评价性传播对中国乙肝病毒感染的独立影响：一项模型研究

StephenW

Evaluating the independent influence of sexual transmission on HBV infection in China: a modeling study
Miaolei Li  1 , Jian Zu  2 , Mingwang Shen  3 , Guihua Zhuang  3 , Siyuan Chen  4 , Fuzhen Wang  5 , Hui Zheng  5 , Guomin Zhang  6
Affiliations
Affiliations

    1
    School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, P. R. China.
    2
    School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, P. R. China. [email protected].
    3
    School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, P. R. China.
    4
    Department of Statistics and Actuarial Science, Simon Fraser University, V5A1S6, Burnaby, British Columbia, Canada.
    5
    Chinese Center for Disease Control and Prevention, Beijing, 102206, P. R. China.
    6
    Chinese Center for Disease Control and Prevention, Beijing, 102206, P. R. China. [email protected].

    PMID: 33607996 DOI: 10.1186/s12889-021-10408-5

Free article
Abstract

Background: The long-term impact of sexual transmission on the hepatitis B virus (HBV) infection in China remains unclear. This study aims to estimate the independent influence of sexual transmission on HBV infection.

Methods: Based on the natural history of HBV infection and three national serosurvey data of hepatitis B in China, we developed an age- and sex-specific discrete model to describe the transmission dynamics of HBV. The initial conditions of the model were determined according to the age- and sex-specific national serosurvey data in 1992. Based on the national survey data of hepatitis B in 1992 and 2006, by using the Markov Chain Monte Carlo (MCMC) method, we estimated the age- and sex-specific seroclearance rates of hepatitis B surface antigen (HBsAg) and the horizontal transmission rates as well as their 95% confidence intervals (CI). Then we used the age- and sex-specific national serosurvey data of hepatitis B in 2014 to test the accuracy of our model-based estimation. Finally, we evaluated the independent impact of sexual transmission on HBV infection and discussed the long-term effect of promotion of condom use in China.

Results: We estimated that the annual rates of HBsAg seroclearance for males and females aged 1-59 years were respectively 1.04% (95% CI, 0.49-1.59%) and 1.92% (95% CI, 1.11-2.73%). Due to sexual transmission, in 2014, the total number of chronic HBV infections in people aged 0-100 years increased 292,581, of which males increased 189,200 and females increased 103,381. In 2006, the acute HBV infections due to sexual transmission accounted for 24.76% (male: 31.33%, female: 17.94%) and in 2014, which accounted for 34.59% (male: 42.93%, female: 25.73%). However, if the condom usage rate was increased by 10% annually starting in 2019, then compared with current practice, the total number of acute HBV infections from 2019 to 2035 would be reduced by 16.68% (male: 21.49%, female: 11.93%). The HBsAg prevalence in people aged 1-59 years in 2035 would be reduced to 2.01% (male: 2.40%, female: 1.58%).

Conclusions: Sexual transmission has become the predominant route of acute HBV infection in China, especially for men. The promotion of condom use plays a significant role in reducing the cases of acute HBV infection.

Keywords: Age-structured model; Condom promotion; HBsAg prevalence; Hepatitis B; Sexual transmission.

StephenW

评价性传播对中国乙肝病毒感染的独立影响：一项模型研究
李妙蕾1，建祖2，沉明旺3，桂花庄3，陈思远4，王福珍5，慧政5，张国敏6
隶属关系
隶属关系

    1个
    西安交通大学数学与统计学院，陕西西安710049
    2
    西安交通大学数学与统计学院，陕西西安710049 [email protected]。
    3
    西安交通大学健康科学中心公共卫生学院，陕西西安710061
    4
    西蒙·弗雷泽大学统计与精算学系，V5A1S6，加拿大不列颠哥伦比亚省本那比。
    5
    中国疾病预防控制中心，北京102206。
    6
    中国疾病预防控制中心，北京102206。 [email protected]。

    PMID：33607996 DOI：10.1186 / s12889-021-10408-​​5

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抽象的

背景：在中国，性传播对乙型肝炎病毒（HBV）感染的长期影响尚不清楚。本研究旨在评估性传播对HBV感染的独立影响。

方法：根据中国乙肝病毒感染的自然史和全国三项乙型肝炎血清学调查数据，我们建立了年龄和性别特异性离散模型，以描述乙肝病毒的传播动态。该模型的初始条件是根据1992年按年龄和性别分类的全国血清调查数据确定的。基于1992年和2006年的乙型肝炎国家调查数据，我们采用了马尔可夫链蒙特卡洛（MCMC）方法，评估了乙型肝炎表面抗原（HBsAg）和水平传播率以及其95％置信区间（CI）的年龄和性别特异性血清清除率。然后，我们使用2014年特定年龄和性别的乙型肝炎国家血清调查数据来检验我们基于模型的估计的准确性。最后，我们评估了性传播对HBV感染的独立影响，并讨论了在中国推广使用安全套的长期效果。

结果：我们估计，1-59岁男性和女性的HBsAg血清清除率分别为1.04％（95％CI，0.49-1.59％）和1.92％（95％CI，1.11-2.73％）。由于性传播，2014年，0至100岁人群的慢性HBV感染总数增加292,581，其中男性增加189,200，女性增加103,381。 2006年，由于性传播引起的急性HBV感染占24.76％（男性：31.33％，女性：17.94％），2014年占34.59％（男性：42.93％，女性：25.73％）。但是，如果从2019年开始安全套使用率每年增加10％，那么与目前的做法相比，2019年至2035年的急性HBV感染总数将减少16.68％（男性：21.49％，女性：11.93％ ）。到2035年，1-59岁年龄段的HBsAg患病率将降至2.01％（男性：2.40％，女性：1.58％）。

结论：性传播已成为中国急性HBV感染的主要途径，尤其是男性。促进使用安全套在减少急性HBV感染病例中起着重要作用。

关键词：年龄结构模型避孕套推广； HBsAg患病率；乙型肝炎；性传播。

StephenW

https://bmcpublichealth.biomedce ... 889-021-10408-5.pdf