Global epidemiology of hepatitis B virus infection: New estimates of age-specific HBsAg seroprevalence and endemicity
Global epidemiology of hepatitis B virus infection: New estimates of age-specific HBsAg seroprevalence and endemicity
复制标题
DOI：
10.1016/j.vaccine.2011.12.116
复制
发表时间：
2012-03-09
期刊：
影响因子：
5.5
通讯作者：
Wiersma, S. T.
中科院分区：
文献类型：
--
作者：
Ott, J. J.;Stevens, G. A.;Wiersma, S. T.
目的：慢性乙型肝炎病毒感染是人类最严重的感染之一，也是导致肝硬变和肝癌死亡的主要危险因素。我们估计了年龄、性别和地区特定的慢性乙肝病毒感染的流行情况，并计算了慢性感染的绝对人数。方法：对报道乙肝病毒感染的文献进行了系统的回顾，并收集了27年间(1980-2007年)全球范围内的乙肝表面抗原血清阳性数据。根据观察数据，使用经验贝叶斯分层模型在全球和世界所有地区估计了1990年和2005年的特定年龄段的流行率和地方性。这一点在撒哈拉以南非洲中部、热带和拉丁美洲中部、东南亚和中欧尤为明显。尽管流行率有所下降，但乙肝表面抗原阳性者的绝对人数从1990年的2.23亿人增加到2005年的2.4亿人。年龄特定流行率因地理区域而异，撒哈拉以南非洲的流行率最高，热带和中拉丁美洲、北美和西欧等区域的流行率低于2%。亚洲地区显示出明显的流行模式，南亚的中等流行率较低，但东亚的乙肝表面抗原流行率高达8.6%。东南亚儿童的感染率明显下降。结论：乙肝病毒感染率的下降可能与扩大免疫有关。慢性感染乙肝病毒的总人数不断增加，以及全球乙肝病毒流行率的广泛差异，要求采取有针对性的方法来解决与乙肝病毒相关的死亡率和发病率。需要国家和国家以下各级的乙肝病毒感染流行数据，以估计疾病负担并指导卫生和疫苗政策。(C)2012爱思唯尔有限公司。保留所有权利。
Objective: Chronic hepatitis B virus infection is one of the most serious infections and a major risk factor for deaths from cirrhosis and liver cancer. We estimate age-, sex- and region-specific prevalence of chronic HBV infection and calculate the absolute number of persons being chronically infected.Methods: A systematic review of the literature for studies reporting HBV infection was conducted and worldwide HBsAg seroprevalence data was collected over a 27-year period (1980-2007). Based on observed data, age-specific prevalence and endemicity were estimated on a global level and for all world regions for 1990 and 2005 using an empirical Bayesian hierarchical model.Findings: From 1990 to 2005, the prevalence of chronic HBV infection decreased in most regions. This was particularly evident in Central sub-Saharan Africa, Tropical and Central Latin America, South East Asia and Central Europe. Despite this decrease in prevalence, the absolute number of HBsAg positive persons increased from 223 million in 1990 to 240 million in 2005. Age-specific prevalence varied by geographical region with highest endemicity levels in sub-Saharan Africa and prevalence below 2% in regions such as Tropical and Central Latin America, North America and Western Europe. Asian regions showed distinct prevalence patterns with lower intermediate prevalence in South Asia, but up to 8.6% HBsAg prevalence in East Asia. Strong declines were seen in South East Asian children.Conclusion: Declines in HBV infection prevalence may be related to expanded immunization. The increasing overall number of individuals being chronically infected with HBV, and the widespread global differences in HBV prevalence call for targeted approaches to tackle HBV-related mortality and morbidity. HBV infection prevalence data are needed at country and sub-national level to estimate disease burden and guide health and vaccine policy. (C) 2012 Elsevier Ltd. All rights reserved.