Changing epidemiology of hepatitis B in a US community
Changing epidemiology of hepatitis B in a US community
复制标题
DOI：
10.1002/hep.20098
复制
发表时间：
2004-03-01
期刊：
影响因子：
13.5
通讯作者：
Melton, LJ
中科院分区：
文献类型：
--
作者：
Kim, WR;Benson, JT;Melton, LJ
尽管自 20 世纪 80 年代中期以来，新获得的乙型肝炎病毒 (HBV) 感染有所减少，但 HBV 仍然是美国肝病的重要原因。我们报告了美国社区慢性 HBV 感染的患病率，并描述了人口和临床特征。罗切斯特流行病学项目记录了明尼苏达州奥姆斯特德县居民的医疗保健经历。对于该数据库中所有可能诊断为乙型肝炎的病例，我们审查了完整的医疗记录，以确定符合纳入标准的受试者，即临床医生诊断为慢性乙型肝炎病毒感染和乙型肝炎表面抗原（HBsAg）阳性的实验室记录。该社区有191名慢性乙肝感染居民，其中亚裔占53%，非洲裔占29%，白种人占13%，其他或未知种族占5%。 2000 年，该社区经年龄和性别调整后的 HBV 总体患病率为 0.15%。种族特定患病率在亚洲人中最高（2.1%），其次是非裔美国人（1.9%）。白种人中的患病率为 0.02%。总体而言，86% 的人出生在美国境外，其中 98% 是非白人。共有 131 名居民接受了 HBV 复制状态检测，其中 27% 有病毒复制。在接受转氨酶检测的人 (n = 184) 中，28% 的人至少有一次出现异常值。在多变量回归分析中，复制状态是与异常转氨酶值相关的最有影响力的因素（优势比 [OR] = 5.98，P < .01），其次是男性（OR = 3.69）和年龄大于 40 岁（OR = 2.32 每十年）。总之，在这个中西部社区，慢性乙型肝炎病毒感染主要见于来自世界流行地区的移民。
Despite a reduction in newly acquired hepatitis B virus (HBV) infections since the mid-1980s, HBV remains an important cause of liver disease in the U.S. We report the prevalence of chronic HBV infection in a U.S. community and describe demographic and clinical characteristics. The Rochester Epidemiology Project records healthcare encounters of residents of Olmsted County, Minnesota. For all cases with a potential diagnosis of hepatitis B in this database, complete medical records were reviewed to identify subjects who met the inclusion criteria, i.e., a clinician diagnosis of chronic HBV infection and a laboratory record of positive hepatitis B surface antigen (HBsAg). There were 191 residents with chronic HBV infection in the community, consisting of 53% Asian, 29% African, 13% Caucasian, and 5% other or unknown race. The overall age- and sex-adjusted prevalence of HBV in this community was 0.15% in 2000. The race-specific prevalence was highest among Asians (2.1%), followed by African Americans (1.9%). The prevalence among Caucasians was 0.02%. Overall, 86% were born outside the U.S., 98% of whom were non-Caucasian. A total of 131 residents were tested for HBV replicative status, of whom 27% had viral replication. Of those tested for aminotransferases (n = 184), 28% had an abnormal value at least once. In a multivariable regression analysis, replicative status was the most influential (odds ratio [OR] = 5.98, P < .01) factor associated with abnormal aminotransferase values, followed by male gender (OR = 3.69) and age greater than 40 years (OR = 2.32 per decade). In conclusion, in this Midwestern community, chronic HBV infection was predominantly seen in immigrants from endemic parts of the world.