| Objective Through the investigation and analysis of the hospital epidemiology of hepatitis B virus(HBV)infection in a hospital in Taizhou from January 2013 to January 2021,It will provide help for the precise prevention and treatment of hepatitis B in Taizhou in the future;Safety study of drug discontinuation after disappearance of hepatitis B virus surface antigen(HBs Ag)in patients with compensated hepatitis B cirrhosis treated with nucleoside/nucleotide analogue(NAs)。Methods Collecting 24,2045 patients who were hospitalized in a hospital in Taizhou from January 2013 to January 2021,and grouped the hepatitis B virus of hospitalization patients with blood virus virus of hospitalization patients with different ages and birthdays,applied chemical emission immune analysis methods to apply chemical emission immune analysis laws.The symbols are detected to analyze the infection of chronic hepatitis B virus in hospitalized patients at different ages and birthdays.The liver function indexes,hepatitis B markers,HBV DNA,and liver imaging were collected from 85 NAs-treated patients with hepatitis B cirrhosis who lost HBs Ag in compensated stage when HBs Ag disappeared,24 months of follow-up,and 48 months of follow-up.According to whether the drug was discontinued or not,a retrospective study of the above indicators was conducted,and the statistical methods of rank sum test,t test and?~2test were used to compare the levels of alanine transferase(ALT),HBs Ag,HBe Ag,and HBV DNA,the occurrence of primary liver cancer or not.Results The overall HBs Ag positivity rate in hospitalized patients was 7.30%.The HBs Ag positivity rate for patients aged 1 to 9 years was 0.27%,the HBs Ag positivity rate for patients aged 10 to 19 years was 1.01%,the HBs Ag positivity rate for patients aged 1 to 19 years was 0.51%;the HBs Ag positivity rate for patients aged20 to 29 years was 5.29%,the HBs Ag positivity rate for patients aged 30 to 39 years was 9.73%,for patients aged 40 to 49 years HBs Ag positivity rate was 11.6%,HBs Ag positivity rate for patients aged 50-59 was 10.66%,HBs Ag positivity rate for patients aged 20-59 was 9.67%,HBs Ag positivity rate for patients aged 60 and above was6.31%,HBs Ag positivity rate for patients born from 1985 to 1991 was 6.82%and for patients born after 2010 The positive rate of HBs Ag in patients was 0.24%,the positive rate of HBs Ag in hospitalized maternal patients was 6.28%.The overall positive rate of anti-HBs in hospitalized patients was 62.46%,of which the positive rate of anti-HBs in patients aged 1-9 years was 70.00%,the positive rate of anti-HBs in patients aged 10-19 years was 47.52%,the positive rate of anti-HBs in patients aged 20-29 years was 50.94%,the positive rate of anti-HBs in patients aged 30-39years was 54.10%,the positive rate of anti The anti-HBs positivity rate was 61.64%for patients aged 50-59 years,64.37%for patients born before 1985 and 78.47%for patients born after 2010.Of the 85 patients,36 discontinued the drug,and 49continued it.When HBs Ag disappeared in both groups,ALT levels were within the normal range at 24 and 48 months of follow-up.The difference in anti-HBs positivity in the discontinuation group compared to the continuation group was not statistically significant(χ~2=0.75,0.39 and 0.90,P=0.78 0.84 and 0.34).The difference in HBe Ag positivity compared to the continuation group was also not statistically significant(χ~2=0.40,0.00 and 0.00,P=0.84,1.00 and 1.00).At 48 months of follow-up,two cases of primary liver cancer occurred in the discontinuation group and no primary liver cancer occurred in the continuation group,with no statistically significant difference between the two groups(χ~2=0.89,P=0.40).Throughout the follow-up,HBs Ag was negative and HBV DNA load was below the lower limit of detection.Conclusion The HBs Ag positive rate of adolescents and children is low,but the overall HBs Ag positive rate of inpatients in a hospital in Taizhou area is still high,and it is at a moderate epidemic level.Hepatitis B"still has a long way to go.The positive rate of HBs Ag in pregnant and lying-in women is still high.For women of child-bearing age,hepatitis B marker detection should be routinely given,and hepatitis B virus screening should be strengthened.Women of child-bearing age with HBV DNA>2×105IU/m L should be given hepatitis B virus during pregnancy.Interruption of mother and child.The positive rate of anti-HBs in patients aged 1 to 9years was 70.00%;the positive rate of anti-HBs in patients aged 10 to 19 years was47.52%.It is recommended that anti-HBs-negative adolescents aged 1 to 19 should be revaccinated with hepatitis B vaccine.The young and middle-aged patients are the main groups for the incidence of viral hepatitis B.Patients aged 20 to 59 years old who are HBs Ag positive and meet the"Guidelines for the Diagnosis and Treatment of Chronic Hepatitis B"(2019 edition)should be given antiviral treatment as soon as possible.Nucleoside(acid)analogues may be discontinued after the disappearance of HBs Ag in patients with compensated hepatitis B cirrhosis. |
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