广州地区无偿献血者戊型肝炎病毒感染流行病学调查
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摘要
目的调查广州地区无偿献血者的戊型肝炎病毒(hepatitis E virus, HEV)感染情况。方法 2017年4月-2018年4月间收集了5 552名广州血液中心无偿献血者的血液样本,采用酶联免疫吸附法(enzyme linked immunosorbent assay, ELISA)检测抗-HEV IgG抗体(HEV IgG)、抗-HEV IgM抗体(HEV IgM)和HEV抗原(HEV Ag),采用χ~2检验分析年龄、性别、民族、职业和ALT等因素分别与HEV IgG和IgM抗体阳性的相关性,采用多因素Logistic回归分析判辨HEV感染的独立风险因素。结果 HEV IgG、IgM和HEV Ag的阳性率分别为20.05%(1 113/5 552)、0.76%(42/5 552)和0.04%(2/5 552)。年龄和民族是HEV IgG和HEV IgM阳性率的独立风险因素:HEV阳性率随着年龄增长而增大(IgG OR=1.089, 95%CI:1.080-1.098,P<0.001; IgM OR=1.055,95%CI:1.028-1.084,P<0.001);壮族的HEV IgG和IgM阳性率(32.69%, 7.69%)高于汉族(19.89%, 0.70%),差异有统计学意义(IgG OR=2.052, 95%CI:1.103-3.819,P=0.023; IgM OR=12.029, 95%CI:4.067-35.580,P<0.001)。此外,我们还发现职业是HEV IgG阳性率的独立风险因素,学生是阳性率最低的人群。结论广州地区无偿献血者中HEV抗体阳性率较高,且在不同人群中感染情况不同,为输血传播HEV的风险评估提供基础数据。
To investigate the prevalence of hepatitis E virus(HEV) infection among voluntary blood donors in Guangzhou. Blood samples from 5 552 blood donors were collected from April 2017 to April 2018 at the Guangzhou Blood Center and were tested for anti-HEV IgG antibody(HEV IgG), anti-HEV IgM antibody(HEV IgM) and HEV antigen(HEV Ag) by enzyme linked immunosorbent assay(ELISA). The association of age, gender, ethnicity, occupation and ALT with HEV IgG and IgM were analyzed by Chi-square test. Multivariate logistic regression analysis was applied to identify the independent risk factors of HEV infection. The positive rates of HEV IgG, IgM and HEV Ag were 20.05%(1 113/5 552), 0.76%(42/5 552) and 0.04%(2/5 552), respectively. Age and ethnicity were independent risk factors for HEV IgG and HEV IgM. The rate of HEV antibody increased significantly with age(IgG OR=1.089, 95%CI: 1.080-1.098, P<0.001; IgM OR=1.055, 95%CI: 1.028-1.084, P<0.001). Donors who were Zhuang minority(32.69%, 7.69%) showed higher anti-HEV than those who were Han ethnicity(19.89%, 0.70%), and the difference was statistically significant(IgG OR=2.052, 95%CI: 1.103-3.819, P=0.023; IgM OR=12.029, 95%CI: 4.067-35.580, P<0.001). In addition, we found that occupation was an independent risk factor for HEV infection, while students showed the lowest anti-HEV rate. The results indicate that the positive rate of HEV antibody among blood donors in Guangzhou is high, and the infection status differs in different populations. Our study provides basic data for the estimation of risk of transfusion-transmitted HEV.
To investigate the prevalence of hepatitis E virus(HEV) infection among voluntary blood donors in Guangzhou. Blood samples from 5 552 blood donors were collected from April 2017 to April 2018 at the Guangzhou Blood Center and were tested for anti-HEV IgG antibody(HEV IgG), anti-HEV IgM antibody(HEV IgM) and HEV antigen(HEV Ag) by enzyme linked immunosorbent assay(ELISA). The association of age, gender, ethnicity, occupation and ALT with HEV IgG and IgM were analyzed by Chi-square test. Multivariate logistic regression analysis was applied to identify the independent risk factors of HEV infection. The positive rates of HEV IgG, IgM and HEV Ag were 20.05%(1 113/5 552), 0.76%(42/5 552) and 0.04%(2/5 552), respectively. Age and ethnicity were independent risk factors for HEV IgG and HEV IgM. The rate of HEV antibody increased significantly with age(IgG OR=1.089, 95%CI: 1.080-1.098, P<0.001; IgM OR=1.055, 95%CI: 1.028-1.084, P<0.001). Donors who were Zhuang minority(32.69%, 7.69%) showed higher anti-HEV than those who were Han ethnicity(19.89%, 0.70%), and the difference was statistically significant(IgG OR=2.052, 95%CI: 1.103-3.819, P=0.023; IgM OR=12.029, 95%CI: 4.067-35.580, P<0.001). In addition, we found that occupation was an independent risk factor for HEV infection, while students showed the lowest anti-HEV rate. The results indicate that the positive rate of HEV antibody among blood donors in Guangzhou is high, and the infection status differs in different populations. Our study provides basic data for the estimation of risk of transfusion-transmitted HEV.
引文
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[20] 何友雄,杨进业,李均伦,等.广西凌云县戊型肝炎病毒感染的血清流行病学调查[J].广西预防医学,1996,2(2):95-97.
[21] Wang M,He M,Wu B,et al.The association of elevated alanine aminotransferase levels with hepatitis E virus infections among blood donors in China[J].Transfusion,2017,57(2):273-279.DOI:10.1111/trf.13991
[2] Wang CH,Flehmig B,Moeckli R.Transmission of hepatitis E virus by transfusion?[J].Lancet,1993,341(8848):825-826.DOI:10.1016/0140-6736(93)90598-b
[3] 孔德广,汤伟峰,胡权.武汉市普通人群戊型肝炎血清学及影响因素分析[J].中华疾病控制杂志,2017,21(3):274-277.DOI:10.16462/j.cnki.zhjbkz.2017.03.014
[4] 王金霞,李雯,张云智.戊型肝炎病原学及流行病学研究进展[J].中国热带医学,2018,18(3):277-281.DOI:10.13604/j.cnki.46-1064/r.2018.03.20
[5] 刘丽,李英兰,焦淑贤.戊型肝炎病毒与血液安全研究进展[J].疑难病杂志,2017,16(9):963-967.DOI:10.3969/j.issn.1671-6450.2017.09.027
[6] Petrik J,Lozano M,Seed CR,et al.Hepatitis E[J].Vox Sang,2016,110(1):93-103.DOI:10.1111/vox.12285
[7] Kaufmann A,Kenfak-Foguena A,André C,et al.Hepatitis E virus seroprevalence among blood donors in southwest Switzerland[J].PLoS One,2011,6(6):e21150.DOI:10.1371/journal.pone.0021150
[8] Slot E,Hogema BM,Riezebos-Brilman A,et al.Silent hepatitis E virus infection in Dutch blood donors,2011 to 2012[J].Euro Surveill,2013,18(31):23-29.DOI:10.2807/1560-7917.ES2013.18.31.20550
[9] Hewitt PE,Ijaz S,Brailsford SR,et al.Hepatitis E virus in blood components:a prevalence and transmission study in southeast England[J].Lancet,2014,384(9956):1766-1773.DOI:10.1016/S0140-6736(14)61034-5
[10] Ren F,Zhao C,Wang L,et al.Hepatitis E virus seroprevalence and molecular study among blood donors in China[J].Transfusion,2014,54(3pt2):910-917.DOI:10.1111/trf.12530
[11] Guo QS,Yan Q,Xiong JH,et al.Prevalence of hepatitis E virus in Chinese blood donors[J].J Clin Microbiol,2010,48(1):317-318.DOI:10.1128/JCM.01466-09
[12] 李美霖,麻静敏,李天君,等.北京部分地区无偿献血者戊型肝炎病毒感染情况研究[J].中国病毒病杂志,2016,6(5):360-362.DOI:10.16505/j.2095-0136.2016.05.008
[13] 朱绍汶,朱胜江,蔡炳刚,等.江苏地区合格无偿献血人群戊型肝炎病毒感染情况调查[J].中国输血杂志,2016,29(11):1246-1249.DOI:10.13303/j.cjbt.issn.1004-549x.2016.11.011
[14] 聂冬梅,郑欣,许晓绚,等.深圳地区献血者戊型肝炎病毒感染流行病学调查[J].热带医学杂志,2014,14(10):1336-1338
[15] Ma L,Sun P,Lin F,et al.Prevalence of hepatitis E virus in Chinese blood donors[J].J Int Med Res,2015,43(2):257-262.DOI:10.1177/0300060514562054
[16] Fischer C,Hofmann M,Danzer M,et al.Seroprevalence and incidence of hepatitis E in blood donors in Upper Austria[J].PLoS One,2015,10(3):e119576.DOI:10.1371/journal.pone.0119576
[17] Nasrallah GK,Al Absi ES,Ghandour R,et al.Seroprevalence of hepatitis E virus among blood donors in Qatar (2013-2016)[J].Transfusion,2017,57(7):1801-1807.DOI:10.1111/trf.14116
[18] 黄国永,王海虹,陈筱华,等.温州3044例献血者戊型肝炎病毒血症及基因分型的研究[J].北京医学,2009,31(6):366-368.DOI:10.15932/j.0253-9713.2009.06.012
[19] 王树声,李荣成,杨进业,等.广西地区戊型肝炎病毒感染的血清流行病学调查[J].广西预防医学,1997,3(1):1-14.
[20] 何友雄,杨进业,李均伦,等.广西凌云县戊型肝炎病毒感染的血清流行病学调查[J].广西预防医学,1996,2(2):95-97.
[21] Wang M,He M,Wu B,et al.The association of elevated alanine aminotransferase levels with hepatitis E virus infections among blood donors in China[J].Transfusion,2017,57(2):273-279.DOI:10.1111/trf.13991