Highly endemic hepatitis B infection in rural Vietnam
Highly endemic hepatitis B infection in rural Vietnam
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DOI：
10.1111/j.1440-1746.2007.05010.x
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发表时间：
2007-12-01
影响因子：
4.1
通讯作者：
Dore, Gregory J.
中科院分区：
文献类型：
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作者：
Nguyen, Van Thi-Thuy;McLaws, Mary-Louise;Dore, Gregory J.
背景和目的：B型肝炎是越南的一个主要公共卫生问题;然而，对越南农村地区B型肝炎病毒（HBV）和丁型肝炎病毒（HDV）的患病率以及风险因素的估计有限。本研究的目的是确定HBV和HDV的患病率，并确定HBV感染的危险因素。方法：在太平省的两个农村地区进行了横断面血清阳性率研究。研究人群采用多阶段抽样随机选择。从837名参与者中获得了人口统计学和行为风险信息以及血清学样本。结果：平均年龄为42.3岁± 15.8岁（范围：16-82岁），50.8%为女性。抗-HBc和B病毒表面抗原（HBsAg）检出率分别为68.2%和19.0%，HBeAg阳性组中16.4%检出B e抗原。HBsAg阳性组HDV患病率为1.3%。HBV感染相关因素（抗-HBc或HBsAg阳性）年龄≥ 60岁（OR，3.82; 95% CI，1.35-10.80; P = 0.01），居住在武秋县住院史（OR = 2.34; 95% CI = 1.33 - 4.13; P = 0.003）和针灸史（OR = 2.01; 95% CI = 1.29-3.13; P = 0.002）。与肝病患者的家庭接触（OR，2.13; 95% CI，1.29-3.52; P = 0.003），重复使用注射器（OR，1.81; 95%CI，1.25-2.62; P = 0.002）和共用剃须刀（OR，1.69; 95%CI，1.03-2.79; P = 0.04）是HBsAg阳性的独立预测因素。丙氨酸氨基转移酶（ALT）水平升高（> 40 IU/L）的HBeAg阳性组中的43%; HBeAg阳性组中ALT水平升高的比例（65%）高于HBeAg阴性组（39%）（P = 0.02.Conclusion：B型肝炎病毒感染在越南农村是高度流行的。卫生保健机构的感染控制活动不力，导致该地区HBV的高流行率。为了改善越南的HBV控制，需要普及HBV婴儿疫苗接种和改进感染控制程序。
Background and Aim: Hepatitis B is a major public health problem in Vietnam; however, estimates of the prevalence of hepatitis B virus (HBV) and hepatitis delta virus (HDV), and risk factors in rural Vietnam are limited. The aim of this study was to determine HBV and HDV prevalence, and identify risk factors for HBV infection.Methods: A cross-sectional seroprevalence study was undertaken in two rural districts in Thai Binh province. The study population was randomly selected using multistage sampling. Demographic and behavioral risk information and serological samples were obtained from 837 participants.Results: Mean age was 42.3 years +/- 15.8 (range, 16-82 years), and 50.8% were female. Prevalence of anti-HBV core antibody (anti-HBc) and hepatitis B virus surface antigen (HBsAg) was 68.2% and 19.0%, respectively, and hepatitis B e antigen HBeAg was detected in 16.4% of the HBsAg-positive group. Prevalence of HDV was 1.3% in the HBsAg-positive group. Factors associated with HBV infection (anti-HBc or HBsAg positive) were age 60 years or older (OR, 3.82; 95% CI, 1.35-10.80; P = 0.01), residence in Vu Thu district (OR, 3.00; 95% CI, 2.16-4.17; P < 0.0001), hospital admission (OR, 2.34; 95% CI, 1.33-4.13; P = 0.003) and history of acupuncture (OR, 2.01; 95% CI, 1.29-3.13; P = 0.002). Household contact with a person with liver disease (OR, 2.13; 95% CI, 1.29-3.52; P = 0.003), reuse of syringes (OR, 1.81; 95% CI, 1.25-2.62; P = 0.002) and sharing of razors (OR, 1.69; 95% CI, 1.03-2.79; P = 0.04) were independent predictors of HBsAg positivity. Alanine aminotransferase (ALT) level was elevated (> 40 IU/L) in 43% of the HBsAg-positive group; proportion elevated was higher in HBeAg-positive (65%) compared with HBeAg-negative (39%) individuals in this group (P = 0.02).Conclusion: Hepatitis B virus infection is highly endemic in rural Vietnam. Poor infection control activities in health-care settings contribute to high HBV prevalence in this region. Universal HBV infant vaccination and improved infection control procedures are required for improved HBV control in Vietnam.