| Objective: The aims of the studies are as following: To find out the present situation of HBV infection which included the serologic markers positive rate, to clarify the HBV infection risk factors among health examination. To known the distribution characters of HBV genotypic differences and serum typing, finally find out the HBV strain with S gene mutation. Provide the theoretical basis for department of health by targeted prevention and control strategied and measures.Methods:Analysis the 3 armour hospital health examination people basic situation in 2016 by using the description epidemiology method, which included theinfection status of hepatitis B, hepatitis B five portfolio model, descriptive analysis. Laboratory testing techniques, including ELISA testing,the s-block PCR amplification and gene sequencing, were carried out in the epidemiological study of HBV.Results:1. The HBV prevalence rate and distribution characteristics of HBV serum markers.There was total 37563 cases of health examination at a three-a-grade hospital in Yunnan, included the 22269(59.28%) cases of male whose average age was 46.74±15.72,and 15294(40.72%) cases of female whose average age was 45.46±15.07,,the ratio of male female was 1.46:1.The weighted HBsAg prevalence rate was 2.91%, There was significant difference in positive rate of HBsAg among men (3.30%) and women (2.35%)(P<0.001). The highest rate was at 40 to 49 years old . The Indunstry and transportation (4.36%) , other careers (4.6%) were higher than others occupation specificily. The soldier got lowest HBsAg positive rate (0.99%) . Among different nationalities, yi nationality (2.99%) and han (2.94%) have higher positive rates.The weighted HBsAb prevalence rate was 67.29%, The positive rate of women's(67.29%) was higher than man (66.84%) (P<0.001) .The 30 to 39 age group had the highest positive rate.The research and development institution (71.36%) got the highest HBsAb positive rate, the enterprise units was the lowest (64.26%) .There was no difference among nationalities was statistically significant (P=0.082) . The weighted HBcAb prevalence rate was 5.69%. The positive rate of HBcAb in man's(6.11%) was higher than women (5.08%) (P<0.001) . The positive rate increases with age. Other careers (8.30%) got the highest HBcAb positive rate, the soldier was the lowest (3.47%) . The other minorities (6.21%) and the han (5.80%) had the highest positive rates.The weighted HBV prevalence rate was 5.71%. The positive rate of HBV infection in man's (6.14%) was higher than man (5.09%) (P <0.001) . The positive rate increases with age. Other careers(7.55%) got the highest HBV infection rate, the students was the lowest (2.99%) .There was difference among nationalities was statistically significant(P<0.05). The infection rate of Han HBV is higher than that of other nationalitiesSusceptibility of HBV was 29.14% . There was no significant difference in Susceptibility of HBV between man women, (P >0.05) .The difference among different age groups were statistically significant(P<0.001),under-39 years the susceptibility of HBV decreased with age,over the 40 years increased with age. The difference among different occupation was statistically significant(P<0.001). The Industry and transportation (52.06%) got the highest rate. The soldier got lowest rate(0.99%) . Hui (35.07%) and Yi nationality (30.49%) were higher than others.Combined pattern of HBV Serum markers showed the 15 modes . The HBsAb single positive detection rate of the highest, accounted for 65.14%, the serum Five indicators of the whole negative mode was the second, accounted for 29.14%,"HBsAg,HBeAb,HBcAb positive" mode checkout rate of third,accounted for 2.39%.There was significant difference in the mode of HBV infection (3, 5, 6, 7, 8,9)between man and women, (P <0.05) The male detection rate was higher than that of females (P<0.05 )15 cases were detected in special mode.There was significant difference of age in the mode of "HBsAg,HBeAb,HBcAb positive" mode (P<0.001),the highest positive rate was aged 60 to 69(3.32%), under 69 years the positive rate was increased with age. There was significant difference of age in the mode of"HBsAg,HBeAg,HBcAb positive" mode (P<0.001) ,the highest positive rate was aged 20 to 29(0.35%),the lowest rate was over 70 years(0.06%),and the positive rate was decreased with age.2. Molecular Epidemiology of Viral Hepatitis B The ELISA test showed 136 cases was positive of HBsAg, 115 cases was"HBsAg,HBeAb,HBcAb positive"mode which accounted 84.56%,8 cases was"HBsAg,HBeAg,HBcAb positive" mode which accounted 5.88%,13 cases was"HBsAg,HBcAb positive" mode which accounted9.56%. Two rounds of 136 specimens were amplified by nested PCR, Amplification succeeded in 17 cases,obtaining nucleotide sequences. The all cases of "HBsAg,HBeAg,HBcAbpositive"mode were sequencing success,and 9 cases of "HBsAg,HBeAb,HBcAb positive"mode were sequencing success. 10 cases of genotype B which are all subtype B2, 7 cases of genotype C, 1 case was subtype C1, 6 cases were subtype C2. There was significant difference of genotype B and genotype C (P<0.05) . All cases of genotype B were serotype adw2, cases of genotype C got one serotype adw2, others were serotype adrq?. The mutation rate of antigenic determinants was found in 1 cases of I126S mode which was genotype C , accounted for 12.5%. 7 cases of S143T mode which were genotype B ,accounted for 87.5%.Conclusion:1. The positive rate in male of HBsAg ,HBcAb positive HBV infection rates were higher than female,adult male for hepatitis B prevention and control of the key people?2. Middle-aged for HBsAg was high-risk of hepatitis B groups.3. Professional unknown people(domestic and unemployed, freelance, farmers, etc.)produce transportation and business services rate of positive of HBsAg were higher than others.4. In the serum mode of HBV,the "HBsAb positive"mode was mainly,the second was "all mark were negative" mode,The "HBsAg,HBeAg,HBcAb"mode was the highest in the mode of HBV infection.5. This study examines two genotype were B and C and the subtype B2 and C2, the adw2 and adrq +, are significantly related to the B and C genotype.6. The detection rate was high and there were two types of mutation: S143T and I126S. The mutant site was concentrated in the 143rd amino acid. |
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