Prevalence of chronic hepatitis B among foreign-born persons living in the United States by country of origin
Prevalence of chronic hepatitis B among foreign-born persons living in the United States by country of origin
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DOI：
10.1002/hep.24804
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发表时间：
2012-08-01
期刊：
影响因子：
13.5
通讯作者：
Brosgart, Carol L.
中科院分区：
文献类型：
--
作者：
Kowdley, Kris V.;Wang, Chia C.;Brosgart, Carol L.
对美国慢性乙肝(CHB)患病率的估计有很大不同，外国出生的人(FB)的贡献没有得到充分的描述。这项研究的目的是根据其原籍国估计美国慢性乙肝患者的数量。我们对102个国家和地区(包括1980年至2010年7月的PubMed)的乙肝表面抗原血清阳性率的报告进行了系统的回顾。1,373篇符合纳入标准的文章的数据被提取到国别数据库中。我们在52个国家(包括689,078人)的移民中确定了256项血清阳性调查，在98个国家(包括17,861,035人)的一般人口中确定了1,797项调查。包括慢性乙肝风险低于或高于一般人群的个人的调查被排除在外。使用荟萃分析方法将数据组合在一起，以确定特定国家的合并CHB患病率。比率乘以2009年居住在美国的FB人数乘以美国人口普查局的出生国家，得出每个国家的FB人数和CHB人数。我们估计，2009年美国慢性乙肝患者总数为132万(95%可信区间：1.04-1.61)；58%来自亚洲，11%来自乙肝高度流行的非洲。大约7%的人来自慢性乙肝发病率较低的中美洲，但移民到美国的人数要多得多。这一分析表明，在美国，患有慢性乙肝的FB患者的数量可能比之前报道的要多得多。假设在美国出生的30-60万人患有慢性乙肝，那么美国的慢性乙肝总患病率可能高达220万。(2012国际肝病)
Estimates of the prevalence of chronic hepatitis B (CHB) in the United States differ significantly, and the contribution of foreign-born (FB) persons has not been adequately described. The aim of this study was to estimate the number of FB persons in the United States living with CHB by their country of origin. We performed a systematic review for reports of HBsAg seroprevalence rates in 102 countries (covering PubMed from 1980 to July 2010). Data from 1,373 articles meeting inclusion criteria were extracted into country-specific databases. We identified 256 seroprevalence surveys in emigrants from 52 countries (including 689,078 persons) and 1,797 surveys in the general populations of 98 countries (including 17,861,035 persons). Surveys including individuals with lower or higher risk of CHB than the general population were excluded. Data were combined using meta-analytic methods to determine country-specific pooled CHB prevalence rates. Rates were multiplied by the number of FB living in the United States in 2009 by country of birth from the U.S. Census Bureau to yield the number of FB with CHB from each country. We estimate a total of 1.32 million (95% confidence interval: 1.04-1.61) FB in the United States living with CHB in 2009; 58% migrated from Asia and 11% migrated from Africa, where hepatitis B is highly endemic. Approximately 7% migrated from Central America, a region with lower CHB rates, but many more emigrants to the United States. This analysis suggests that the number of FB persons living with CHB in the United States may be significantly greater than previously reported. Assuming 300,000-600,000 U.S.-born persons with CHB, the total prevalence of CHB in the United States may be as high as 2.2 million. (Hepatology 2012)