Acute viral hepatitis morbidity and mortality associated with hepatitis E virus infection: Uzbekistan surveillance data.
Acute viral hepatitis morbidity and mortality associated with hepatitis E virus infection: Uzbekistan surveillance data.
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DOI：
10.1186/1471-2334-9-35
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发表时间：
2009-03-25
影响因子：
3.7
通讯作者：
Chorba TL
中科院分区：
文献类型：
--
作者：
Sharapov MB;Favorov MO;Yashina TL;Brown MS;Onischenko GG;Margolis HS;Chorba TL
在乌兹别克斯坦，还没有常规血清学检测来区分急性病毒性肝炎的病因。为了确定在记录的AVH流行期间受戊型肝炎病毒（HEV）影响最大的年龄组，对15年期间每10万人中AVH相关死亡率（MR）的趋势和35年期间AVH报告的发病率进行了检查。研究了1971年至2005年报道的AVH发病率数据和1981年至1995年AVH相关死亡率数据。从流行期（1987年）的AVH住院患者样本和非流行期（1992年）的AVH孕妇样本中测定了A、B、D和E型肝炎病毒感染的血清学标志物。确定了两次多年AVH爆发：一次在1975-1976年，一次在1985-1987年。在1985-1987年期间，AVH相关的MR在一般人群中为12.3-17.8/100，000。最高的AVH相关MR发生在生命的前3年的儿童（40-190/100，000）和20-29岁的妇女（15-21/100，000）中。在1988-1995年期间，当报道的AVH发病率在一般人群中低得多时，AVH相关的MR在这些相同年龄组中明显较低。在1988年，农村（21/100，000）的AVH相关MR高于城市（8/100，000）人群（RR 2.6; 95% CI 1.16-5.93; p < 0.05）。1987年，396例AVH患者中有280例（71%）发现急性HEV感染的血清学证据，1992年，99例AVH妊娠患者中有12例（12%）发现急性HEV感染。在缺乏确证性检测的情况下，有时可以使用监测数据，比较AVH发病率与AVH相关死亡率，并着眼于基于人群的病毒性肝炎控制措施，来推断可能的肝炎流行病因。这里提供的数据表明，戊型肝炎病毒是1985-1987年期间乌兹别克斯坦孕妇和3岁以下儿童高死亡率的可能病因。在以前对流行性戊型肝炎的描述中，观察到孕妇的死亡率很高，但3岁以下儿童的死亡率并不高。在与戊型肝炎相关的AVH暴发中观察到的幼儿高死亡率值得在未来的暴发中得到证实。
In Uzbekistan, routine serologic testing has not been available to differentiate etiologies of acute viral hepatitis (AVH). To determine the age groups most affected by hepatitis E virus (HEV) during documented AVH epidemics, trends in AVH-associated mortality rate (MR) per 100,000 over a 15-year period and reported incidence of AVH over a 35-year period were examined. Reported AVH incidence data from 1971 to 2005 and AVH-associated mortality data from 1981 to 1995 were examined. Serologic markers for infection with hepatitis viruses A, B, D, and E were determined from a sample of hospitalized patients with AVH from an epidemic period (1987) and from a sample of pregnant women with AVH from a non-epidemic period (1992). Two multi-year AVH outbreaks were identified: one during 1975–1976, and one during 1985–1987. During 1985–1987, AVH-associated MRs were 12.3–17.8 per 100,000 for the general population. Highest AVH-associated MRs occurred among children in the first 3 years of life (40–190 per 100,000) and among women aged 20–29 (15–21 per 100,000). During 1988–1995 when reported AVH morbidity was much lower in the general population, AVH-associated MRs were markedly lower among these same age groups. In 1988, AVH-associated MRs were higher in rural (21 per 100,000) than in urban (8 per 100,000) populations (RR 2.6; 95% CI 1.16–5.93; p < 0.05). Serologic evidence of acute HEV infection was found in 280 of 396 (71%) patients with AVH in 1987 and 12 of 99 (12%) pregnant patients with AVH in 1992. In the absence of the availability of confirmatory testing, inferences regarding probable hepatitis epidemic etiologies can sometimes be made using surveillance data, comparing AVH incidence with AVH-associated mortality with an eye to population-based viral hepatitis control measures. Data presented here implicate HEV as the probable etiology of high mortality observed in pregnant women and in children less than 3 years of age in Uzbekistan during 1985–1987. High mortality among pregnant women but not among children less than 3 years has been observed in previous descriptions of epidemic hepatitis E. The high mortality among younger children observed in an AVH outbreak associated with hepatitis E merits corroboration in future outbreaks.
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影响因子：
5.9
作者：
KHUROO, MS;TELI, MR;KHUROO, MI
通讯作者：
KHUROO, MI
DOI：
10.4269/ajtmh.1998.58.330
发表时间：
1998-03-01
影响因子：
3.3
作者：
Coursaget, P;Buisson, Y;Roue, R
通讯作者：
Roue, R
影响因子：
5.5
作者：
Englund, J;Glezen, WP;Piedra, PA
通讯作者：
Piedra, PA
影响因子：
28.2
作者：
Beutels, P;Musabaev, EI;Yasin, T
通讯作者：
Yasin, T
影响因子：
9.4
作者：
MCLEAN, B;HOLMES, IH
通讯作者：
HOLMES, IH