宠物犬饲养者狂犬病知识水平及影响因素分析

目的了解新泰市宠物犬饲养者对狂犬病知识的知晓情况及其影响因素,为进行宣传教育提供依据。方法采用分层整群抽样法,在新泰市城里小区抽取16栋楼居民,对年龄≥18岁的宠物犬饲养者(养犬时间≥6个月)进行问卷调查,并对数据进行统计分析。结果201名宠物犬饲养者狂犬病知识及格率为74.62%(150/201),平均得分为(66.76±12.99)分。结论新泰市社区宠物饲养者狂犬病相关知识知晓率偏低,文化程度、月收入和宠物犬饲养时间是影响知识知晓的影响因素。     

合肥市瑶海区社区女性居民对HPV及其疫苗的认知情况调查和疫苗接种意愿的影响因素分析

目的：调查合肥市瑶海区社区女性居民对人乳头瘤病毒（HPV）及其疫苗的认知情况,并分析疫苗接种意愿的影响因素。方法：采用多阶段随机抽样法于2021年3月～2023年1月期间在合肥市瑶海区抽取6个社区开展调查。采用自行涉及的调查问卷调查合肥市瑶海区社区女性居民对HPV及其疫苗的认知情况,采用多因素Logistic回归模型分析疫苗接种意愿的影响因素。结果：本次调查共发放问卷1124份,收回问卷1118份,问卷有效率为99.47%。调查的1118例合肥市瑶海区社区女性居民中,对"HPV阳性不一定患有宫颈癌"的知晓率较高,为75.04%。而对"各类HPV疫苗的适宜接种年龄"的知晓率较低,为4.20%。1118调查者中,804人（71.91%）表示愿意接种HPV疫苗,314人（28.09%）表示不愿意接种HPV疫苗,按照是否愿意接种将调查人员分为愿意组（n=804）和不愿意组（n=314）。HPV疫苗接种意愿与年龄、家庭人均月收入、教育水平、婚育状况、性生活史、知晓HPV疫苗、疫苗供应不足、育有子女、有亲友患肿瘤有关（P<0.05）,而与职业、居住地无关（P>0.05）。多因素Logi...     

社区居民对基因检测服务需求意愿及其影响因素调查分析

目的:了解社区居民对基因检测服务的知晓、需求状况及需求意愿的影响因素。方法:采用典型抽样方法,对杭州市下城区1647户居民进行问卷调查。结果:调查人群对基因检测知晓率为21.8%,需求率为12.7%,有需求意愿的占到61.9%。有无家庭成员患病(OR=1.619,95%CI=1.279-2.049)、对基因检测服务知晓情况(OR=2.368,95%CI=1.782-3.146)、有无家族遗传史(OR=2.784,95%CI=1.685-4.600)年龄(x2=27.210,P<0.001)、对婚前基因检测的认可度(x2=23.185,P<0.001)等五个因素对社区居民基因检测服务需求意愿有显著影响。结论:社区居民对基因检测服务需求意愿较强,但是知晓率、需求率均偏低。有待加强相关方面的宣传、教育、培训等工作。     

慢性重型乙肝继发侵袭性真菌感染的研究

目的明确侵袭性真菌感染(invasive fungal infections,IFI)在慢性重型乙肝患者中发病情况及主要病因。方法依据IFI和乙肝诊断标准,筛选上海长征医院感染科慢性重症乙肝患者,60例IFI者为病例组,66例未发生IFI为对照组,进行回顾性分析。结果 IFI患病率47.62%,病死率40%。乙肝病毒DNA水平是最主要的危险因素,当DNA高于3.16×103copies/mL,IFI发病可能性增大。结论慢重肝患者IFI的患病率和病死率超出临床预期,降低DNA拷贝可延缓乙肝进展,在预防及治疗IFI中亦具积极意义。     

待孕夫妇乙肝表面抗原及乙肝表面抗体阳性情况分析

目的分析与探讨待孕夫妇乙肝表面抗原及乙肝表面抗体检测结果,并研究其对临床孕前检查的影响及评价。方法随机选取2015-2017年度在我院进行孕前检查的夫妇2 440对(4 880例)为研究对象,按照年度将待孕夫妇分为两组,每组2 440例,两组均加强孕前检查中的乙肝表面抗原(HBsAg)及乙肝表面抗体(HBsAb)的检测。A组为2015年3月-2016年2月在我院进行乙肝表面抗原及乙肝表面抗体检查的待孕夫妇;B组为2016年3月-2017年2月在我院进行乙肝表面抗原及乙肝表面抗体检查的待孕夫妇。比较两组待孕夫妇乙肝表面抗原及乙肝表面抗体检测的阳性结果。结果 B组HBsAg阳性率、HBsAb阳性率明显高于A组(6.43%vs 4.63%;62.99%vs 58.44%),差异有统计学意义(P0.05)。B组、A组男性HBsAg阳性率明显高于同组女性(59.87%vs 40.13%;60.18%vs 39.82%),HBsAb阳性率低于同组女性(46.52%vs 53.48%;47.41%vs 52.59%),差异均有统计学意义(P0.05)。B组、A组高中及以上学历HBsAg阳性率明显低于同组高中以下学历(38.85%vs 61.95%;38.05%vs 61.15%),高中及以上学历HBsAb阳性率高于同组高中以下学历(53.15%vs 46.84%;51.75%vs 48.25%),差异均有统计学意义(P0.05)结论目前夫妇乙肝感染仍处于增高趋势,对于进行孕前检查的待孕夫妇加强乙肝表面抗原及乙肝表面抗体的检测,有助于疾病的早期诊断、干预及治疗,能够减少乙肝传播,可有效降低新生儿乙肝发病率,促进优生优育,提高出生人口整体素质。     

沈阳市居民乙肝感染状况调查

对不同性别、年龄的沈阳市居民乙型肝炎病毒血清标志物进行检测,分析HBV感染状况。采集3 780名健康体检者血清标本检测乙肝5项、ALT和TBIL,统计分析后的结果显示:乙肝感染率为3.28%,不同性别间结果无明显差异(P>0.05),但不同年龄组间乙肝感染率有显著差异(P<0.01),41～50岁年龄组感染率是6.23%,30岁以下和50岁以上感染率较低,分别为2.94%和1.84%;1、4、5感染模式占总感染例数的69.4%,HBV感染者中ALT或TBIL单项升高及二者均升高者占22.6%。沈阳市居民乙肝感染率低于全国平均水平,慢性乙肝感染较多,肝功能与乙肝感染病程不呈平行关系,疫苗接种可有效预防乙肝感染。     

许昌市小学生传染病知识知晓途径及行为情况调查分析

目的分析许昌市小学生了解传染病途径及行为,以期为进一步加强传染病预防控制及实践工作提供科学依据。方法采用两阶段分层整群抽样法,对许昌市6个区县18所小学2160名小学生,通过问卷调查小学生传染病获取途径、知晓率及行为情况。结果小学生传染病知识知晓率调查显示,女生流感预防措施、艾滋病传播途径、手足口病传染途径、乙肝传播途径、接种禁忌证、肺结核症状体征、狗咬伤处理方法知晓率高于男生(P0.05),城市流感预防措施、手足口病传染途径、麻疹预防方法、接种禁忌证、艾滋病传播途径、肺结核症状体征、狗咬伤处理方法高于郊区(P0.05)。经课堂教学、多媒体录像、电视及周围人群谈论知晓率分别为32.08%、26.44%、23.70%及17.78%,饭前便后洗手率、毛巾共用率、洗手使用肥皂率、吐痰至痰盂率、有疾病症状通知师长率分别为71.25%、35.79%、43.10%、90.32%、68.19%。结论许昌市小学生传染病知识知晓率仍有不足,通过前期调查了解,依据小学生掌握情况及特点,结合多种途径进行健康教育促进其健康行为提升。     

西安市雁塔区育龄女性宫颈癌防治知识知晓情况调查及影响因素分析

摘要 目的：调查西安市雁塔区育龄女性宫颈癌防治知识知晓情况,并分析其影响因素。方法：选取2019年3月~2020年7月期间于我院进行健康体检的育龄期女性1500例作为研究对象,采用我院自制的调查问卷对研究对象个人信息、宫颈癌防治知识知晓情况进行调查。分析西安市雁塔区育龄女性宫颈癌防治知识知晓情况的影响因素。结果：共发放调查问卷1500份,收回合格问卷1491份,合格率为99.40%（1491/1500）。西安市雁塔区育龄女性宫颈癌防治知识总体知晓率为34.14%（509/1491）。将知晓5项及其以上宫颈癌防治知识的受试者509例纳为知晓组,知晓5项以下的982例作为知晓不足组。单因素分析结果显示：两组在文化程度、年龄、宫颈癌家族病史、家庭月收入、居住地、职业、既往生殖病史、接受过宫颈癌知识宣教、5年内体检史方面对比差异有统计学意义（P<0.05）。多因素Logistic回归分析发现：家庭月收入<5000元、文化程度为初中及以下、接受过宫颈癌知识宣教、既往生殖病史、5年内体检史均是西安市雁塔区育龄女性宫颈癌防治知识知晓情况的影响因素（P＜0.05）。结论：西安市雁塔区育龄女性具有较低的宫颈癌防治知识总体知晓率,且既往生殖病史、家庭人均月收入、文化程度等均为其宫颈癌防治知识知晓情况影响因素,当地相关部门可结合相关影响因素开展针对性的健康教育,以提高当地育龄女性对宫颈癌防治知识的认知。     

北京2024名社区居民食品安全相关知识知晓情况调查

目的：了解社区居民食品安全知识现状,为食品安全健康教育和行为干预提供科学依据。方法 采取多阶段分层随机抽样,于2015年5月—2016年4月对北京朝阳区2 024名居民进行入户面对面问卷调查,采用SPSS13.0软件进行统计分析。结果：在本次调查的2 024份问卷中;88.66%的调查对象表示愿意了解食品安全相关知识;60.87%的调查对象认为其了解食品安全相关知识的主要困难是信息太多、可信性差。部分食品安全知识知晓率低于50%。结论：社区居民对所调查的食品安全知识掌握水平一般,存在一些关于食品安全的食品购买、储存、制作的错误认识,但对获取食品安全知识具有良好意愿。要根据社区人群特点,帮助人们弥补相关知识欠缺,纠正转变不健康的食品购买、储存、制作行为。     

2004—2018年青海省乙型病毒性肝炎流行病学特征分析

目的 了解青海省2004—2018年乙型病毒性肝炎(简称乙肝)流行病学特征,为乙肝防治工作提供科学依据。方法 对青海省15年间乙肝监测数据进行描述性流行病学分析。结果 15年来青海省共报告乙肝患者201931例,年平均报告发病率239.71/10万,总体呈下降趋势。2004—2018年西宁市乙肝报告病例98218例,占48.64%;果洛藏族自治州最低,乙肝报告病例6766例,仅占3.35%。玉树藏族自治州乙肝报告发病率最高332.89/10万,海东市最低133.43/10万,不同地区乙肝报告发病率有统计学意义(χ^2=21997.32,P<0.05)。报告病例主要分布在25~55岁人群中,50~<55岁组发病率最高为454.99/10万,0~<5岁组发病率最低为23.69/10万;男、女性别比为1.57∶1。报告病例职业分布以农、牧民为主,占47.19%。结论 青海省经过多年的计划免疫的实施,乙肝防控效果明显,2009年以后乙肝报告病例呈现平稳状况。     

Assessment of Knowledge and Practice towards Hepatitis B among Medical and Health Science Students in Haramaya University,Ethiopia

Introduction

Hepatitis B (HB) is a serious infection that affects liver and caused by hepatitis B virus (HBV). HB is a serious global public health problem and the health professionals are most at risk. It is contagious and easy to be transmitted from one infected individual to another by blood to blood contact, mother to child, unprotected sexual intercourse, sharing of eating utensils and other barber shop and beauty salon equipment. The aim of this study was to assess knowledge and practices about transmissions and prevention of hepatitis B among medical and health science students on clinical attachment in Haramaya University.

Methods and Findings

A cross sectional study was conducted among 322 health science and medical students who are starting clinical attachment (year II, III, IV, V and IV) from February 1–15, 2013. Self-administered structured questionnaire was used to collect information. Out of 322 distributed questionnaires, 322 were returned with a response rate of 100.0%. Majority of the students (91%) were in the age group 20–24 and 232 (72%) of the respondents were male. Majorities (95.3%) of students were not fully vaccinated against Hepatitis B and 48.4% of the students were not aware about the availability of post exposure prophylaxis for HB. Mean scores for knowledge and practice were 11.52±2.37 and 2.76±1.1 respectively. Significant and positive linear correlations between knowledge-practice (r = 0.173, p = 0.002) was observed. Study department was significantly associated with mean knowledge and practice of study respondents.

Conclusion

This study indicates that lack of awareness about Hepatitis B, its route of transmission and modes of prevention among the medical students entering into the profession. Similarly, 95.3% the students were not fully vaccinated against Hepatitis B, which makes them vulnerable to the disease.     

Knowledge on HBV vaccine and vaccination status among health care workers of Hawassa University Comprehensive Specialized Hospital,Hawassa, southern Ethiopia: a cross sectional study

Objectives

The study was conducted to assess the knowledge on HBV vaccine and vaccination status among health care workers of Hawassa University Comprehensive Specialized Hospital.

Result

From the total 258 questionnaire prepared for the study participant, data was collected from 241 participants making the response rate of 93.4%. Regarding socio-demographic characteristics of respondents 98 (40.7%), and 159 (66%) were females and Bachelor of Science graduates respectively. Only 73 (30.3%) respondents reported that they are vaccinated for hepatitis B vaccine. But only 16 (21.9%) received three doses of Hepatitis B vaccine, which was 6.6% of the total health care workers. More than half 146 (60.6%) of the respondents had good knowledge about hepatitis B virus infection and 120 (49.8%) had good knowledge about hepatitis B vaccine. Regarding knowledge about hepatitis B virus infection prevention and control methods, 131 (28.5%) of the respondents have good knowledge.

     

乙肝患者肝组织乙型肝炎病毒cccDNA和血清MIF表达的相关性研究

目的:探讨乙肝患者肝组织乙型肝炎病毒(hepatitis B virus,HBV)共价闭合环状DNA(covalently closed circular DNA,cccDNA)和血清巨噬细胞移动抑制因子(Macrophage migration inhibitory factor,MIF)的表达相关性。方法:选择2016年2月到2016年7月在我院诊治的乙肝患者144例作为乙肝组,同期选择体格检查健康者144例作为对照组,采集所有入选者的血清样本,检测血清MIF、谷丙转氨酶(Glutamic pyruvic transaminase,ALT)、谷草转氨酶(Glutamic pyruvic aminotransferase,AST)、总胆红素(total bilirubin,TBIL)的表达,并对乙肝组患者肝组织HBV cccDNA采用荧光定量PCR技术检测表达分析,直线相关分析乙肝组的血清HBV cccDNA表达量与血清ALT、TBi L、AST、MIF含量相关性。结果:乙肝组的血清MIF、ALT、TBi L、AST含量均明显高于对照组(P0.05)。乙肝组的肝组织HBV cccDNA阳性率为54.17%(78/144)。直线相关分析显示乙肝组的肝组织HBV cccDNA表达量与血清ALT、TBi L、AST、MIF含量均呈现明显正相关性(P0.05)。结论:乙肝患者体内血清MIF水平明显升高,伴肝组织HBV cccDNA的表达也升高,两者存在明显的正相关性。因此检测血清MIF水平有助于评估乙肝患者HBV的感染情况。     

Hepatitis B,Hepatitis C and HIV-1 Coinfection in Two Informal Urban Settlements in Nairobi,Kenya

Background

HIV-1 and Hepatitis B and C viruses coinfection is common in Sub-Saharan Africa due to similar routes of transmission and high levels of poverty. Most studies on HIV-1 and Hepatitis B and C viruses have occurred in hospital settings and blood transfusion units. Data on Hepatitis B and C viruses and HIV-1 coinfection in informal urban settlements in Kenya are scanty, yet they could partly explain the disproportionately high morbidity and mortality associated with HIV-1 infections in these slums.

Objectives

The objective of this study was to determine the prevalence of HIV and Hepatitis B and C dual infection in urban slums in Nairobi.

Methods

Blood samples were collected from residents of Viwandani and Korogocho between 2006 and 2007. A structured questionnaire was used to obtain socio-demographic data from participants. Samples were screened for Hepatitis B surface antigen (HBsAg), anti-HCV and anti-HIV-1. Statistical analysis was done using STATA.

Results

Samples were successfully collected from 418 (32%) men and 890 (68%) females. The HIV-1, HBV and HCV prevalence was 20.4%, 13.3% and 0.76% respectively at the time of the study. Of the 268 (20.4%) HIV-1 positive participants, 56 (4.26%) had HBV while 6 (0.46%) had HCV. Of the 1041 HIV-1 negative participants, 117 (8.9%) had HBV while 4 (0.31%) had HCV. Only two people (0.15%) were co-infected with all the three viruses together.

Discussion

The odds of getting hepatitis infection were higher in HIV-1 participants (for HBV OR 2.08,p<0.005 and for HCV OR 5.93, p<0.005). HIV prevalence rates were similar in both informal settlements. HIV infection was highest in age group 35-39 years and among the divorced/separated or widowed. Prevalence of all viruses was highest in those who did not have any formal education.

Conclusion

The HIV prevalence in these informal settlements suggests a higher rate than what is observed nationally. The prevalence rates of HBV are significantly higher in the HIV-1 positive and negative populations. HCV as well as triple HIV-1, HBV and HCV coinfection are uncommon in Korogocho and Viwandani. This clearly indicates the need for HIV-1 control programmes and hepatitis B virus vaccination to be promoted through public awareness as preventive strategy.     

Hepatitis B Virus (HBV) Variants in Untreated and Tenofovir Treated Chronic Hepatitis B (CHB) Patients during Pregnancy and Post-Partum Follow-Up

BackgroundChronic hepatitis B (CHB) is a dynamic disease that may be affected by immune changes in pregnancy. Guidelines suggest consideration of nucleos/tide analogs (NA), i.e., tenofovir, (TDF) in highly viremic mothers to reduce vertical transmission risk. HBV variability affects CHB outcome, but little is known about HBV genetic changes in pregnancy due to immune or NA selection.ObjectivesTo evaluate HBV diversity in NA treated or untreated pregnant vs. post-partum CHB carriers.ResultsThe median age was 31 y, 71% Asian, 68% genotype B or C, 33% HBV eAg+, 5 received TDF (median HBV DNA 8.5 log IU/ml). In untreated mothers, median antepartum vs. post-partum ALT was 21 vs. 24 U/L and HBV DNA was 2.7 vs. 2.4 log(10) IU/ml. ALT and/or HBV DNA flares occurred during pregnant and/or post-partum period in 47% (10/21). Clonal sequencing antepartum showed the presence of minor “a determinant” and/or vaccine escape mutants (VEM) but drug resistant variants were infrequent. Analysis of pregnant vs. post-partum samples showed different HBV variants and viral diversity.ConclusionsDifferences in immune and/or by NA selective pressures during pregnancy may affect HBV evolution during pregnancy. The presence of minor VEM warrant infant follow-up.     

未婚人工流产女性生殖健康知识知晓现状调查及其影响因素分析

摘要 目的：探究未婚人工流产女性生殖健康知识知晓现状,并分析其影响因素。方法：随机选取2018年3月~2021年5月期间在同济大学附属第一妇婴保健院计划生育科终止妊娠的未婚女性486例作为研究对象。其中,拒绝调查者21例,实际调查465例,应答率95.68%（465/486）,数据清理后有效问卷459份,有效率为98.71%（459/465）。调查未婚人工流产女性生殖健康知识知晓现状,未婚人工流产女性生殖健康知识知晓情况的危险因素采用单因素及多因素Logistic回归分析。结果：研究对象中,女性生殖健康知识知晓总分最低分17分,最高分为92分,平均（65.74±10.82）分;得分大于80分者179例,优良率为39.00%（179/459）。得分在80分及其以下的女性280例。未婚人工流产女性生殖健康知识知晓情况与年龄、女方文化程度、父母婚姻状况、流产次数、工作性质、居住地、恋爱经历、男方文化程度有关（P<0.05）。而与家庭月收入、更换工作次数无关（P>0.05）。年龄、男方文化程度工作性质、居住地、女方文化程度、流产次数、父母婚姻状况是未婚人工流产女性生殖健康知识知晓情况的影响因素（P<0.05）。结论：未婚人工流产女性生殖健康知识知晓水平一般,受到年龄、女方文化程度、父母婚姻状况等多种因素影响,应针对其影响因素特点加强生殖健康知识的宣教,以降低人工流产的风险。     

慢性乙型肝炎病毒感染对妊娠期糖尿病及妊娠结局的影响

目的:探讨慢性乙型肝炎病毒(HBV)感染对妊娠期糖尿病(GDM)及妊娠结局的影响,为妊娠期产妇慢性HBV感染预防提供参考。方法:回顾性分析2015年2月-2017年2月在我院住院分娩的2615例慢性HBV感染产妇的临床病历资料,根据《慢性乙型肝炎防治指南》(2015年版)诊断标准,将所有产妇分为4组:慢性HBV携带者(A组)1128例、乙型肝炎e抗原(HBe Ag)阳性慢性乙型肝炎(B组)406例、HBe Ag阴性慢性乙型肝炎(C组)307例、非活动性乙型肝炎表面抗原(HBs Ag)携带者(D组)774例,并收集同期入院的823例HBV阴性产妇为对照组(E组)。比较各组的GDM发生率及不良妊娠结局发生率。结果:2615例慢性HBV感染产妇中,共发生GDM 866例,发生率为33.12%。B组与C组GDM发生率分别为38.92%、37.46%,均大于E组的30.74%(P0.05)。A组、B组、C组的妊娠期高血压疾病(PIH)发生率分别为7.98%、8.87%、9.77%,均高于E组的3.52%(P0.05);A组、B组、C组及早产发生率分别为3.10%、3.94%、4.56%,均高于E组的0.49%(P0.05)。C组的新生儿窒息发生率为1.63%,高于E组的0.36%(P0.05)。结论:产妇慢性HBV感染若合并肝功能受损或肝组织学病变,可能增加GDM的发生率,若HBV病毒复制活跃,可能导致PIH及早产发生风险增加。     

Seroprevalence of the Hepatitis B,Hepatitis C,and Human Immunodeficiency Viruses and Treponema pallidum at the Beijing General Hospital from 2010 to 2014: A Cross-Sectional Study

BackgroundThe hepatitis B, hepatitis C, human immunodeficiency viruses and Treponema pallidum are important causes of infectious diseases concern to public health.MethodsBetween 2010 and 2014, we used an automated chemiluminescence microparticle immunoassay to detect the hepatitis B, hepatitis C, and human immunodeficiency viruses as well as Treponema pallidum (the rapid plasma regain test was used in 2010–2011). Positive human immunodeficiency virus tests were confirmed via western blotting.ResultsAmong 416,130 subjects, the seroprevalences for hepatitis B virus, hepatitis C virus, human immunodeficiency virus, and Treponema pallidum were 5.72%, 1.23%, 0.196%, and 0.76%, respectively. Among 671 patients with positive human immunodeficiency virus results, 392 cases were confirmed via western blotting. Hepatitis B and human immunodeficiency virus infections were more frequent in men (7.78% and 0.26%, respectively) than in women (4.45% and 0.021%, respectively). The hepatitis B and C virus seroprevalences decreased from 6.21% and 1.58%, respectively, in 2010, to 5.37% and 0.988%, respectively, in 2014. The human immunodeficiency virus seroprevalence increased from 0.04% in 2010 to 0.17% in 2014, and was elevated in the Infectious Disease (2.65%), Emergency (1.71%), and Dermatology and Sexually Transmitted Diseases (1.12%) departments. The specificity of the human immunodeficiency virus screening was 71.4%. The false positive rates for the Treponema pallidum screening tests increased in patients who were 60–70 years old. The co-infection rates for the hepatitis C and human immunodeficiency viruses were 0.47% in hepatitis C virus-positive patients and 7.33% in human immunodeficiency virus-positive patients.ConclusionsDuring 2010–2014, hepatitis B virus and human immunodeficiency virus infections were more frequent among men at our institution. Although the seroprevalences of hepatitis B and C viruses decreased, the seroprevalence of human immunodeficiency virus infection increased (with higher seroprevalences in high-risk departments). Older patients were more likely to exhibit false positive findings for syphilis.     

Ongoing Transmission of Hepatitis B Virus in Rural Parts of the Netherlands, 2009–2013

BackgroundReported acute hepatitis B incidence in the Netherlands reached its nadir in 2013. However, regional signals about increased number of hepatitis B cases raised the question how hepatitis B incidence was distributed over the country. In this study, regional differences in hepatitis B epidemiology were investigated using epidemiological and molecular data.MethodsAcute hepatitis B virus (HBV) infections, reported between 2009–2013, were included. If serum was available, a fragment of S and C gene of the HBV was amplified and sequenced. Regional differences in incidence were studied by geographical mapping of cases and cluster analysis. Regional differences in transmission were studied by constructing regional maximum parsimony trees based on the C gene to assess genetic clustering of cases.ResultsBetween 2009 and 2013, 881 cases were notified, of which respectively 431 and 400 cases had serum available for S and C gene sequencing. Geographical mapping of notified cases revealed that incidences in rural border areas of the Netherlands were highest. Cluster analysis identified two significant clusters (p<0.000) in the South-western and North-eastern regions. Genetic cluster analysis showed that rural border areas had relatively large clusters of cases with indistinguishable sequences, while other regions showed more single introductions.ConclusionThis study showed that regional differences in HBV epidemiology were present in the Netherlands. Rural border regions showed higher incidences and more ongoing transmission, mainly among MSM, than the more urban inland areas. Therefore, preventive measures should be enhanced in these regions.     

High Risk of Hepatitis B Reactivation among Patients with Acute Myeloid Leukemia

BackgroundHepatitis B virus (HBV) infections are common and associated with significant morbidity and mortality in cancer patients. However, the incidence and risk factors of HBV reactivation in patients with acute myeloid leukemia (AML) are rarely investigated.MethodsAML patients followed-up at the National Taiwan University Hospital between 2006 and 2012 were analyzed. The clinical characteristics and laboratory data were retrospectively reviewed.ResultsFour hundred and ninety patients comprising 265 men and 225 women were studied. The median age was 52 years (range, 18 - 94). Chronic HBV carriage was documented at the time of leukemia diagnosis in 57 (11.6%) patients. Forty-six (80.7%) of the 57 HBV carriers received prophylaxis with anti-HBV agents. Sixteen HBV carriers (28.1%) developed hepatitis B reactivation during or after chemotherapy, including 7 patients who had discontinued antiviral therapy. The incidence of hepatitis B reactivation among AML patients with HBV carriage was 9.5 per 100 person-years. Prophylaxis with anti-HBV agents significantly decreased the risk of hepatitis B reactivation among HBV carriers (13% vs. 61%, p<0.001). Four (2.8%) of 142 patients with initial positive anti-HBsAb and anti-HBcAb experienced hepatitis B reactivation and lost their protective anti-HBsAb. Multivariate analysis revealed that diabetes mellitus (p=0.008, odds ratio (OR) = 2.841, 95% confident interval (CI): 0.985-8.193) and carriage of HBsAg (p<0.001, OR=36.878, 95% CI: 11.770-115.547) were independent risk factors for hepatitis B reactivation in AML patients.ConclusionsHepatitis B reactivation is not uncommon in the HBsAg positive AML patients. Prophylaxis with anti-HBV agent significantly decreased the risk of hepatitis B reactivation.