中文摘要：

目的分析社区人群乙型肝炎表面抗原（hepatitis B surface antigen,HBsAg）携带者发生自发性再激活的流行病学特征,为社区人群乙型肝炎的防控和管理提供科学依据。方法在2010年9月甘肃省武威市乙型肝炎血清流行病学调查建立的HBsAg携带者队列基础上,于2012年和2014年开展随访研究,分析自发性再激活的发生情况和流行病学特征。结果随访发现,852例HBsAg携带者中共有72例发生再激活,发病密度为2 746.8/10万人年。不同性别间再激活率差异存在统计学意义（χ^2=3.901,P=0.048）,男性累积再激活率为10.39%,高于女性累积再激活率（6.62%）。各年龄组间再激活率也存在统计学差异（χ^2=6.524,P=0.038）,其中46-59岁年龄组累积再激活率最高,为11.95%。HBsAg携带者基线乙型肝炎病毒（hepatitis B virus,HBV）DNA水平不同,再激活率也不同（χ^2=10.404,P=0.006）,当HBV DNA基线水平〉1×10^5IU/ml时,累积再激活率可达14.36%。结论社区HBsAg携带者中存在一定比例的自发性再激活,其中男性、中年人群和基线HBV DNA水平较高者易发生再激活,应进一步加强HBV携带者的管控工作,对其定期进行随访监测,合理选择抗病毒治疗时机。

英文摘要：

Objective To analyze the epidemiological characteristics of the spontaneous reactivation of hepatitis B surface antigen（ HBsA g） carriers in the community,and to provide a scientific management for the chronic hepatitis B virus（ HBV） carriers. Methods A serum epidemiological cross-sectional study was conducted in September 2010,and the HBsA g carriers cohort was established. Then the cohort was followed in 2012 and 2014 to clarify the HBV reactivation rate and epidemiological characteristics. Results After the follow-up,there were 72 carriers developed to HBV reactivation of852 HBsA g carriers. The spontaneous reactivation incidence was 2 746. 8 per one hundred thousand person-years. Different reactivation rate were observed in different gender（ χ^2= 3. 901,P = 0. 048）. The male accumulated reactivation rate was10. 39%,which was higher than that of the female（ 6. 62%）. Meanwhile,significant differences were also found in different age groups（ χ^2= 6. 524,P = 0. 038）. The reactivation rate of 46-59 age group was 11. 95%. Besides,when the deoxyribonucleic acid of hepatitis B virus（ HBV DNA） level was high,the reactivation incidence was rising（ χ^2= 10. 404,P =0. 006）. Especially in the HBV DNA level 〉1 × 10^5IU/ml group,the reactivation rate could reach 14. 36%. Conclusions The HBsA g carriers may develop to HBV reactivation among community. Male,middle-age period and high baseline HBV DNA load are important risk factors for hepatitis B virus（ HBV） reactivation. Therefore,we should enhance the management of HBV carriers,conduct regular follow-up to monitor the condition change,and choose the reasonable time to initiate treatment.