摘要目的:了解农村社区非活动性HBsAg携带者（IHC）中HBV再激活的发生强度和特征。方法:分别于2018、2020年对济南市章丘区农村社区人群体检中发现的IHC进行随访调查，比较2次随访结果，分析基于社区人群的IHC的HBV再激活发生率和分布特征。结果:424名IHC完成了2次随访，发现HBV再激活者47例，累积再激活发生率为11.08%，发病密度为5.46/100人年；多因素分析显示，性别、年龄、吸烟、饮酒及肝病家族史和慢性病史与HBV再激活不相关（ P>0.05），基线HBV DNA载量与再激活相关（ P<0.05），当HBV DNA基线水平≥1 000 IU/ml时，累积再激活发生率可达18.92%。发生再激活后，ALT平均水平较基线升高且异常率增加，再激活者肝功能趋于异常。4例（8.51%）再激活者发生肝炎，其中1例（2.13%）为黄疸型肝炎。 结论:济南市农村社区IHC中HBV再激活发生率较高；大部分再激活者处于无症状或轻度再激活状态；应加强对IHC的随访并密切监测其ALT和HBV DNA水平变化，并适时采取正规的治疗措施。

abstractsObjective:To analyze the intensity and epidemiological characteristics of hepatitis B virus (HBV) reactivation among inactive HBsAg carriers (IHC) of rural areas in Ji'nan.Methods:In 2018 and 2020, follow-up investigations were conducted on IHC identified in the population physical examination in Zhangqiu district of Ji'nan. The results of the two follow-up visits were compared to analyze the incidence and distribution characteristics of HBV reactivation in IHC at the community level.Results:A total of 424 IHC completed two follow-up visits, and 47 cases of HBV reactivation were found, the cumulative reactivation rate was 11.08%, and the incidence density was 5.46/100 person-years. Multivariate analysis showed that gender, age, smoking, drinking , family history of liver disease and chronic diseases were not associated with HBV reactivation ( P>0.05), and baseline HBV DNA load was associated with reactivation ( P<0.05), in the HBV DNA level ≥1 000 IU/ml group, the reactivation rate could reach 18.92%. After reactivation, the mean level of ALT increased from baseline and the abnormal rate increased, liver function tended to be abnormal in reactivated patients. 4 (8.51%) reactivators had hepatitis, and 1 (2.13%) had jaundice hepatitis. Conclusions:The incidence of HBV reactivation was higher among IHC in rural communities in Ji'nan. Most of the reactivators were asymptomatic or mildly reactivated. Follow-up of inactive HBsAg patients should be strengthened and changes in ALT and HBV DNA levels should be closely monitored.