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首页> 外文期刊>The Internet Journal of Tropical Medicine >Seroprevalence of Hepatitis B Surface Antigen and Liver Function Tests among Adolescents in Abakaliki, South Eastern Nigeria
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Seroprevalence of Hepatitis B Surface Antigen and Liver Function Tests among Adolescents in Abakaliki, South Eastern Nigeria

机译：尼日利亚东南部阿巴卡利基市青少年乙型肝炎表面抗原和肝功能检测的血清阳性率

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Of the 785 apparently healthy adolescents, 386 (49.2%) males and 399 (50.8%) females (mean age, 15.6 ± 2.3 years) screened for hepatitis B surface antigen (HBsAg) using a third generation enzyme linked immunosorbent assay method, 32 (4.1%) were seropositive. Although, males and females did not differ significantly in HBsAg seropositivity (17 vs. 15; 95%CI: -0.025-0.065) more infections were found in patients from lower- than middle-/or and upper- socioeconomic classes (p < 0.05). The major routes of HBV transmission in this population were unsafe injection (28.1%; 95%CI; 0.03-0.15), tribal marks/circumcision/scarification (12.5%; 95%CI; 0.00-0.08) and blood/blood products transfusions (6.3%; 95%CI; -0.04-0.28) while 53.1% (95%CI; 0.02-0.04) of HBV infections have no identifiable mode of transmission. While HBsAg seropositive patients showed significantly higher levels of liver enzymes and lower conjugated bilirubin than their seronegative counterparts, total protein, albumin and total bilirubin were comparable among the groups. Asymptomatic HBV infection among adolescents without proper identifiable risk factors or mode of acquisition calls for general surveillance, mass immunisation, and public health education to curtail the spread of the virus and its sequalae. Intoduction Hepatitis B virus (HBV) has been recognised as one of the public health challenges worldwide with approximately 2 billion people infected [1] , an estimated 1-2 million annual deaths due to infection and about 400 million persons being chronic carriers of the bacterium globally [2,3]. The prevalence of HBV varies between 2% in developed countries where the prevalence is low to about 8% in developing countries where infection is endemic with sex, age and socio-economic status as important risk factors for infection [4-6]. Apart from aflatoxin contamination of foods, hepatotoxic medicinal herbs, and hepatitis C virus infection, HBV infection accounts for the high incidence of hepatocellular tumours in sub-Saharan Africa [7]. In Africa, hepatitis B virus infection is the most common cause of liver disease which is the third most common cause of death in medical wards with 15-60% seropositivity for HBsAg in normal population [8]. Nigeria is a holoendemic area for HBV with carrier rate of 15-37% [8] and an estimated 12% of the total population being chronic carriers of HBsAg [9]. According to a recent study [10] HBV prevalence of 67% was found among hepatocellular carcinoma patients in north eastern Nigeria. Hepatitis B virus is transmitted parenterally and most common by transfusion of HBV infected blood or blood products, intravenous drug abuse, from mother to child, needle stick injury, ear piercing, tattooing and other tribal ceremonies (scarification), barbers razors e.t.c.[11-13]. Infection may also spread by formites, sharing of tooth brush, abrasion, and sexual contact (hetero- or homosexual) with infected persons. Comprehensive strategies for the elimination of HBV transmission include (1). Universal vaccination of infants beginning at birth, (2). Prevention of perinatal HBV infection through routine screening of all pregnant women for HBV infection and by providing immunoprophylaxis to infants born to infected women or to women of unknown infection status, (3). Routine vaccination of previously unvaccinated children and adolescents, and (4). Vaccination of adults at increased risk for infection, including health-care workers, dialysis patients, household contacts and sex partners of persons with chronic HBV infection, recipients of certain blood products, persons with recent history of multiple sex partners or a sexually transmitted disease, and injection-drug users [14]. In Nigeria, the availability of most of these strategies is limited. Early childhood acquisition of HBV which remains typically asymptomatic with subsequent progression to chronic infection underscores the importance for early detection through screening. This study therefore aims t
机译：使用第三代酶联免疫吸附试验方法筛查的乙型肝炎表面抗原（HBsAg）在785名显然健康的青少年中，男性386名（49.2％）和399名（50.8％）女性（平均年龄，15.6±2.3岁）进行了筛查。 4.1％）呈血清阳性。尽管男性和女性的HBsAg血清阳性率没有显着差异（17比15; 95％CI：-0.025-0.065），但来自中低社会经济地位和中高社会经济地位的患者感染率更高（p <0.05 ）。该人群中HBV传播的主要途径是不安全注射（28.1％; 95％CI; 0.03-0.15），部族斑痕/包皮环切/疤痕形成（12.5％; 95％CI; 0.00-0.08）和血液/血液制品输血（ 6.3％; 95％CI; -0.04-0.28），而53.1％（95％CI; 0.02-0.04）的HBV感染没有可识别的传播方式。尽管HBsAg血清反应阳性患者的血清肝酶水平明显高于血清阴性患者，但共轭胆红素水平较低，但两组患者的总蛋白，白蛋白和总胆红素相当。没有适当可识别的危险因素或获得方式的青少年无症状HBV感染，要求进行全面监测，大规模免疫和公共卫生教育，以减少病毒及其两性传播。乙型肝炎病毒（HBV）已被公认为是全球范围内的公共卫生挑战之一，约有20亿人被感染[1]，估计每年因感染而死亡1-2百万，约有4亿人是该细菌的慢性携带者全球[2,3]。在感染率很低的发展中国家，其流行率很低，在发达国家中，HBV的流行率在2％之间，而在发展中国家，其流行率低至大约8％[4-6]。除了食物中的黄曲霉毒素污染，肝毒性药和丙型肝炎病毒感染外，HBV感染还导致撒哈拉以南非洲地区肝细胞肿瘤的高发[7]。在非洲，乙型肝炎病毒感染是最常见的肝病病因，是医疗病房中第三大最常见的死亡原因，正常人群中HBsAg的血清阳性率为15-60％[8]。尼日利亚是HBV的全流行地区，携带者率为15-37％[8]，估计总人口的12％为HBsAg的慢性携带者[9]。根据最近的一项研究[10]，在尼日利亚东北部的肝细胞癌患者中发现HBV患病率为67％。乙型肝炎病毒是通过肠胃外传播的，最常见的是通过输注HBV感染的血液或血液制品，静脉内吸毒，从母婴传播，针刺受伤，刺耳，纹身和其他部落仪式（疤痕形成），剃须刀等[11- 13]。感染也可能通过以下形式传播：禽类，与他人共用牙刷，擦伤和与感染者发生性接触（异性恋或同性恋）。消除HBV传播的综合策略包括（1）。从出生开始就对婴儿进行通用疫苗接种（2）。通过常规筛查所有孕妇的HBV感染并为感染妇女或感染状况不明的妇女所生的婴儿提供免疫预防，以预防围产期HBV感染（3）。以前未接种疫苗的儿童和青少年的常规疫苗接种，以及（4）。为感染风险较高的成年人接种疫苗，包括医护人员，透析患者，慢性乙肝病毒感染者的家庭接触者和性伴侣，某些血液制品的接受者，近期有多个性伴侣或性传播疾病史的人，和注射毒品使用者[14]。在尼日利亚，大多数这些策略的可用性有限。儿童期早期获得的HBV通常无症状，随后逐渐发展为慢性感染，这强调了通过筛查早期发现的重要性。因此，本研究旨在

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