张掖市乙型肝炎母婴阻断监测分析

目的 为预防乙型肝炎母婴传播,提高新生儿乙型肝炎疫苗首针及时接种率,降低乙型肝炎发病率和乙肝病毒表面抗原携带率,探索适合甘肃省张掖市的乙型肝炎有效防控策略。方法 以2016—2018年HBsAg阳性的入院孕妇为研究对象,追踪随访所生新生儿,调查分娩和喂养方式、乙型肝炎疫苗接种史,并开展免疫学检测。结果 共完成随访591人,随访率97.85%;新生儿乙型肝炎疫苗接种率为99.49%,乙型肝炎免疫球蛋白注射率为99.66%,表面抗体阳性率为96.11%,总阻断成功率为99.32%。在接种乙型肝炎疫苗和注射乙型肝炎球蛋白的基础上,孕妇不同乙型肝炎指标、分娩和喂养方式的母婴阻断成功率差异均无统计学意义(P>0.05)。结论 及时接种乙型肝炎疫苗和乙型肝炎免疫球蛋白,可有效减少乙型肝炎病毒母婴传播。     

加强对慢性乙型肝炎抗病毒治疗的研究

加强对慢性乙型肝炎抗病毒治疗的研究斯崇文我国是乙型肝炎病毒（ＨＢＶ）感染的高发地区，慢性乙型肝炎表面抗原（ＨＢｓＡｇ）携带率为９．７５％。根据推算，慢性乙型肝炎患者约３０００万人。此类病人病情迁延不愈，部分病人可发展为肝硬化和肝癌，危害极大。慢性乙型...     

基于文献计量学的2016年至2021年全球乙型肝炎研究热点和趋势分析

目的对全球2016年至2021年乙型肝炎研究热点和趋势进行分析。方法检索2016年1月1日至2021年11月22日Web of Science核心合集数据库中收录的乙型肝炎相关文献。利用InCites平台和VOSviewer 1.6.8可视化分析工具总结文献发表情况、高被引论文、全球核心研究国家/地区, 并进行主题聚类, 结合相关文献的具体内容进行阐述, 分析研究热点。结果截至2021年11月22日, 共检索到12 299篇文献, 2016年至2021年全球乙型肝炎相关研究文献发表数量分别为2 045篇、1 996篇、2 039篇、2 118篇、2 186篇和1 915篇。中国内地(大陆)是发文量最多的国家/地区(4 422篇, 35.95%), 篇均被引频次为7.46, 美国发文量排在第2位(1 949篇, 15.85%), 篇均被引频次为13.78。关键词主题聚类后得到的主要研究方向为:乙型肝炎病毒(hepatitis B virus, HBV)感染及HBV与丙型肝炎病毒、人类免疫缺陷病毒等的重叠感染、原发性肝细胞癌、抗病毒治疗与乙型肝炎治愈、HBV病毒学、HBV与宿主免疫、HBV...     

高校新生乙型肝炎表面抗原(HBsAg)阳性分析

乙型肝炎是全球性传染病 ,我国是乙型肝炎高发国之一 ,流行面广 ,人群病毒携带率高 ,一旦感染不易清除 ,对人类健康是一个极大的威胁。为了解大学新生乙型肝炎病毒携带状况、乙型肝炎病毒感染率与性别、新生地区来源 ,以及乙型肝炎病毒感染与乙型肝炎的发病关系 ,以便采取防治对策。我们对每年入校新生进行乙型肝炎病毒表面抗原检测。现将 95、96、97、98、99级新生检测结果分析如下 :材料和方法一、本组测对象为我校 95、96、97、98、99级秋季入学国家统招新生共 44 3 8人 ,新生来自全国二十多个省、市、自治区。二、所有学生在入校报到一…     

某高职院校新生乙型肝炎乙型肝炎病毒携带情况及原因调查分析

<正>乙型肝炎病毒(HBV,简称乙型肝炎病毒),感染性强,据我国卫生部2006年的调查数据显示,我国人群乙型肝炎表面抗原(HBsAg)携带率为7.18%,而且另有研究发现,大学生是HBsAg携带率较高的人群[1],且大部分是在入学前即有携带。高职院校的新生来自于全国乙型肝炎发病率不同的各个地区,而且大部分生理和心理刚刚成熟,各种活动都很活跃,容易通过性接触、医学器械等接触方式的传播感染HBV,因此为     

新生儿和儿童乙肝免疫

自1991年WHO提出将乙型肝炎病毒(HBV)疫苗纳入新生儿计划免疫以来,绝大多数国家新生儿HBV疫苗接种覆盖率平均在90%以上,婴儿HBV疫苗接种覆盖率为85％-99％．我国HBsAg携带率从10．19％下降到0．2％-3．2％．不同地区新生儿和儿童全程接种率、首针及时接种率、免疫覆盖率差异较大．对不同新生儿和儿童HB免疫尚需注意的问题如HBV疫苗接种程序和接种剂量,早产、低体质量儿的免疫接种,HBsAg阳性母亲子女的免疫接种和母乳喂养,抗-HBs保护时间和加强免疫问题．     

慢性乙型肝炎病毒感染孕妇血清学及病毒学特征——沈阳部分地区2016年与2010年对比研究北大核心CSCD

目的通过比较2016年和2010年沈阳部分地区孕妇乙型肝炎病毒表面抗原(hepatitis B s antigen,HBsAg)携带率、乙型肝炎病毒e抗原(hepatitis B e antigen,HBeAg)阳性和高病毒载量的比例,探讨HBV感染模式变化趋势。方法调查2016年1-12月中国医科大学附属盛京医院产科收治孕妇慢性HBV感染的血清标志物和HBV DNA,并与2010年6月至2011年11月收治的孕妇进行比较。结果 2016年收治孕妇HBsAg携带率为3.08%(441/14 314),在441例HBsAg阳性的孕妇中,HBeAg阳性151例(34.24%),高病毒载量112例(25.40%),主要见于HBeAg阳性孕妇(95.54%,107/112);2010年孕妇HBsAg携带率为5.49%(249/4536),在249例HBsAg阳性的孕妇中,HBeAg阳性167例(67.07%),高病毒载量37例(14.86%),仅见于HBeAg阳性孕妇。2016年和2010年收治孕妇的HBsAg携带率、HBeAg阳性比例、高病毒载量的比例两组之间比较差异均有统计学意义(χ~2=56.59,P<0.01;χ~2=69.02,P<0.01;χ~2=10.44,P<0.01)。结论 2016年沈阳部分地区孕妇与2010年比较,HBsAg携带率下降但HBeAg阴性比例和高病毒载量的比例增高,应加强对HBeAg阴性孕妇的筛查。     

南宁市789名3岁以下儿童乙肝疫苗接种的免疫应答调查分析

目的了解南宁市3岁以下计划免疫健康儿童乙型肝炎疫苗免疫效果。方法采用酶联免疫吸附技术(ELISA)检测2002￣2005年间经过酵母重组乙型肝炎疫苗计划免疫的3岁健康儿童血中乙型肝炎病毒表面抗体(抗-HBs)。结果3岁以下儿童共检测789名儿童,其中免疫成功的414名,成功率占52.47%。结论此组免疫接种成功率较文献报道低,且有部分群体肝细胞对酵母重组乙型肝炎疫苗处于不应答,需要从头免疫。     

慢性乙型肝炎抗病毒治疗的进展

全世界乙型肝炎病毒(HBV)携带者约3.5亿人。根据国内1992-1994年全国血清流行病学调查,HBsAg携带率达9.75％,约1.2亿人。慢性乙型肝炎患者约为3000万,其中10％～20％可发展为肝硬化,1％～5％可演变为肝癌。母亲携带的HBV可通过垂直传播方式传给婴儿,其中90％以上可成为慢性HBsAg携带者。 目前慢性乙型肝炎的治疗,采用抗病毒、免疫调节、改善肝功能和抗肝纤维化等综合疗法,抗病毒治疗是其中最主     

青少年乙型肝炎疫苗加强免疫的证据与必要性

我国自1992年在全国开展新生儿乙型肝炎疫苗普种并于2005年纳入免疫规划以来, 垂直传播及婴幼儿时期早期暴露导致的慢性乙型肝炎病毒(HBV)感染显著减少。但我国目前仍属于HBV感染的中高流行区, 慢性HBV感染人数超过8 000万例。此外, 越来越多的证据显示在新生儿时期完成乙型肝炎疫苗全程接种的儿童, 因暴露而感染HBV甚至感染后慢性化的比例随着年龄的增长而增加。现综述接种乙型肝炎疫苗后, 随年龄增长, 接种者的乙型肝炎表面抗体(抗-HBs)水平下降、部分接种者抗-HBs免疫记忆消退的证据, 分析通过加强免疫降低HBV感染的可能性、研究证据及相应的卫生经济学。建议结合国情进一步优化我国的乙型肝炎疫苗接种策略, 对于青少年儿童, 特别是母亲为HBsAg阳性且成功阻断垂直传播、家庭及亲密接触者中有慢性HBV感染者的儿童和青少年, 应在适当年龄段进行加强免疫以进一步降低HBV感染风险。     

2006年甘肃省天祝县人群乙型肝炎监测分析

目的了解甘肃省天祝藏族自治县（天祝县）人群乙型肝炎（乙肝）病毒表面抗原（HBsAg）携带状况。方法开展全人群HBsAg携带、乙肝疫苗（HepB）接种率调查,儿童HepB接种免疫效果血清学检测。结果全人群HBsAg阳性率为3.08%;1～4岁、5～14岁儿童HBsAg阳性率分别为0.83%和2.27%;男、女HBsAg阳性率分别为3.57%和2.55%;城镇、农村HBsAg阳性率分别为1.30%和3.83%。结论天祝县1～14岁儿童HBsAg阳性率明显降低,表明自1992年将HepB纳入儿童计划免疫管理后,免疫效果显著。     

北京市新生儿接种乙型肝炎疫苗的流行病学效果评价

目的评价新生儿接种乙型肝炎疫苗后的流行病学效果.方法收集接种人群历年的报告、现场调查接种情况;分析接种后历年来传染病疫情报告;采用多阶段随机抽样方法,收集接种儿童的血清标本,应用固相放射免疫法(SPRIA)检测血清中乙型肝炎表面抗原(HBsAg)、抗HBs和抗-HBc,并与接种初期的检测结果进行比较.结果新生儿接种乙型肝炎疫苗后,其乙型肝炎发病率由接种初期1 8.5 9～20.5 2/10万(x2=58.26,P＜0.01)降至0.39～2.38/10万;HBsAg携带率由2.82%降至0.60%,下降约80.00%(x2=10.75,P＜0.01).结论给新生儿接种乙型肝炎疫苗是预防和控制乙型肝炎病毒感染的有效手段.     

Maternal knowledge of the risk of vertical transmission and offspring acquisition of hepatitis B

Introduction and objectivesUniversal vaccination at birth and in infancy is key to the elimination of chronic hepatitis B infection. We aimed to assess hepatitis B immune-prophylaxis and perinatal transmission knowledge, in a large and ethnically diverse cohort of previously pregnant North American women, chronically infected with hepatitis B.Materials and methodsThe Hepatitis B Research Network (HBRN) is comprised of 28 Clinical Centers in the United States and Canada. Female cohort participants were administered a questionnaire to assess: (1) their assertion of knowledge regarding HBV prophylaxis at birth, testing, and diagnosis of hepatitis B in their children, and (2) the percentage of affirmative to negative responses for each of the HBV-related interventions her child may have received. The relationship between asserted knowledge, actions taken and maternal demographics were assessed.ResultsA total of 351 mothers with 627 children born in or after 1992 were included. Median age at enrollment was 39.8 years. Mothers were mostly foreign-born with the largest percentage from Asia (73.4%) and Africa (11.7%). Of the 627 children, 94.5% had mothers who asserted that they knew whether their child had received HBIG or HBV vaccine at birth, for 88.8% of the children, their mothers indicated that they knew if their child was tested for HBV and for 84.5% of children, their mothers knew if the child was diagnosed with HBV infection. Among children whose mothers asserted knowledge of their HBV management, 95.3% were reported to have received HBIG or HBV vaccine, 83.4% of children were said to have been tested for HBV, and 4.8% of children were said to have been diagnosed with HBV. Younger maternal age was the only factor significantly associated with higher percentage of children for whom mothers reported knowledge of testing (p = 0.02) or diagnosis of HBV (p = 0.02).ConclusionsWhile high percentages of North American children had mothers asserting knowledge of HBV prophylaxis and testing, knowledge gaps remain, with mothers of 5.5–15.5% of children lacking knowledge of key components of the HBV prevention and diagnosis in the perinatal setting. Targeted education of HBsAg-positive mothers may aid in closing this gap and reducing vertical transmission.     

Veterans health administration hepatitis B testing and treatment with anti-CD20 antibody administration

AIM: To evaluate pretreatment hepatitis B virus(HBV) testing, vaccination, and antiviral treatment rates in Veterans Affairs patients receiving anti-CD20 Ab for quality improvement.METHODS: We performed a retrospective cohort study using a national repository of Veterans Health Administration(VHA) electronic health record data. We identified all patients receiving anti-CD20 Ab treatment(2002-2014). We ascertained patient demographics, laboratory results, HBV vaccination status(from vaccination records), pharmacy data, and vital status. The high risk period for HBV reactivation is during antiCD20 Ab treatment and 12 mo follow up. Therefore, we analyzed those who were followed to death or for at least 12 mo after completing anti-CD20 Ab. Pretreatment serologic tests were used to categorize chronic HBV(hepatitis B surface antigen positive or HBs Ag+), past HBV(HBs Ag-, hepatitis B core antibody positive or HBc Ab+), resolved HBV(HBs Ag-, HBc Ab+, hepatitis B surface antibody positive or HBs Ab+), likely prior vaccination(isolated HBs Ab+), HBV negative(HBs Ag-, HBc Ab-), or unknown. Acute hepatitis B was defined by the appearance of HBs Ag+ in the high risk period in patients who were pretreatment HBV negative. We assessed HBV antiviral treatment and the incidence of hepatitis, liver failure, and death during the high risk period. Cumulative hepatitis, liver failure, and death after anti-CD20 Ab initiation were compared by HBV disease categories and differences compared using the χ2 test. Mean time to hepatitis peak alanine aminotransferase, liver failure, and death relative to anti-CD20 Ab administration and follow-up were also compared by HBV disease group.RESULTS: Among 19304 VHA patients who received anti-CD20 Ab, 10224(53%) had pretreatment HBs Ag testing during the study period, with 49% and 43% tested for HBs Ag and HBc Ab, respectively within 6 mo pretreatment in 2014. Of those tested, 2%(167/10224) had chronic HBV, 4%(326/7903) past HBV, 5%(427/8110) resolved HBV, 8%(628/8110) likely prior HBV vaccination, and 76%(6022/7903) were HBV negative. In those with chronic HBV infection, ≤ 37% received HBV antiviral treatment during the high risk period while 21% to 23% of those with past or resolved HBV, respectively, received HBV antiviral treatment. During and 12 mo after anti-CD20 Ab, the rate of hepatitis was significantly greater in those HBV positive vs negative(P = 0.001). The mortality rate was 35%-40% in chronic or past hepatitis B and 26%-31% in hepatitis B negative. In those pretreatment HBV negative, 16(0.3%) developed acute hepatitis B of 4947 tested during anti-CD20 Ab treatment and followup. CONCLUSION: While HBV testing of Veterans has increased prior to anti-CD20 Ab, few HBV+ patients received HBV antivirals, suggesting electronic health record algorithms may enhance health outcomes.     

Impact of the implementation of a vaccination strategy on hepatitis B virus infections in China over a 20-year period

Hepatitis B virus (HBV) vaccination has been recommended for all neonates in China since 1992. This article reviews the impact of HBV vaccination throughout the past 20 years in China. Before the introduction of the HBV vaccination program, approximately 9.8% of the general Chinese population tested positive for hepatitis B virus surface antigen (HBsAg). Since 1992, vaccination coverage has increased each year. In 1999, a National Expanded Programme on Immunization (EPI) review showed that the immunization coverage with three doses of HBV vaccine was 70.7%, and reached 99.0% in Beijing. The HBsAg carrier rate in the general population decreased to 7.2% in 2006. In particular, the prevalence of HBsAg decreased to 2.3% among children aged 5-14 years and to 1.0% among children younger than 5 years. In addition, the administration of the HBV vaccine may have reduced the risk of hepatocellular carcinoma among adults. Despite the administration of hepatitis B immunoglobulin and the HBV vaccine to children with HBsAg-positive mothers, the failure rate of HBV immunoprophylaxis was 5-10%. In China, vaccine failure was related to HBV S gene mutation and inadequate administration of HBV vaccine. The prevalence of HBV carriers in China was markedly reduced after the introduction of the universal HBV vaccination program. If we immunize all susceptible individuals with the hepatitis B vaccine (especially children), interrupt transmission, and provide antiviral treatment for existing HBV carriers, the number of new cases may be reduced to close to zero in the future and this may eventually result in the eradication of HBV.     

The relationship of hepatitis B virus infection between adults and their children in Guangxi Province, China

BACKGROUND/AIM: This study aimed to describe the seroepidemiology of hepatitis B virus (HBV) infection, with emphasis on transmission of HBV infection between adults and their children. METHODS: We analyzed the hepatitis sero-survey data collected from 2132 persons aged 1-59 years (624 families) in Guangxi Province, China, 1992. Blood was tested for the presence of the hepatitis B surface antigen (HBsAg), the antibody to hepatitis B core antigen (anti-HBc), and the antibody to hepatitis B surface antigen (anti-HBs). RESULTS: Of the 2132 persons surveyed, 119 (5.6%) reported receiving HBV vaccination. Among those persons who did not receive HBV vaccination, 19% were HBsAg positive (current HBV infection) and 57% had a past HBV infection (they were HBsAg negative and either anti-HBc positive or anti-HBs positive). Among 519 children aged 1-10 years who did not receive HBV vaccination, 21% had current HBV infection and 37% had past HBV infection. Among 289 children of both parents who were HBsAg negative, 16% had current HBV infection and 36% had past HBV infection. CONCLUSIONS: The high prevalence of community-acquired HBV infection in children and the low HBV vaccination coverage in Guangxi should alert public health agencies to re-examine their current policies for preventing HBV transmission.     

2005年康定县雅拉乡乙型病毒性肝炎血清流行病学调查

目的了解康定县雅拉乡1～59岁人群乙型病毒性肝炎病毒(HBV)感染状况,为乙肝防治提供依据。方法采用多阶段分层随机抽样的方法抽取康定县雅拉乡312名1～59岁人群进行问卷调查和血清学检测,利用ELISA方法检测乙肝病毒表面抗原(HBsAg),乙肝病毒表面抗体(Anti-HBs),乙肝病毒e抗原(HBeAg)和乙肝病毒e抗体(Anti-HBe),乙肝病毒核心抗体(Anti-HBc),检测。结果康定县雅拉乡1～59岁人群乙肝病毒表面抗原(HBsAg),乙肝病毒表面抗体(Anti-HBs),乙肝病毒核心抗原(HBcAg)经标化后阳性率分别为2.10%、21.65%和15.65%;男、女性人群HBcAg阳性率分别为4.27%、0;HBsAg阳性人群中,乙肝病毒e抗原阳性率为1.92%。结论康定县雅拉乡1～59岁人群HBsAg阳性率明显下降,提示提高乙肝疫苗的接种率是降低人群HBsAg阳性率的关健措施。     

乙型肝炎相关性肝移植后乙型肝炎复发的临床特点分析

目的 总结和探讨乙型肝炎相关性终末期肝病患者在肝移植术后乙型肝炎复发的临床特点.方法 回顾性分析2005年4月至2010年4月期间的253例乙型肝炎相关性肝移植患者的术后随访资料.结果 253例肝移植患者中乙型肝炎复发16例,复发率6.32%(16/253),中位复发时间为术后13个月,术后1、3、5年的累积复发率分别...     

Epidemiological and clinical burden of chronic hepatitis B virus/hepatitis C virus infection. A multicenter Italian study

BACKGROUND/AIMS: This study assess prevalence, risk factors, and clinical and virological features of dual hepatitis B virus (HBV)/hepatitis C virus (HCV) infection. METHODS: We evaluated 837 hepatitis B surface antigen positive patients, prospectively enrolled in 14 Italian units. RESULTS: Anti-HCV was present in 59 cases (7%); age specific prevalences were 4.5% (0-30 years), 4.4% (>30-50) and 14% (>50). Independent predictors of dual infection were age >42 years, history of I.V. drug use (IDU), blood transfusion and residence in the South of the country. The strength of the association with IDU was high, but this exposure accounted for five coinfection cases only. Cirrhosis was present in 107 of the 709 patients with HBV alone (15.1%), in 30 of 69 with hepatitis D virus coinfection (43%) and in 17 of 59 with HCV coinfection (28.8%); a light alcohol use was marginally associated with cirrhosis. Of 36 B/C coinfected patients, 16 (44.4%) had only HBV-DNA in serum, (median age=47.5 years) five (13.9%) had both HBV-DNA and HCV-RNA (age=53), nine (25%) had HCV-RNA alone (age=59) and six (16.7%) tested negative for both. CONCLUSIONS: This study depicts the epidemiological and clinical burden of dual HBV/HCV infection in Italy.     

新生儿乙型肝炎疫苗普遍接种的长期免疫效果

目的 观察新生儿乙型肝炎(简称乙肝)疫苗普遍接种预防儿童期乙型肝炎病毒(HBV)感染的长期免疫效果和对儿童乙肝发病的影响。 方法 1986年起在乙肝高发区隆安县实施不筛检母亲HBsAg、新生儿普遍接种常规剂量乙肝疫苗的免疫方案。采用出生队列定群随访、横断面调查和监测乙肝发病情况的方法对血源乙肝疫苗和重组酵母乙肝疫苗的保护效果进行观察。 结果 血源乙肝疫苗免疫后1～1 3年HBsAg阳性率为0.7％～2.9％,平均1.7％,保护率为83.5％～96.6％,HBV感染率为1.1％～5.1％,平均2.4％,保护率为93.5％～98.4％。重组酵母乙肝疫苗免疫儿童的HBsAg阳性率为1.8％～2.4％,平均2.0％,保护率为78.4％-85.2％。免疫实施14年后, 1～14岁人群乙肝发病率为1.5/10万,比历史对照同龄者减少了91.8％;未免疫儿童发病率为14.4/1 0万,与历史对照差异无显著性,免疫儿童中无乙肝病例发生,保护率为100％。 结论 新生儿乙肝疫苗免疫后13年内不必加强免疫,重组酵母乙肝疫苗与血源性乙肝疫苗的保护效果相似,乙肝疫苗预防作用已初见成效。