Risk factors of chronic hepatitis B and liver cirrhosis: a cross-sectional study based on Qidong hepatitis B intervention study
-
摘要: 目的 探索启东乙型肝炎疫苗(以下简称乙肝疫苗)干预研究人群患慢性乙型肝炎(以下简称慢乙肝)、肝硬化的危险因素。方法 采用分层随机抽样方法,于2013年1月~10月,在启东乙肝疫苗干预研究随访人群中抽取研究对象进行面对面问卷调查,调查内容包括人口社会学资料、个人及家族成员慢乙肝、肝硬化及肝癌史等;同时进行谷丙转氨酶(alanine aminotransferase, ALT)、乙型肝炎病毒(hepatitis B virus, HBV)感染血清学标志物检测及肝脏彩色超声检查。使用多因素Logistic回归分析乙肝疫苗干预研究随访人群罹患慢乙肝、肝硬化的危险因素。结果 疫苗组慢性乙型肝炎及肝硬化患病率均低于对照组;慢性乙型肝炎患者中男性、有肝癌家族史、新生儿期未接种乙肝疫苗和出生于1986年以前四个因素,调整后的OR(95% CI)值分别为:3.60(2.04~6.34)、2.47(1.25~4.88)、2.68(1.57~4.56)和1.72(1.02~2.89)。肝硬化患者中男性因素,调整后的OR(95% CI)值为6.89(2.02~23.43)。结论 启东新生儿接种乙肝疫苗能降低青年期罹患慢乙肝、肝硬化的风险,男性、肝癌家族史及出生于1986以前为慢性乙型肝炎的危险因素,男性亦为肝硬化的危险因素。Abstract: Objective To explore the risk factors of chronic hepatitis B and liver cirrhosis in the participants from Qidong Hepatitis B intervention Study. Methods From January to October, 2013, by using a cross-sectional study design, all the participants from Qidong Hepatitis B intervention Study were sampled by a stratified random method. Questionnaire survey was conducted to gain their sociodemographic information and family history of liver cancer. Blood tests for Alanine aminotransferase (ALT), hepatitis B virus surface antigen (HBsAg), anti-HBs, anti-HBc, hepatitis B virus e antigen (HBeAg), anti-HBe, and ultrasonic examination of liver were implemented in every sampled subject. Multivariate Logistic regression analyses were conducted to explore the risk factors of chronic hepatitis B and liver cirrhosis. Results The prevalence rate of chronic hepatitis B and liver cirrhosis of vaccination group was significantly lower than that of control group. Multivariate Logistic regression showed that male, liver cancer family history, no neonatal vaccination and born before 1986 in patients with chronic hepatitis B, the adjusted OR (95% CI) were 3.60(2.04-6.34), 2.47(1.25-4.88), 2.68(1.57-4.56), 1.72(1.02-2.89), respectively. Male factors in patients with liver cirrhosis, the adjusted OR (95% CI) was 6.89(2.02-23.43). Conclusions Neonatal hepatitis B vaccination could protect inoculated population from chronic liver diseases. Male, liver cancer family history, no neonatal vaccination, born before 1986 were risk factors of chronic hepatitis B and male was also a risk factor of liver cirrhosis.
-
Key words:
- Hepatitis B virus /
- Risk factors /
- Vaccines /
- Cross-sectional studies
-
Qu C, Chen T, Fan C, et al. Efficacy of neonatal HBV vaccination on liver cancer and other liver disease over 30-year follow-up of the Qidong hepatitis B intervention study: a cluster randomized controlled trial [J]. PLoS Med, 2014,11(12):e1001774. Sun Z, Ming L, Zhu X, et al. Prevention and control of hepatitis B in China [J]. J Med Virol, 2002,67(3):447-450. Sun Z, Zhu Y, Stjernsward J, et al. Design and compliance of HBV vaccination trial on newborns to prevent hepatocellular carcinoma and 5-year results of its pilot study [J]. Cancer Detect Prev, 1991,15(4):313-318. Sun TT, Chu YR, Ni ZQ, et al. A pilot study on universal immunization of newborn infants in an area of hepatitis B virus and primary hepatocellular carcinoma prevalence with a low dose of hepatitis B vaccine [J]. J Cell Physiol Suppl, 1986,4:83-90. 单爱兰,赵莹,何海艳,等. 天津市<20岁人群乙型病毒性肝炎控制效果分析 [J]. 中国疫苗和免疫, 2011,17(6):487-489,534. 党如波,张顺祥,张卫东,等. 中国新生儿乙肝疫苗免疫效果评估 [J]. 中国公共卫生, 2009,25(4):385-387. Peto TJ, Mendy ME, Lowe Y, et al. Efficacy and effectiveness of infant vaccination against chronic hepatitis B in the Gambia Hepatitis Intervention Study (1986-90) and in the nationwide immunization program [J]. BMC Infect Dis, 2014,14(1):7. Wen WH, Chang MH, Zhao LL, et al. Mother-to-infant transmission of hepatitis B virus infection: significance of maternal viral load and strategies for intervention [J]. J Hepatol, 2013,59(1):24-30. 黎健,刘景壹,胡家瑜,等. 上海市乙型肝炎感染者家庭成员感染状况及影响因素分析 [J]. 中华流行病学杂志, 2013,34(3):205-209. Lai CL, Ratziu V, Yuen MF, et a1.Viral hepatitis B [J]. Lancet, 2003,362(9401):2089-2094. 姚红玉,陈陶阳,曲春枫,等. 我国新生儿乙肝疫苗免疫后效应概述及相关问题 [J]. 科学通报, 2012,57(20):1911-1917. 陈陶阳,曲春枫,姚红玉. 启东新生儿乙肝疫苗接种后长期免疫效果 [J]. 江苏医药, 2012,38(14):1701-1703. 俞顺章,郑莹,吴春晓,等. 上海市肝细胞癌防治40年 [J]. 中华流行病学杂志, 2013,34(6):637-641. Chien YC, Jan CF, Chiang CJ, et al. Incomplete hepatitis B immunization, maternal carrier status, and increased risk of liver diseases: a 20-year cohort study of 3.8 million vaccinees [J]. Hepatology, 2014,60(1):125-132. 阿达力别克,巴哈提古丽. 新生儿乙肝疫苗接种后无(弱)应答的影响因素研究 [J]. 新疆医科大学学报,2015,38(3):370-372. Wood RC, MacDonald KL, Whire KE, et al. Risk factors for lack of detectable antibody following hepatitis B vaccination of minnesota health care workers [J]. JAMA, 1993,270(24):2935-2939. 熊艺玫,周瑞玲,蔡军. 北京某高校新生儿乙型肝炎疫苗接种效果及影响因素分析 [J]. 中华保健医学杂志, 2011,13(5):415-416. 丁峥嵘,康文玉,陆林,等. 云南省乙型肝炎母婴阻断实施效果评价 [J]. 中华流行病学杂志, 2014,35(2):114-116. Wen WH, Chang HL, Ni YH, et al. Secular trend of the viral genotype distribution in children with chronic hepatitis B virus infection after universal infant immunization [J]. Hepatology, 2011,53(2):429-436. 赵东设,董雷,谢海斌,等. 乙肝疫苗免疫失败因素研究 [J]. 中国预防医学杂志, 2009,10(12):1085-1087. 王洋,苏海霞,王安辉,等. 乙型肝炎防治示范区社区儿童HBV感染情况的调查 [J]. 中华疾病控制杂志, 2016,20(1):13-16.
点击查看大图
计量
- 文章访问数: 455
- HTML全文浏览量: 101
- PDF下载量: 47
- 被引次数: 0