| ObjectiveHepatitis B virus( HBV) infection is the most common chronic virus infections in the world. The high prevalence of HBV infection occurs in Guangdong Province. To determine the infection status, monitor the efficacy of antiviral therapies and evaluate the prognosis are the core contents of the prevention and treatment of hepatitis B virus infections, but the traditional testing of HBV serological markers are not enough to provide effective support for the clinical practice. The quantification detection of HBV DNA can directly reflect the HBV replication and infectivity, therefore it is widely used to examine the level of HBV replication and monitor the efficacy of antiviral treatment. The purpose of this study is to investigate the HBV infection status of the HBs Ag-positive populations in Guangdong Province, providing objective reference for prevention and treatment of HBV infection.MethodsThe HBV DNA quantification assay of 74347 HBs Ag positive serum samples from18 areas of Guangdong Province collected in 2007, 2010 and 2014 were performed by use of the fluorescent real-time PCR, the HBs Ag and HBe Ag were detected by ELISA. The HBV DNA positive rates, virus loading, HBe Ag status, and the gender-,age- and region-characteristics of the various pupolations infected with HBV were analyzed.Results1. The positive rates of HBV DNA in HBs Ag positive people were 56.86 %( 8906 /15664), 60.28 %( 18534 / 30747), 51.50 %( 8906 / 15664),with the HBV DNA viral loading median 8.61 × 106 cp/m L, 1.99 × 106 cp/m L, 6.02 × 105 cp/m L respectively in 2007, 2010, 2014. The positive rates of HBV DNA were the highest in2010, lowest in 2014, the difference was significant( P < 0.01).2. Chronic HBV infection status determined by HBV DNA loading and HBe Ag positivity: The distribution of chronic inactive HBs Ag carriers, chronic HBV carriers,HBe Ag(-) CHB, HBe Ag(+) CHB were 43.74%, 11.90%, 17.34%, 25.76% in the74347 HBs Ag positive serum samples from 18 areas of Guangdong Province.Chronic HBV carriers in 2010 and in 2014 were significantly higher than that in 2007.3. HBe Ag status: Viral loading in HBe Ag(+) patients was significantly higher than that in HBe Ag(-) patients. The rate of HBe Ag(-) patients was higher in male than in female and the rates of both genders increased along with the time( P<0.01).4. The relationship between gender and HBV DNA: The positive rate of HBV DNA detection in male was higher than female( 58.18% vs 54.74%, 61.95% vs 57.54%, P< 0.01) in 2007 and in 2010, but there was no statistical significance in 2014. In addition, the male and female viral loading median was decreased with time.5. The relationship between age and HBV DNA: The portion of patients ranging from0 to 15 years old in HBs Ag positive people accounted for 6.09%(954/15664), 3.59%( 1105/30747), 2.14%( 598/27936) respectively in 2007, 2010 and 2014, which showed a downward trend, P < 0.01. In addition, the viral loading decreased with age.6. The status of HBV infection in the women at child-bearing age: The HBV DNA positive rate in women at child-bearing age was 56.32%( 9388 / 16668), with the HBV DNA viral loading median ranging from 3.85 × 106 cp/m L to 1.23 × 107 cp/m L.The HBV DNA positive rates of the 20- 25 age group were 60.17 %( 1310 / 2177),65.92%( 1936 / 2937), 62.10%( 1057 / 1702) respectively in 2007, 2010, 2014,significantly higher than other age groups( P < 0.01).7. The relationship between regions and HBV DNA: The HBV DNA positive rates of HBs Ag positive people in the Pearl River Delta region and western Guangdong were first increased and then decreased in 2007, 2010, 2014, a downward trend in eastern Guangdong and not statistically significant in northern Guangdong. The HBV DNA positive rate in the Pearl River Delta region was the lowest in Guangdong Province in2007, 2010, 2014.ConclusionIn the HBs Ag-positive population studied, over 50% were HBV-DNA detectable and the HBV loading median was in the range from 6.02 × 105 cp/m L to 1.2 × 107 cp / m L.HBV loading decreased along with age and time. The portion of chronic asymptomatic HBV carriers and HBe Ag(-) CHB patients increased. The proportion and HBV DNA positive rate of patients aging from 0 to 15 years decreased,indicating that Guangdong Province has achieved remarkable results in the prevention and control work of children’s HBV infection. In the women at child-bearing age,both HBV-DNA positive rate and viral-loading were not ignorable, indicating it is still important approach for HBV spreading. Therefore, the molecular epidemiological status of Guangdong Province was understood relying on HBV DNA and HBe Ag,providing objective reference for prevention and treatment of HBV infection. |
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