中国无偿献血人群HEV抗体阳性率性别和年龄分层Meta分析

Hepatitis E virus seroprevalence in Chinese voluntary blood donors:a Meta-analysis by gender and age

目的运用Meta分析探讨中国无偿献血人群中戊型肝炎病毒(hepatitis E virus,HEV)抗体阳性率的性别和年龄特征,评估无偿献血人群HEV感染情况,为献血者招募及HEV血液筛查提供依据。方法使用关键词或主题词组合检索中国知网、万方医学、PubMed等数据库,提取符合纳入标准的文献数据,以性别和年龄为分层因素,运用R 4.1.3软件进行HEV抗体阳性率的Meta分析。结果1)获得符合纳入标准的性别相关文献15篇。其中涉及抗-HEV IgG的14篇,献血者男性38203名、女性25760名;涉及抗-HEV IgM的13篇,献血者男性46125名、女性33345名。男、女2组无偿献血者抗-HEV IgG阳性率合并值分别为24.54%[95%CI(17.32%,32.56%)]、19.52%[95%CI(11.71%,28.76%)](P>0.05);男、女2组无偿献血者抗-HEV IgM合并阳性率分别为1.16%[95%CI(0.93%,1.40%)]、0.84%[95%CI(0.54%,1.20%)](P>0.05)。2)获得符合纳入标准的年龄相关文献12篇。其中涉及抗-HEV IgG的11篇,献血者<30岁31097名、≥30岁19122名;涉及抗-HEV IgM的11篇,献血者<30岁44909名、≥30岁21303名。<30岁组与≥30岁组无偿献血者抗-HEV IgG阳性率合并值分别为13.56%[95%CI(7.03%,21.81%)]、29.47%[95%CI(19.04%,41.11%)](P<0.05);<30岁组与≥30岁组无偿献血者抗-HEV IgM阳性率合并值分别为0.85%[95%CI(0.65%,1.08%)]、1.22%[95%CI(0.94%,1.54%)](P>0.05)。结论无偿献血者人群中存在一定比例的HEV携带者,不同地区无偿献血人群中HEV流行率具有不同的性别及年龄分布特征;不同性别的无偿献血人群中HEV流行率无差异;≥30岁无偿献血者HEV既往感染率高于<30岁无偿献血者,但现症感染率无差异;有必要多中心联合进行统一年龄分组标准进行HEV流行率的后续研究,为建立科学的献血者招募及血液筛查策略提供数据支撑。

Objective To explore the gender and age characteristics of Hepatitis E virus seroprevalence in Chinese voluntary blood donors by Meta-analysis,so as to evaluate the prevalence of HEV and provide reference for blood donor recruitment and HEV screening.Methods Databases such as CNKI,Wanfang Medicine and PubMed were searched by keywords or subject words,and the eligible literature were extracted for Meta-analysis of Hepatitis E virus seroprevalence by gender and age using R4.1.3 software.Results 1)A total of 15 gender related literature were obtained,of which 14 involved anti-HEV IgG,containing 38203 males and 25760 females,with pooled estimated positive rate of anti-HEV IgG as 24.54%[95%CI(17.32%,32.56%)]and 19.52%[95%CI(11.71%,28.76%)],respectively(P>0.05);13 involved anti-HEV IgM,containing 46125 males and 33345 females,with pooled estimated positive rate of anti-HEV IgM as 1.16%[95%CI(0.93%,1.40%)]and 0.84%[95%CI(0.54%,1.20%),respectively(P>0.05);2)A total of 12 age related literature were obtained,of which 11 involved anti-HEV IgG:<30 years old subgroup(n=31097)and≥30 years old(n=19122),with pooled estimated positive rate of anti-HEV IgG as 13.56%[95%CI(7.03%,21.81%)]and 29.47%[95%CI(19.04%,41.11%)]respectively(P>0.05);and 11 involved anti-HEV IgM:<30 years old subgroup(n=44909)and≥30 years old subgroup(n=21303),with pooled estimated positive rate of anti-HEV IgM as 0.85%[95%CI(0.65%,1.08%)]and 1.22%[95%CI(0.94%,1.54%)]respectively(P>0.05).Conclusion There was a certain amount of HEV carriers among Chinese voluntary blood donors and the prevalence of HEV in different regions showed different distribution characteristics by gender and age.No difference was found in the prevalence of HEV among voluntary blood donors by gender.The past infection rates of HEV among voluntary blood donors≥30 years old was higher than those <30 years old,but no difference was noticed in the current infection rates.It is necessary to carry out a multi-center follow-up study on the prevalence of HEV by age to provide references for the establishment of scientific blood donor recruitment strategy and blood screening strategy.