Prevalence of immunologic markers of hepatitis A and B infection in hospital personnel in Miyazaki Prefecture, Japan

Between 1980 and 1983, a total of 1,883 serum samples from employees of four prefectural hospitals in Miyazaki prefecture, Japan were surveyed for antibody to hepatitis A virus (anti-HAV) and for the following hepatitis B virus markers: hepatitis B surface antigen (HBsAg), antibody to HBsAg (anti-HBs), and antibody to hepatitis B core antigen (anti-HBc). Overall prevalences were 36.9% for anti-HAV, 3.4% for HBsAg, 23.3% for anti-HBs, and 36.6% for anti-HBc. In the control group of 233 healthy persons, prevalences were 51.5% for anti-HAV, 3.0% for HBsAg, 28.3% for anti-HBs, and 33.5% for anti-HBc. No significant difference in the distribution of HBsAg was seen among five work categories. Anti-HBc prevalence was significantly higher in nurses than in office workers (p less than 0.05), other medical personnel (p less than 0.05), and controls (p less than 0.01). The differences between nurses and office workers and other medical personnel became greater with age, but a difference between nurses and the control group was recognized in every age group. A significant difference in the distribution of anti-HBc was seen between surgical physicians (36.7%) and nonsurgical physicians (27.1%). Prevalence of anti-HAV in physicians (32.8%), nurses (29.6%), and laboratory technicians (40.1%) was significantly lower than in the control group (51.5%). These data suggest that in the hospitals studied, hepatitis B is an occupational hazard to nurses and surgical physicians, but that hepatitis A is not.     

无锡市城区乙型肝炎流行病学调查分析

目的 了解无锡市社区成人乙型肝炎(HB)知识知晓率、乙型肝炎病毒(HBV)感染率和免疫水平,探讨成人HBV免疫策略.方法 采用横断面整群抽样的方法入户问卷调查,采集空腹血样并采用ELISA方法检测HBsAg、抗-HBs、HBeAg、抗-Hbe和抗-HBc.结果 3744名调查者8项HB相关知识知晓率较高,其中"HB是传染病"单项知晓率高达87.30%,有疫苗接种史者HB知晓率得分≥5分者占60.18%(239/393),明显高于无接种史的49.49%(1071/2164),x2=17.07,P＜0.01;有HBV家族史者知晓率得分≥5分者占60.00%(318/530),明显高于无家族史者的43.00%(1382/3214),x2=53.05,P＜0.01;HBV总感染率经标化后为49.88%;HBV 5项指标全部阴性者1109名,占29.62%;HBsAg、HBeAg和抗HBc 3项同时阳性者为8例,占0.21%;HBsAg、抗-Hbe和抗-HBc 3项同时阳性者133例,占3.55%;男性抗-HBc阳性率显著高于女性,分别为59.37%和53.08%,P=0.00;HBV 5项指标阳性率随着年龄的增长而上升,20岁、80岁年龄组的HBsAg分别是为2.84%和5.69%,抗-HBs分别为44.05%和65.85%,HBeAg分别为0.64%和0.81%,抗-Hbe分别为1.93%和4.07%,抗-HBc分别为33.44%和69.11%,趋势性x2=256.16,P＜0.001;3744名调查者中有HB家族史者占14.16%(530/3744),HBV疫苗接种率为11.77%(393/3339),经标化后为20.20%,有接种疫苗史者抗-HBs阳转率为21.12%(83/393).结论 成人HBV感染率高,HBV疫苗接种率低,抗-HBs抗体水平低,提高成人HB免疫水平是降低HBV感染的重要措施.     

A ten year serological survey of hepatitis A, B and C viruses infections in Nepal

BACKGROUND: In 1987, we reported that the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in Nepal was low, as compared to hepatitis A virus (HAV) infection, and that no human T-lymphotropic type-1 (HTLV-1) infection was found in Nepal. OBJECTIVES: To determine changes in the prevalence of HAV, HBV, and HCV infections between 1987 and 1996 in inhabitants of Bhadrakali (suburban) and Kotyang (rural) villages in Nepal. STUDY DESIGN: We did a cross-sectional survey of 458 inhabitants of two Nepalese villages, to assess the prevalence of antibody to HAV (anti-HAV), antibody to hepatitis B core antigen (anti-HBc), hepatitis B surface antigen (HBsAg), antibody to HCV (anti-HCV), and antibody to HTLV-I (anti-HTLV-I). RESULTS: Anti-HAV was detected in 454 (99.1%), HBsAg in 5 (1.1%), anti-HBc in 33 (7.2%) and anti-HCV in 8 (1.7%) of serum samples tested in 1996. Statistically significant differences by gender or age group were nil. The prevalence of HCV infection was significantly higher in 1996 than in 1987 after adjusting for age of subjects living in the two villages (p < 0.01). The prevalence of HBsAg was significantly higher in 1996 than 1987 in Bhadrakali after adjusting for the factor of age (p < 0.05). Between 1987 and 1996, evidence for HTLV-1 positive residents was nil. CONCLUSION: These results suggest that HAV has been endemic in Nepal for long time while not of HBV, and that HCV infection tends to be increased recently.     

Prevalence study of different hepatitis markers among pregnant Albanian refugees in Greece

Aim of the study was to record the prevalence of the various types of viral hepatitis, especially hepatitis B, in pregnant Albanian refugees in Greece. The study comprised 500 pregnant refugees of mean age 25:1 ± 4,6 years. In Albania, all women had lived in overcrowded houses and had been exposed to non throw-away needles and syringes. Various indices for all hepatitis types were determined. The prevalence of HBsAg was 13.4%, of anti-HBs 53%, of total anti-HBc 70.8%, of anti-HBc IgM 0.4%, of HBeAg 1.2%, of anti-HBe 58.6%, of anti-HAV 96.2%, of anti-HAV IgM 1%, of anti-HDV 0.4%, of anti-HCV 0.6% and of anti-HEV 2%. HBeAg was found positive in 7.5% of HBsAg carriers. Prevalence of hepatitis B markers, as determined by HBsAg and/or anti-HBs and/or total anti-HBc was significantly higher in those with a history of previous hospitalization in Albania (p = 0.01) and those with previous history of hepatitis (p = 0.02). The high prevalence of hepatitis B markers in pregnant Albanian refugees proves that HBV infection is highly endemic in Albania and the possibility of perinatal transmission to the offsprings urges for HBV vaccination programmes. On the other hand improvements in the socioeconomic conditions and the sanitation system in Albania is anticipated to reduce the incidence of HAV and HBV infections.     

对四种国产乙型肝炎酶联免疫试剂盒的灵敏度和特异度分析

目的 比较4种国产乙型肝炎(乙肝)ELISA试剂盒的灵敏度和特异度.方法 取慢性乙肝患者和不合格献血员血液样本594份,应用4种国产乙肝ELISA试剂盒检测HBsAg、抗-HBs、HBeAg、抗-HBe和抗-HBc,并与1种国外乙肝化学发光试剂盒(Abbott公司Architect)比较,对结果不一致的样本再用各试剂盒做双孔重复检测,对HBsAg 临界值附近的样本用Abbott HBsAg确证试剂盒(Architect HBsAg confirm)验证;以Abbott试剂盒(Architect)的检测结果为标准,计算4种国产ELISA试剂盒的灵敏度、特异度、总符合率和约登指数.然后用上述试剂盒榆测HBV 5项标志物的灵敏度参比品,比较不同试剂盒的灵敏度.结果与Abbott公司Architect试剂盒相比,国产HBsAgELISA试剂盒的灵敏度低4～10倍;抗-HBs、HBeag、抗.HBe和抗-HBc ELISA试剂盒的灵敏度低4～16倍;且有假阳性.HBsAg、抗-HBs、HBeAg、抗-HBe和抗-HBc的总符合率分别为96.46%～98.15%、94.28%～98.15%、98.15%～99.49%、90.07%～96.30%、92.09%～96.80%.结论国产乙肝ELISA试剂盒的灵敏度和特异度有待进一步提高.     

无锡市城区20岁以上人群乙型肝炎病毒感染及免疫状况调查

目的 对江苏省无锡市城区20岁以上自然人群HBV感染与乙型肝炎(乙肝)疫苗接种关系进行研究.方法 按知情、自愿、随机的原则抽取无锡市20岁以上的自然人群3744名进行乙肝血清流行率和乙肝疫苗接种调查,采用ELISA和放射免疫分析法测定乙肝五项指标(HBsAg、抗-HBS、HBeAg、抗-HBe和抗-HBc).结果 3744名调查对象总HBV感染率经标化后为51.7%,HBsAg、抗-HBs、HBeAg、抗-HBe、抗-HBc阳性率经标化后分别为4.5%、48.5%、0.3%、3.5%、51.4%.30岁以下人群HBsAg阳性率最低,分别为2.9%和2.6%.抗-HBc阳性率男性显著高于女性(P<0.05),且随着年龄的增加而逐步升高(趋势χ2=256.2,P<0.001).该人群乙肝疫苗标化接种率为17.6%,随着年龄的增加接种率迅速下降(P<0.05).接种疫苗人群的HBsAg阳性率和HBV感染率明显低于未接种疫苗人群、抗-HBs阳性率则高于未接种人群(P值均<0.05).结论 成年人接种乙肝疫苗可以影响整个人群的HBV感染模式,在加强新生儿乙肝疫苗计划免疫同时,应进一步加强对成年人的乙肝疫苗免疫策略.     

Nigerian medical students are at risk for hepatitis B infection

Medical students are exposed to blood and body fluids. This study was conducted to estimate the prevalence of hepatitis B virus (HBV) infection amongst medical students of the Lagos State University College of Medicine, Ikeja, Nigeria. Data were collected through a self-administered questionnaire and through blood analysis for hepatitis B surface antigen (HBsAg), hepatitis B 'e' antigen (HBeAg) as well as antibodies to the core (anti-HBc), surface (anti-HBs) and 'e' (anti-HBe) antigens. Three hundred and thirteen of 325 students (96%) participated. The mean age was 24.3+/-3.98 years; 231 (74%) were pre-clinical students and 82 (26%) were in the clinical years of study. Only 8 (2.6%) had received three doses of vaccination against HBV. Eighty-one (26%) tested positive for anti-HBc, 10 (3.2%) were positive for HBsAg and 56 (17.9%) had anti-HBs antibodies. A significant relationship was found between students who had a positive history of hepatitis B in the family and anti-HBc (P=0.03). Age was also significantly associated with HBsAg (P=0.012). Two hundred and twenty-five (72%) students were susceptible to the infection and required vaccination. Most students at this medical school are susceptible to HBV infection and should be vaccinated.     

Seroepidemiology of hepatitis A and hepatitis B virus in Luxembourg

A prospective seroepidemiological survey was carried out in Luxembourg in 2000-2001 to determine the antibody status of the Luxembourg population against hepatitis A virus (HAV) and hepatitis B virus (HBV). One of the objectives of this survey was to assess the impact of the hepatitis B vaccination programme, which started in May 1996 and included a catch-up campaign for all adolescents aged 12-15 years. Venous blood from 2679 individuals was screened for the presence of antibodies to HAV antigen and antibodies to hepatitis B surface antigen (anti-HBs) using an enzyme immunoassay. Samples positive for anti-HBs were tested for antibody to hepatitis B core antigen (anti-HBc) using a chemiluminiscent microparticle immunoassay to distinguish between individuals with past exposure to vaccine or natural infection. The estimated age-standardized anti-HAV seroprevalence was 42.0% [95% confidence interval (CI) 39.8-44.1] in the population >4 years of age. Seroprevalence was age-dependent and highest in adult immigrants from Portugal and the former Yugoslavia. The age-standardized prevalence of anti-HBs and anti-HBc was estimated at 19.7% (95% CI 18.1-21.3) and 3.16% (95% CI 2.2-4.1) respectively. Anti-HBs seroprevalence exceeding 50% was found in the cohorts targeted by the routine hepatitis B vaccination programme, which started in 1996. Our study illustrates that most young people in Luxembourg are susceptible to HAV infection and that the hepatitis B vaccination programme is having a substantial impact on population immunity in children and teenagers.     

Transmission of hepatitis B virus among siblings

The authors investigated families with at least one hepatitis B surface antigen (HBsAg) carried in Okinawa, Japan, to determine possible routes of hepatitis B virus transmission within family units. A total of 175 members of 37 families on the western part of Iriomote Island, Okinawa, were followed up for 2-13 years; 68 were HBsAg-positive at least once. Sera were collected once a year. All serum samples were assayed by radioimmunoassay to determine presence of HBsAg, antibody to HBsAg (anti-HBs), hepatitis B e antigen (HBeAg), antibody to hepatitis B e antigen (anti-HBe) and antibody to hepatitis B core antigen (anti-HBc). In five of the 15 families with a positive mother and negative father, one or more HBsAg-positive children were found. In contrast, an HBsAg-positive child was found in only one of the eight families with a negative mother and positive father. In nine of the 14 families with both parents negative, two or more children were positive. Apparent sibling-to-sibling hepatitis B transmission occurred during the period of observation in four of the families with both parents negative. Eight children less than four years old were HBsAg-positive when first surveyed or became HBsAg carriers when four years of age or younger. No one over four years of age changed from HBsAg-negative to positive. This study found 1) in the family setting, there were cases of apparent maternal transmission but there were more cases of apparent sibling-sibling transmission, and 2) children under four years of age seemed to become carriers more easily than older children.     

The changing epidemiology of hepatitis B virus infection in the Canadian north

Hepatitis B virus infections are common in the Eskimo (Inuit) populations of the world. In this study, serologic markers of hepatitis B infection were measured in 172 inhabitants (78%) of an isolated Canadian Inuit settlement. Evidence of hepatitis B infection was found in 22% of residents. The prevalence increased with age, being uncommon under the age of 20 (7%), yet present in the majority of inhabitants over the age of 40 (64%). Sera from four individuals (2.3%) were hepatitis B surface antigen- (HBsAg) positive. All four HBsAg carriers were negative for immunoglobulin M (IgM) antibody to hepatitis B core antigen (IgM anti-HBc), hepatitis B e antigen (HBeAg), and DNA polymerase, but positive for antibody to hepatitis B e antigen (anti-HBe). These data suggest that hepatitis B infection has become relatively uncommon in the inhabitants of this community born during the past 20-30 years. The apparent decline in prevalence did not appear to be related to recent demographic or socioeconomic changes in the area.     

广州市社区居民病毒性肝炎血清流行病学调查及相关影响因素分析

目的了解社区居民病毒性肝炎的血清流行病学情况,分析乙型肝炎（乙肝）的危险因素,为进一步探索社区居民肝炎综合防治措施提供科学依据。方法以分层随机抽样方法,于2010年在广州市选取3个街道的社区居民为调查对象,采用面对面询问方式问卷调查,收集一般情况、生活史、家族史、乙肝知识、乙肝疫苗注射史等信息。采用ELISA法检测调查对象血样的HBsAg、抗-HBs、HBeAg、抗-HBe、抗-HBc和抗-HAVIgG、抗-HCVIgG共7项指标。采用logistic回归分析方法分析影响乙肝感染率的因素。结果调查了2015户家庭居民共3511人,其中男性1403人,女性2108人。人群抗-HAVIgG、抗-HCV IgG、HBsAg、抗-HBs、HBeAg、抗-HBe和抗-HBc阳性率分别为91．83％、0．74％、7．18％、61．75％、0．85％、12．90％和17．23％;HBsAg阳性率峰值出现在31～40岁年龄组（12．80％,43／337）;乙肝疫苗计划免疫策略实施后出生人群HBsAg阳性率为0．30％（1／328）,大幅低于政策实施前出生的人群（7．89％,251／3183）（P〈0．01）;HBV感染率为16．80％（590／3511）。多因素logistic回归分析结果表明,有肝炎家族史是HBV感染的危险因素（OR=33．52）,而接种乙肝疫苗是保护因素（OR=0．56）。结论广州市社区居民甲肝免疫水平较高,通过持续的肝炎防治,乙肝和丙肝的感染率有所降低,乙肝疫苗免费接种有效降低了新生儿和青少年的乙肝感染率,但成年人这一指标仍处于较高水平,建议今后应针对性改进社区居民尤其乙肝患者家属这一高危人群肝炎综合防治措施。     

Hepatitis B virus circulation in three different villages of Somalia

Hepatitis B virus (HBV) circulation was surveyed in three Somalian villages (Buur-Fuul, Mooda-Moode and Bajuni Islands) in different districts and 52 children living in a closed community, aged under one year, were studied. Of the 331 village subjects aged one to 83 years, 12.08% were HBs positive, 29.9% anti-HBs positive, 43.8% anti-HBc positive and 21.4 anti-HBe positive. Among the HBs-positive subjects, 34.7% had HBeAg and 21.7% had anti-HBcAg-IgM. No statistically significant differences were found for HBs, anti-HBs, anti-HBc and anti-HBe among the three villages. HBeAg prevalence was higher in Buur-Fuul than in Mooda-Moode and in Bajuni Islands. HBsAg prevalence was about the same for each age group studied, whereas the prevalence of anti-HBc showed a continuous rise and reached its maximum level of 43.8% in those aged 39 years and older. The proportion of HBs-positive subjects who also carried HBeAg was high in the youngest children but fell with age. HBs-positive children aged under one year had a high anti-HBc-IgM prevalence. Our finding suggests that perinatal infection may play an important role among the Somalian population in determining the reservoir of virus carriers.     

Prevalence and risk factors of hepatitis B in Spanish prostitutes

Eighty prostitutes were tested by solid-phase radioimmunoassay for serum markers of hepatitis B virus (HBV). Of 8 (10%) with hepatitis B surface antigen (HBsAg), 6 (75%) also had hepatitis Be antigen (HBeAg). Antibodies to HBsAg (anti-HBs) and to hepatitis B core antigen (anti-HBc) were found in 52 (65%). Antibodies to HBeAg (anti-HBe) were positive in 32 (40%). Anti-HBc alone was found in 5 (6%) and anti-HBs alone in 2 (2%). Sixty-seven (84%) were positive for at least one HBV marker and 13 (16%) were still susceptible to infection. Hepatitis B markers were more prevalent in prostitutes than in the normal Spanish population. Age, a history of sexually transmitted diseases (STD), drug abuse and promiscuity are factors which were highly related to hepatitis B markers. We concluded that screening prostitutes for the presence of markers and vaccinating those who are negative would be worth while.     

Universal immunization of infants with low doses of a low-cost,plasma-derived hepatitis B vaccine in South Africa

OBJECTIVE: To evaluate the effectiveness of universal vaccination against viral hepatitis B in South Africa among 18-month-old rural children. METHODS: Children were immunized with a course of low-dose (1.5 microg), plasma-derived hepatitis B vaccine at 6, 10 and 14 weeks of age, and blood samples from the children were tested for three hepatitis B markers: hepatitis B surface antigen (HBsAg), anti-HBs and anti-HBc. FINDINGS: One year after vaccination, a protective anti-HBs antibody titre of at least 10 IU/l was present in 669/769 (87.0%) of blood serum samples tested. Only 3/756 children (0.4%) were HBsAg positive and a fourth child was anti-HBc positive (HBsAg negative). This is a marked decrease compared to the hepatitis B prevalences reported in previous studies. Among rural migrant mine-workers, for example, HBsAg prevalence was 9.9%, and was 10.1% among children 0-6 years of age in the Eastern Cape Province. CONCLUSION: The low-dose, plasma-derived hepatitis B vaccine, which is affordable to most developing countries, was very successful in controlling endemic hepatitis B infection, where the virus is predominantly spread by horizontal transmission among infants and young children.     

Infection by hepatitis B and C virus in non-intravenous drug using female prostitutes in Spain

We have studied the prevalence of hepatitis B (HBV) and hepatitis C virus (HCV) serologic markers in female blood donors and in female prostitutes and the relationship of antibodies to hepatitis B core antigen (anti-HBc) and of antibodies to HCV (anti-HCV) with the presence of treponemal antibodies (FTA-ABS) in non-intravenous drug using female prostitutes. Hepatitis B surface antigen (HBsAg) was found in 1.0% of the female blood donors, anti-HBc in 15.6% and anti-HCV in 0.7%. In the prostitutes, the prevalence of HBsAg was 6.1%, anti-HBc was positive in 29.0% and anti-HCV in 8.8%. No significant statistical association between the prevalence of anti-HBc or anti-HCV and the age of prostitutes (p = 0.9111 and p = 0.8254 respectively) or the length of time as prostitutes (p = 0.3583 and p = 0.5770) was found. FTA-ABS positive prostitutes had a significantly higher prevalence of anti-HCV than FTA-ABS negative prostitutes (p < 0.001). No statistical association was found between anti-HBc antibodies and positive FTA-ABS prostitutes (p = 0.336).Corresponding author.     

Prevalence of hepatitis B in selected Alaskan Eskimo villages

Sera collected in 1973-1975 from 3053 residents of 12 selected Alaskan Eskimo villages were tested for evidence of hepatitis B virus infection. Overall, hepatitis B surface antigen (HBsAg) was found in 6.4% of those tested. Evidence of hepatitis B infection (positive for HBsAg or antibody to hepatitis B surface antigen (anti-HBs] varied considerably by village, from 4.6% to 69.9%, and increased with advancing age. The proportion with HBsAg was significantly higher in those under the age of 13 years, and the male/female ratio varied from 0.9 to 1.5 to 1.5 in the prepubertal, postpubertal-premenopausal, and postmenopausal age groups, respectively. The prevalence of hepatitis B e antigen (HBeAg) in HBsAg-positive persons decreased with advancing age, and conversely, the prevalence of antibody to hepatitis B e antigen (anti-HBe) increased with age. Hepatitis B infection was found to be sporadically distributed, with great village-to-village variation and further variation by household within most villages. The high HBsAg and HBeAg seropositivity observed in children suggests that children are both more recently infected with hepatitis B and are more involved in hepatitis B transmission in these villages.     

2372例慢性无症状HBV携带者血清HBVM模式的转变规律分析

目的 研究乙型肝炎病毒（HBV）感染血清标记物（HBVM）模式的转变规律。方法 对2372例无症状HBV携带进行了2－11年（平均4．14年）血清HBVM模式的随访，随访期内不用任何抗病毒药。结果 最初HBVM模式为HBsAg、HBeAg、抗－HBc均阳性（简称“大三阳”）和HBsAg、抗－HBe、抗－HBc均阳性（简称“小三阳”），随访终点时分别有62．1％和67．4％保持原模式不变；而最初模式为“大二阳”（HBsAg、HBeAg均阳性）、“小二阳”（HBsAg、抗－HBc均阳性）、“单抗－HBc阳性”（单项抗－HBc阳性，其余4项均阴性）、“单HBsAg阳性”（HBsAg阳性，其余4项均阴性），随访终点时保持原模式不变的比率较低（分别为39．3％、32．4％、8．7％、5．6％）。小三阳或小二阳随访期间仍可出现病毒复制（HBsAg阳转）。HBsAg、HBeAg平均每年阴转率分别为1．16％、7．1％，抗－HBs、抗－HBe平均每年阳转率分别为0．63％、4．8％；HBeAg阴转率明显高于HBsAg阴转率（P＜0．01）；抗－HBe阳转率明显高于抗－HBs转阳率（P＜0．01）。在随访期出现ALT升高468例（19．7％），其中160例（6．7％）表现为急性肝炎发作。结论 慢性无症状HBV携带长期随访中不同的血清HBVM模式可相互转换，并可出现肝炎活动。HBsAg自然阴转率和抗－HBs的自然阳转率均较低。     

深圳市居民乙型肝炎病毒感染危险因素分析

目的 了解广东省深圳市居民乙肝病毒(HBV)感染现状,分析HBV感染的相关危险因素.方法 于2010年在深圳市采用多阶段系统随机抽样方法抽取10个社区、1000户家庭,进行入户个案调查乙肝感染相关危险因素,并采集血样.用酶联免疫吸附试验(ELISA)检测乙肝血清标志物:乙肝表面抗原(HBsAg)、乙肝表面抗体(抗-HBs)和乙肝核心抗体(抗-HBc).结果 HBsAg、抗-HBs、抗-HBc阳性率和HBV感染率分别为6.68％ (252/3771)、71.92％(2 712/3771)、37.39％(1564/3771)和45.98％(1734/3771);≤15岁人群乙肝疫苗接种率为93.62％(1 752/1 872),＞15岁人群接种率为79.48％(1 509/1899),差异有统计学意义(x2=160.89,P ＜0.01);接种乙肝疫苗者与未接种者的HBV感染率分别为32.45％(1508/3261)和87.24％ (445/510),差异有统计学意义(x2 =552.72,P＜0.01);HBsAg阳性率与HBV感染率均随年龄上升有增加的趋势;多因素Logistic回归分析结果显示,家中有乙肝患者、内窥镜史、手术史及有偿献血史是深圳市居民乙肝感染的危险因素.结论 深圳市乙肝感染情况低于全国平均水平;乙肝感染具有家庭聚集性;医疗卫生因素对乙肝感染的影响较大.     

HBeAg阴性的慢性HBV感染者乙肝病毒前C区G1896A变异分析

目的:了解HBeAg阴性的慢性HBV感染者乙肝病毒前C区G1896A变异情况,为临床乙肝诊治提供科学依据。方法:北京市海淀医院HBeAg阴性的慢性HBV感染者496例,其中HBeAg阴性慢性乙型肝炎患者380例,非活动期HBV感染者196例,取血液及肝组织样本进行HBV血清学标志检测(HBsAg、抗-HBs、HBeAg、抗-HBe和抗-HBc)、丙氨酸谷丙转移酶(ALT)、HBV DNA定量检测;HBV前C区G1896A变异检测;肝组织学检查;采用SPSS13.0软件进行数据分析。结果:两组患者血清中均检测到HBV DNA,其中HBeAg阴性慢性乙型肝炎患者组检出率100%(296/296),平均值为4.90±1.49log10拷贝数/毫升,非活动期HBV感染者组检出率42.0%(84/200)平均值为3.22±0.59 log10拷贝数/毫升,两组比较HBV DNA载量差异有显著性;在HBV DNA载量>1000拷贝/ml的病例中HBeAg阴性慢性乙型肝炎组的乙肝病毒存在前C区G1896A变异,发生率为83.8%(248/296),非活动期HBV感染组乙肝病毒前C区G1896A也存在变异,发生率为33.3%...     

Immunogenicity and safety of a plasma-derived heat-inactivated hepatitis B vaccine (CLB). Studies in volunteers at a low risk of infection with hepatitis B virus

The safety and immunogenicity of a plasma-derived heat-inactivated hepatitis B vaccine (CLB) were evaluated in 471 healthy human volunteers, who, both in their occupations and in their private lives, had been at minimal risk of being infected with hepatitis B virus. The first 202 individuals received three 3-micrograms doses of heat-inactivated hepatitis B surface antigen (HBsAg) at one-month intervals (trial A). A total of 42% one month after the first injection, 84% after two months, and 93% after five months had become anti-HBs (antibody to hepatitis B surface antigen) positive. In a second randomized study (trial B), the immunogenicity of five different dosages of the vaccine was compared in 269 volunteers. When the dose of HBsAg was diminished from 3 micrograms to 1.5, 0.6, and 0.25 microgram, no decrease of the anti-HBs response was observed. However, when the dose was diminished to 0.1 microgram of HBsAg, the anti-HBs response dropped significantly to 63% (p less than 0.001). In the recipients of all five vaccine dosages, no influence of sex and age was found on the anti-HBs conversion rates. During the eight-month observation period, none of the vaccinees became HBsAg and/or anti-HBc (antibody to hepatitis B core antigen) positive, and none developed antibodies associated with autoimmune liver disease. No serious side effects were observed.