Epidemiological Patterns of hepatitis B virus (HBV) in highly endemic areas
Epidemiological Patterns of hepatitis B virus (HBV) in highly endemic areas
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DOI：
10.1017/s0950268800001497
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发表时间：
1996-10-01
影响因子：
4.2
通讯作者：
Hall, AJ
中科院分区：
文献类型：
--
作者：
Edmunds, WJ;Medley, GF;Hall, AJ
本文使用已发表数据的荟萃分析和乙型肝炎病毒（HBV）传播的确定性数学模型来描述HBV高流行地区的感染模式。我们描述了携带者的流行与感染率的简单度量之间的关联，即一半人口被感染的年龄（a(50)），并评估了水平传播和围产期传播对这种关联的贡献。我们发现撒哈拉以南非洲和东亚两个主要的高流行区具有相似的携带者患病率和A（50）值，并且A（50）与高流行区携带者患病率之间存在负非线性关系（Spearman's Rank, P = 0.0086）。我们量化了围产期传播的风险和年龄依赖性感染率，以便对主要高流行地区进行比较。与撒哈拉以南非洲地区相比，东亚地区HBeAg阳性母亲的患病率更高，HBeAg阳性母亲的围产期传播风险也更高，尽管差异没有统计学意义。然而，这两个地区的水平传播程度和年龄相关率相似。一个简单的区室模型的结果表明，相似的水平传播率足以产生a（50）和携带者患病率之间的相似模式。通过大规模免疫阻断水平传播预计将对新携带者的获得率产生重大的非线性影响。
This paper uses meta-analysis of published data and a deterministic mathematical model of hepatitis B virus (HBV) transmission to describe the patterns of HBV infection in high endemicity areas. We describe the association between the prevalence of carriers and a simple measure of the rate of infection, the age at which half the population have been infected (A(50)), and assess the contribution of horizontal and perinatal transmission to this association. We found that the two main hyper-endemic areas of sub-Saharan Africa and east Asia have similar prevalences of carriers and values of A(50), and that there is a negative nonlinear relationship between A(50) and the prevalence of carriers in high endemicity areas (Spearman's Rank, P = 0.0086). We quantified the risk of perinatal transmission and the age-dependent rate of infection to allow a comparison between the main hyper-endemic areas. East Asia was found to have higher prevalences of HBeAg positive mothers and a greater risk of perinatal transmission from HBeAg positive mothers than sub-Saharan Africa, though the differences were not statistically significant. However, the two areas have similar magnitudes and age-dependent rates of horizontal transmission. Results of a simple compartmental model suggest that similar rates of horizontal transmission are sufficient to generate the similar patterns between A(50) and the prevalences of carriers. Interrupting horizontal transmission by mass immunization is expected to have a significant, nonlinear impact on the rate of acquisition of new carriers.