文章摘要
赵雪,吕静静,颜丙玉,冯艺,窦璇,刘甲野,徐爱强,张丽.农村社区非活动性HBsAg携带者HBV再激活发生率及特征分析[J].中华流行病学杂志,2021,42(9):1553-1558
农村社区非活动性HBsAg携带者HBV再激活发生率及特征分析
Rates and characteristics for hepatitis B reactivation of inactive hepatitis B carriers in rural communities
收稿日期:2021-03-19  出版日期:2021-09-27
DOI:10.3760/cma.j.cn112338-20210319-00220
中文关键词: 慢性乙型肝炎;乙型肝炎表面抗原;非活动性乙型肝炎表面抗原携带者;乙型肝炎病毒再激活
英文关键词: Chronic hepatitis B;HBsAg;Inactive HBsAg carriers;Hepatitis B virus reactivation
基金项目:国家科技重大专项(2018ZX10721202);国家自然科学基金(81803299);山东省自然科学基金(ZR2019PH046);山东省医药卫生科技发展计划(2015WS0285)
作者单位E-mail
赵雪 山东大学齐鲁医学院公共卫生学院, 济南 250012  
吕静静 山东省疾病预防控制中心免疫预防管理所, 济南 250014  
颜丙玉 山东省疾病预防控制中心免疫预防管理所, 济南 250014  
冯艺 山东省疾病预防控制中心免疫预防管理所, 济南 250014  
窦璇 山东大学齐鲁医学院公共卫生学院, 济南 250012  
刘甲野 深圳市第三人民医院 518112  
徐爱强 山东大学齐鲁医学院公共卫生学院, 济南 250012 aqxuepi@163.com 
张丽 山东省疾病预防控制中心免疫预防管理所, 济南 250014 zl9127@163.com 
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中文摘要:
      目的 了解农村社区非活动性HBsAg携带者(IHC)中HBV再激活的发生强度和特征。方法 分别于2018、2020年对济南市章丘区农村社区人群体检中发现的IHC进行随访调查,比较2次随访结果,分析基于社区人群的IHC的HBV再激活发生率和分布特征。结果 424名IHC完成了2次随访,发现HBV再激活者47例,累积再激活发生率为11.08%,发病密度为5.46/100人年;多因素分析显示,性别、年龄、吸烟、饮酒及肝病家族史和慢性病史与HBV再激活不相关(P>0.05),基线HBV DNA载量与再激活相关(P<0.05),当HBV DNA基线水平≥ 1 000 IU/ml时,累积再激活发生率可达18.92%。发生再激活后,ALT平均水平较基线升高且异常率增加,再激活者肝功能趋于异常。4例(8.51%)再激活者发生肝炎,其中1例(2.13%)为黄疸型肝炎。结论 济南市农村社区IHC中HBV再激活发生率较高;大部分再激活者处于无症状或轻度再激活状态;应加强对IHC的随访并密切监测其ALT和HBV DNA水平变化,并适时采取正规的治疗措施。
英文摘要:
      Objective To analyze the intensity and epidemiological characteristics of hepatitis B virus (HBV) reactivation among inactive HBsAg carriers (IHC) of rural areas in Ji'nan. Methods In 2018 and 2020, follow-up investigations were conducted on IHC identified in the population physical examination in Zhangqiu district of Ji'nan. The results of the two follow-up visits were compared to analyze the incidence and distribution characteristics of HBV reactivation in IHC at the community level. Results A total of 424 IHC completed two follow-up visits, and 47 cases of HBV reactivation were found, the cumulative reactivation rate was 11.08%, and the incidence density was 5.46/100 person-years. Multivariate analysis showed that gender, age, smoking, drinking, family history of liver disease and chronic diseases were not associated with HBV reactivation (P>0.05), and baseline HBV DNA load was associated with reactivation (P<0.05), in the HBV DNA level ≥ 1 000 IU/ml group, the reactivation rate could reach 18.92%. After reactivation, the mean level of ALT increased from baseline and the abnormal rate increased, liver function tended to be abnormal in reactivated patients. 4 (8.51%) reactivators had hepatitis, and 1 (2.13%) had jaundice hepatitis.Conclusions The incidence of HBV reactivation was higher among IHC in rural communities in Ji'nan. Most of the reactivators were asymptomatic or mildly reactivated. Follow-up of inactive HBsAg patients should be strengthened and changes in ALT and HBV DNA levels should be closely monitored.
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