Prevalence of Chronic Hepatitis B Virus (HBV) Infection in US Households: National Health and Nutrition Examination Survey (NHANES), 1988-2012
Prevalence of Chronic Hepatitis B Virus (HBV) Infection in US Households: National Health and Nutrition Examination Survey (NHANES), 1988-2012
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DOI：
10.1002/hep.28109
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发表时间：
2016-02-01
期刊：
影响因子：
13.5
通讯作者：
Holmberg, Scott D.
中科院分区：
文献类型：
--
作者：
Roberts, Henry;Kruszon-Moran, Deanna;Holmberg, Scott D.
自1991年以来，由于普遍接种婴儿疫苗，容易感染乙肝病毒的年轻人人数不断减少，这影响了美国慢性乙肝病毒感染者的人数，但从流行国家移民到美国的乙肝病毒感染者人数抵消了这一影响。在6岁及以上的非住院儿童中，通过血清学检测和分析：抗乙肝核心抗原抗体(抗-HBc)，表明有过乙肝病毒感染史；抗乙肝表面抗原，表明有慢性(当前)感染；以及抗乙肝表面抗原抗体(抗-HBs)，表明接种疫苗免疫。这些患病率估计值在国家健康和营养检查调查的三个阶段进行了分析：1988-1994年(21,260人)；1999-2008年(29,828人)；以及2007-2012年(22,358人)。在20112012，非西班牙裔亚洲人第一次在国民健康保险制度中被过度抽样。在最近一段时间(2007-2012年)，3.9%的人有抗-HBc，这表明大约有1080万(95%可信区间[CI]：940万-12.2)的非住院美国居民感染过乙肝病毒。自1999年以来，慢性乙肝病毒感染的总流行率保持不变：0.3%(95%可信区间：0.2-0.4)，自1999年以来，非西班牙裔黑人的慢性乙肝感染流行率比一般人群高2至3倍。据估计，2011-2012年间，约有3.1%(1.8%-5.2%)的非西班牙裔亚裔人慢性感染了乙肝病毒，这一比例是普通人群的10倍。自1999年以来，疫苗诱导免疫的调整流行率增加了16%，拥有疫苗预防乙肝病毒感染的血清学证据的人数(主要是年轻人)从5780万人(95%可信区间：5540万-6010万)上升到6850万人(95%可信区间：65.4-71.2)。结论：尽管在婴儿时期接种疫苗的年轻人加强了免疫保护，但对种族和民族人群中慢性乙肝流行率的分析表明，2011-2012年间，在非制度化的美国人口中，有84.7万人感染了乙肝病毒(其中包括大约40万名非西班牙裔亚裔)。
The number of persons with chronic hepatitis B virus (HBV) infection in the United States is affected by diminishing numbers of young persons who are susceptible because of universal infant vaccination since 1991, offset by numbers of HBV-infected persons migrating to the United States from endemic countries. The prevalence of HBV infection was determined by serological testing and analysis among noninstitutionalized persons age 6 years and older for: antibody to hepatitis B core antigen (anti-HBc), indicative of previous HBV infection; hepatitis B surface antigen (HBsAg), indicative of chronic (current) infection; and antibody to hepatitis B surface antigen (anti-HBs), indicative of immunity from vaccination. These prevalence estimates were analyzed in three periods of the National Health and Nutrition Examination Survey (NHANES): 1988-1994 (21,260 persons); 1999-2008 (29,828); and 2007-2012 (22,358). In 20112012, for the first time, non-Hispanic Asians were oversampled in NHANES. For the most recent period (2007-2012), 3.9% had anti-HBc, indicating approximately 10.8 (95% confidence interval [CI]: 9.4-12.2) million noninstitutionalized U.S. residents having ever been infected with HBV. The overall prevalence of chronic HBV infection has remained constant since 1999: 0.3% (95% CI: 0.2-0.4), and since 1999, prevalence of chronic HBV infection among non-Hispanic blacks has been 2- to 3-fold greater than the general population. An estimated 3.1% (1.8%-5.2%) of non-Hispanic Asians were chronically infected with HBV during 2011-2012, which reflects a 10-fold greater prevalence than the general population. Adjusted prevalence of vaccine-induced immunity increased 16% since 1999, and the number of persons (mainly young) with serological evidence of vaccine protection from HBV infection rose from 57.8 (95% CI: 55.4-60.1) million to 68.5 (95% CI: 65.4-71.2) million. Conclusion: Despite increasing immune protection in young persons vaccinated in infancy, an analysis of chronic hepatitis B prevalence in racial and ethnic populations indicates that during 2011-2012, there were 847,000 HBV infections (which included similar to 400,000 non-Hispanic Asians) in the noninstitutionalized U.S. population.