高级检索

2010至2015年南通地区人群戊型肝炎病毒感染的血清流行病学调查

Seroepidemiological survey of hepatitis E virus infection in Nantong City during 2010-2015

  • 摘要: 目的:探讨2010至2015年南通市人群戊肝病毒(hepatitis E virus, HEV)的感染状况及流行特点,为戊型病毒性肝炎(简称戊肝)防治提供依据。方法:选择南通大学附属医院2010年1月1日至2015年12月31日收诊并作HEV血清学检测的病例6 772例。采用酶联免疫吸附试验(ELISA)诊断试剂盒检测血清抗HEV抗体(IgM、IgG)。对不同年度、年龄、性别人群的HEV感染率进行统计分析,并对戊肝发病率进行分析。结果:6年间,6 772例受测试者抗HEV抗体(IgM/IgG)总阳性率为3.35%(227例);2010至2015年各年度人群血清HEV抗体阳性率分别为6.92%、1.74%、3.53%、0.90%、3.50%、2.13%。20岁以下、20~29岁、30~39岁、40~49岁和50~59岁年龄段人群血清HEV抗体阳性率随年龄增加而升高(P=0.001);59岁以后各年龄段人群血清HEV抗体阳性率逐步下降。男性抗HEV抗体阳性率明显高于女性(P=0.001)。227例血清抗HEV抗体阳性者中,显性感染率为72.25%;其中,急性黄疸型肝炎发病率显著高于急性无黄疸型肝炎发病率(P=0.001)。HEV感染者中,HBV-HEV重叠感染率为21.15%,HCV-HEV重叠感染率为0.88%;HAV-HEV重叠感染率为0.44%。HBV-HEV重叠感染的戊肝组患者血清丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、总胆红素水平与单纯戊肝组患者差异无统计学意义,凝血酶原活动度、血清白蛋白水平均低于单纯戊肝组(P<0.01)。结论:2010年南通市人群HEV感染率为6.92%,此后5年HEV感染率维持在较低水平(0.90%~3.53%)。男性较女性更易感染HEV;40~59岁人群具有相对较高的HEV感染风险,应引起高度重视。HEV感染后,多数表现为急性黄疸型肝炎;慢性HBV感染重叠HEV感染可致肝损伤加重。

     

    Abstract: Objective:To investigate the infection status of hepatitis E virus (HEV) in the population of Nantong city during 2010-2015 and explore its epidemic features, thereby to provide data for the prophylaxis and treatment of hepatitis E. Methods:A total of 6 772 patients from the Affiliated Hospital of Nantong University during 2010-2015 who were all received serological detection of HEV were enrolled. Serum anti-HEV antibodies (IgM and IgG) were detected with ELISA. The infection rates of HEV were analyzed according to different years, ages, and genders, respectively, and the incidence of hepatitis E was evaluated. Results:During the recent six years, the total positive rate of anti-HEV antibody including IgM or/and IgG in 6772 subjects was 3.35%. The annual positive rates of anti-HEV during 2010 to 2015 were 6.92%, 1.74%, 3.53%, 0.90%, 3.50%, and 2.13%, respectively. The positive rates of anti-HEV in five groups of < 20, 20-29, 30-39, 40-49, and 59-59 years old increased with age (P=0.001). The positive rates of anti-HEV in patients whose age over 50 years declined gradually. The positive rate of anti-HEV in male patients was significantly higher than that in female patients (P=0.001). The apparent infection rate in the 227 patients with positive anti-HEV antibody was 72.25%, among whom the incidence of acute icteric hepatitis was significantly higher than that of acute anicteric hepatitis (P=0.001). In patients infected with HEV, the overlapping infection rate of HBV-HEV, HCV-HCV, and HAV-HEV were 21.15% and 0.88%, 0.44%, respectively. There were no statistical differences in the serum levels of ALT, AST, and TBIL between the patients with overlapping infection of HBV-HEV and those with only hepatitis E. However, the level of prothrombin activity (PTA) and serum albumin (ALB) in the overlapping infection group were lower than that in the simple hepatitis E group (P<0.01). Conclusions:In the population of Nantong city, the infection rate of HEV in 2010 was 6.92%, which remained at a low level during the following 5 years (0.90%-3.53%). The infection rate of HEV in males was higher than that in females. There was a relative high risk for HEV infection in 40-59 years old people. After the HEV infection, the manifestation of most patients was acute icteric hepatitis. For chronic hepatitis B patients overlapped with HEV infection, the liver injury might be aggravated.

     

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