Epidemiological characteristics of the spontaneous reactivation of HBV carriers in community population in Wuwei City
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摘要: 目的 分析社区人群乙型肝炎表面抗原(hepatitis B surface antigen,HBsAg)携带者发生自发性再激活的流行病学特征,为社区人群乙型肝炎的防控和管理提供科学依据。方法 在2010年9月甘肃省武威市乙型肝炎血清流行病学调查建立的HBsAg携带者队列基础上,于2012年和2014年开展随访研究,分析自发性再激活的发生情况和流行病学特征。结果 随访发现,852例HBsAg携带者中共有72例发生再激活,发病密度为2 746.8/10万人年。不同性别间再激活率差异存在统计学意义(χ2=3.901,P=0.048),男性累积再激活率为10.39%,高于女性累积再激活率(6.62%)。各年龄组间再激活率也存在统计学差异(χ2=6.524,P=0.038),其中46~59岁年龄组累积再激活率最高,为11.95%。HBsAg携带者基线乙型肝炎病毒(hepatitis B virus,HBV)DNA水平不同,再激活率也不同(χ2=10.404,P=0.006),当HBV DNA基线水平>1×105 IU/ml时,累积再激活率可达14.36%。结论 社区HBsAg携带者中存在一定比例的自发性再激活,其中男性、中年人群和基线HBV DNA水平较高者易发生再激活,应进一步加强HBV携带者的管控工作,对其定期进行随访监测,合理选择抗病毒治疗时机。Abstract: Objective To analyze the epidemiological characteristics of the spontaneous reactivation of hepatitis B surface antigen (HBsAg) carriers in the community, and to provide a scientific management for the chronic hepatitis B virus (HBV) carriers. Methods A serum epidemiological cross-sectional study was conducted in September 2010, and the HBsAg carriers cohort was established. Then the cohort was followed in 2012 and 2014 to clarify the HBV reactivation rate and epidemiological characteristics. Results After the follow-up, there were 72 carriers developed to HBV reactivation of 852 HBsAg carriers. The spontaneous reactivation incidence was 2 746.8 per one hundred thousand person-years. Different reactivation rate were observed in different gender (χ2=3.901,P=0.048). The male accumulated reactivation rate was 10.39%, which was higher than that of the female (6.62%). Meanwhile, significant differences were also found in different age groups (χ2=6.524,P=0.038). The reactivation rate of 46-59 age group was 11.95%. Besides, when the deoxyribonucleic acid of hepatitis B virus (HBV DNA) level was high, the reactivation incidence was rising (χ2=10.404,P=0.006). Especially in the HBV DNA level >1×105 IU/ml group, the reactivation rate could reach 14.36%. Conclusions The HBsAg carriers may develop to HBV reactivation among community. Male, middle-age period and high baseline HBV DNA load are important risk factors for hepatitis B virus (HBV) reactivation. Therefore, we should enhance the management of HBV carriers, conduct regular follow-up to monitor the condition change, and choose the reasonable time to initiate treatment.
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Key words:
- Hospital, community /
- Hepatitis B surface antigen /
- Epidemiologic studies
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