2020—2023年海南省献血人群乙型肝炎病毒感染流行病学特征分析

Epidemiological characteristics of hepatitis B virus infection among blood donors in Hainan Province from 2020 to 2023

【目的】分析海南省献血人群乙型肝炎病毒(HBV)感染流行病学特征。【方法】抽样选取海南省2020年1月—2023年1月6851份无偿献血者标本进行HBV筛检,按献血次数、方式、年龄、性别、职业及受教育程度等进行分组,分析HBV感染及基因型相关危险因素。【结果】初次献血者HBV感染率(3.59%)高于多次献血者(0.16%)。在初次献血者中,男性HBV感染率(2.22%)高于女性(1.66%),且献血者的HBV感染率随年龄增大呈上升趋势,差异均有统计学意义(均P<0.05);职业为教师(1.18%)、军人(1.01%)、公务员(1.27%)、医护人员(0.85%)的献血者HBV感染率较低,职业为工人(6.05%)、农民(6.15%)、自由职业(7.61%)、服务行业(8.77%)的献血者HBV感染率较高,且随着献血者学历的增高HBV感染率呈下降趋势,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,多次献血(OR=0.623,95%CI:0.337~0.945)、静脉输液史(OR=1.694,95%CI:1.517~1.946)、HBV感染家族史(OR=1.768,95%CI:1.265~1.934)是感染HBV的独立影响因素,差异均有统计学意义(均P<0.05)。不同HBV基因型感染者HBV e抗原(HBeAg)阳性率、HBV e抗体(HBeAb)阳性率、乙型肝炎后肝硬化发生率,以及丙氨酸转氨酶、天冬氨酸转氨酶、总胆红素、HBV‑脱氧核糖核酸(DNA)比较,差异均有统计学意义(均P<0.05)。多因素logistic回归分析结果显示,年龄、HBeAg、HBV‑DNA、临床类型(无症状携带者及急、慢性乙型肝炎)是HBV基因型分布的影响因素,差异有统计学意义(P<0.05)。【结论】海南省属于HBV感染低流行区,但HBV感染隐匿风险依然存在。详细了解献血者的基本资料及HBV感染基因型,对于优选健康献血者,减少献血人群HBV阳性的发现及传播具有积极意义。

[Objective]To analyze the epidemiological characteristics of hepatitis B virus(HBV)infection among blood donors in Hainan Province.[Methods]HBV screening was conducted on 6851 samples from voluntary blood donors in Hainan Province from January 2020 to January 2023.The samples were grouped according to donation frequency,method,age,gender,occupation,and education level,and risk factors related to HBV infection and genotypes were analyzed.[Results]The HBV infection rate among first-time blood donors(3.59%)was higher than that among repeat donors(0.16%).Among first-time blood donors,the HBV infection rate in males(2.22%)was higher than in females(1.66%),and the infection rate increased with age(all P<0.05).Blood donors who were teachers(1.18%),militaries(1.01%),civil servants(1.27%),and medical staffs(0.85%)had lower HBV infection rate,while workers(6.05%),farmers(6.15%),and freelancers(7.61%),and service industry workers(8.77%)had higher HBV infection rate.The infection rate decreased with higher education levels(P<0.05).Multivariate logistic regression analysis showed that multiple blood donations(OR=0.623,95%CI:0.337‒0.945),history of intravenous transfusions(OR=1.694,95%CI:1.517‒1.946),and family history of HBV infection(OR=1.768,95%CI:1.265‒1.934)were independent risk factors for HBV infection(all P<0.05).Significant differences were observed among different HBV genotypes in terms of HBeAg positivity rate,HBeAb positivity rate,incidence of post hepatitis B cirrhosis,as well as levels of ALT,AST,and HBV-DNA(all P<0.05).The results of multivariate logistic regression analysis showed that age,HBeAg,HBV-DNA,and clinical type were risk factors for HBV genotype distribution(P<0.05).[Conclusion]Hainan Province is a low-prevalence area for HBV infection,but the latent risk for HBV infection still exists.Therefore,it is important to thoroughly understand the basic information and HBV infection genotypes of blood donors,so as to select healthy blood donors and reduce the discovery and transmission of HBV-positive cases among blood donors.