6%(95%置信区间ci: 3.4 - 3.8%), 3.1%(3.0 - 3.3%), 0.78%(0.69 - 0.87%),分别为和3.3%(3.1 - 3.5%)。男性比女性更容易出现HBsAg血清阳性（OR: 1.63; 95%CI: 1.40 - 1.90），但抗hcv血清阳性（0.85;0.74 - 0.98）和HIV血清阳性（0.65;0.49 - 0.85）的可能性较小。首都的患病率低于其他省份。血清HBsAg、抗- hcv、抗- t阳性率呈下降趋势。2012 - 2015年梅毒梅毒（趋势P值分别为P = 0.01, P < 0.0001, P < 0.0001），而HIV血清患病率上升（P = 0.049）。180名献血者（0.48%）血清多重感染阳性。合并感染率最高的是抗t。其次是抗hcv和抗t抗体。苍白病（5.2%），HIV和抗hcv（4.9%）。数据表明，吉尔吉斯斯坦可以将HBsAg的高流行率重新分类为中低流行率，而艾滋病毒的高流行率和上升趋势是一个令人震惊的发现，需要公共卫生当局紧急处理。观察到的合并感染表明有共同的危险因素，但也有共同的预防措施。本文的在线版本（doi:10.1186/s40249-017-0255-9）包含补充材料，可供授权用户使用。
Post-Soviet Kyrgyzstan has experienced a major surge in blood-borne infections, but data from adequately powered, up-to-date studies are lacking. We thus examined a) the seroprevalences of hepatitis B virus surface antigen (HBsAg), HIV-1 p24 antigen and antibodies against hepatitis C virus (anti-HCV), human immunodeficiency viruses (anti-HIV-1/2, HIV-1 group O), and Treponema pallidum among blood donors in Kyrgyzstan and assess their distribution according to sex, age, and provinces of residence; b) trends in the respective seroprevalences; and c) co-infection rates among the pathogens studied. Serological screening was performed on 37 165 blood donors at the Republican Blood Centre in Bishkek, Kyrgyzstan, between January 2013 and December 2015. We applied poststratification weights to control for sampling bias and used logistic regression analyses to examine the association of seropositivity and co-infections with sex, age, provinces of residence, and year of blood donation. Twenty nine thousand and one hundred forty-five (78%) donors were males and 8 020 (22%) were females. The median age was 27 years (range: 18 – 64). The prevalences of HBsAg, anti-HCV, HIV (p24 Ag and anti-HIV), and anti-T. pallidum were 3.6% (95%CI: 3.4 – 3.8%), 3.1% (3.0 – 3.3%), 0.78% (0.69 – 0.87%), and 3.3% (3.1 – 3.5%), respectively. Males were more likely to be seropositive for HBsAg than females (OR: 1.63; 95%CI: 1.40 – 1.90), but less likely to be seropositive for anti-HCV (0.85; 0.74 – 0.98) and HIV (0.65; 0.49 – 0.85). Prevalences were lower in the capital than in the other provinces. There was a decreasing trend in the seroprevalences of HBsAg, anti-HCV, and anti-T. pallidum from 2012 to 2015 (P-value for trend, P = 0.01, P < 0.0001, P < 0.0001, respectively), while the seroprevalence of HIV increased (P = 0.049). One hundred eighty donors (0.48%) were seropositive for multiple infections. The highest co-infection rate was observed between anti-T. pallidum and HBsAg (6.0%), followed by anti-HCV and anti-T. pallidum (5.2%), and HIV and anti-HCV (4.9%). The data suggest that Kyrgyzstan can be reclassified from high to lower-intermediate HBsAg endemicity, whereas the high HIV prevalence with a rising trend is an alarming finding that needs to be urgently addressed by public health authorities. The observed co-infections suggest common risk factors but also common preventive interventions. The online version of this article (doi:10.1186/s40249-017-0255-9) contains supplementary material, which is available to authorized users.