从整体医学观探讨乙型病毒性肝炎的流行模式及干预措施

乙型病毒性肝炎是目前全球广泛流行的传染性疾病,中国是乙型病毒性肝炎的高发地区,流行态势并不稳定,部分地区仍呈上升趋势.详细阐述乙型病毒性肝炎的传播途径,并从整体医学观的角度探讨乙型病毒性肝炎的流行模式,从生物、心理、社会3方面提出一系列切实可行的综合干预措施,为降低乙型病毒性肝炎的传播流行提供有力依据.     

乙型病毒性肝炎病原学诊断及其感染因素调查

乙型病毒性肝炎病原学诊断及其感染因素调查薛韶华，梁继新，赵连珠，李建启，吴瑞病毒性肝炎是一种严重危害人类健康的常见传染病，它传染性强，流行广泛、发病率高、传播途径复杂。尤其是部分乙型、丙型及丁型病毒性肝炎可演变成慢性过程，其危害更为严重。本次调查旨在...     

乙型病毒性肝炎病原学及疫苗研究新进展

随着国际、国内的频繁交流与交往导致的大规模人口流动,使得许多传播病仍广泛存在。病毒性肝炎流行区域极广,几乎世界范围内均有病例报道。我国病毒性肝炎,尤其是乙型病毒性肝炎的人群感染率很高,是当前危害人民健康最严重的传染病之一。而预防乙型肝炎的发生就显得至关重要。因此就乙型病毒性肝炎的病原学及疫苗接种等方面的问题进行了简要的综述。     

免疫系统在乙型、丙型病毒性肝炎发病过程中作用研究进展

乙型病毒性肝炎和丙型病毒性肝炎分别由乙型肝炎病毒和丙型肝炎病毒感染所致。乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）感染呈全球分布,我国是高流行地区,由于HBV、HCV基因的高变性,容易逃避机体免疫系统的清除。HBV、HCV感染免疫系统细胞,造成机体对HBV、HCV感染的免疫应答异常,并引起组织的损伤,导致肝细胞的慢性持续性感染,并可进一步发展成肝硬化,甚至肝细胞肝癌。HBV、HCV主要经血液传播,包括输血与血制品传播、静脉吸毒、针刺、医源性传播、性接触和母婴垂直传播。     

积极防治慢性病毒性肝炎

病毒性肝炎我们可能都不陌生．它在世界上广泛流行．是重要的传染病之一。依据引起肝炎的病毒不同．将病毒性肝炎分别命名为甲型、乙型、丙型、丁型和戊型病毒性肝炎。最简单的分类方法．是根据它们的传播途径不同对其进行分类。一类是经“粪一口”途径（消化道途径）传播,也就是我们常说的“病从口入”．     

围产期乙型肝炎病毒的母婴传播与预防

乙型病毒性肝炎是由乙型肝炎病毒(HBV)引起的一种严重危害人类健康的世界性疾病.研究表明,围产期母婴传播是乙肝流行的一个重要原因,控制围产期HBV母婴传播对控制乙肝流行具有关键意义.现就围产期HBV母婴传播概况、传播途径与发生机理、预防措施与远期效果综述如下.     

乙肝患者家庭成员乙肝相关知识与行为调查

<正>我国是乙型病毒性肝炎(乙肝)流行高发地区,乙肝病例居法定报告传染病前列。乙肝患者家庭成员是乙肝感染的高危人群,探讨该人群的乙肝知识知晓率和相关行为情况,对预防乙肝传播有积     

病毒性肝炎防治方案(试行)

病毒性肝炎(包括甲型、乙型和非甲非乙型)是法定传染病,具有传染性较强、传播途径复杂、流行面广泛、发病率较高等特点;部分乙型和非甲非乙型肝炎病人可演变成慢性,对人民健康危害甚大。     

嫩江县1990—2006年病毒性肝炎流行特点分析

病毒性肝炎从流行病学及预后等方面基本上可分为2类，一类包括甲型肝炎和戊型肝炎，主要经粪一口途径传播，有季节性，可引起暴发流行，不变为慢性；另一类包括乙型、丙型肝炎等，主要经血液传播，无季节性，多为散发，常变成慢性。嫩江县病毒性肝炎发病始终位居前3位，为探讨嫩江县病毒性肝炎（简称肝炎）的流行特点，摸清流行规律，为卫生行政部门制订防治对策提供科学依据，笔者等对嫩江县1990—2006年肝炎有关资料进行了分析。     

血源传播肝炎对感染人群所致疾病负担与经济负担的研究

病毒性肝炎目前已确定的有甲型（HAV）、乙型（HBV）、丙型（HCV）、丁型（HDV）及戊型（HEV）5种类型。乙型病毒性肝炎（以下简称乙肝）和丙型病毒性肝炎（以下简称丙肝）在世界范嗍流行最为广泛,经血液传播的途径有多种方式,如经输血和血液制品、血液透析、静脉吸毒共用注射器、通过器官移植等,通过注射、     

乙型肝炎免疫球蛋白与乙型肝炎疫苗联合免疫预防围产期乙型肝炎病毒传播

中国是乙型病毒性肝炎(乙肝)高发地区,乙肝病毒(HBV)的感染对人群健康构成严重的威胁。而母婴传播是HBV在中国传播的重要途径。联合使用乙肝免疫球蛋白和乙肝疫苗(HepB)被广泛用于阻断围产期HBV母婴传播。国内外的诸多研究表明,联合免疫的阻断效果要强于单独使用HepB,同时随着流行情况及人群流行病学特征的差异以及免疫剂量和免疫程序不同,联合免疫的效果也会有相应的差异。     

重庆市慢性乙型、丙型肝炎患病率调查研究

[目的]为探讨在我国开展慢性乙型、丙型肝炎（乙肝、丙肝）患病率调查方法提供参考依据。[方法]采用多阶段分层随机抽样的方法抽取重庆市3251名1～59岁人群进行问卷调查和血清学检测,标本检测HBsAg、抗-HBs、抗-HBc,抗-HCV和谷丙转氨酶（ALT）;HBsAg或（和）抗-HCV阳性者再进行B超检查。[结果]重庆市慢性乙肝、丙肝标化患病率分别为707.97∕10万和7.38∕10万;男性和女性慢性乙肝患病率分别为2027.03∕10万和260.55∕10万,城市、农村慢性乙肝患病率分别为966.96∕10万、995.02∕10万;饮白酒史与慢性乙肝患病有关（P﹤0.05）。[结论]本次慢性乙肝、丙肝感染现状调查方法可行,建议慢性肝炎判断标准以实验室检测结果为主,被调查者自述结果为辅。     

Seroepidemiology of hepatitis B virus in the Philippines

Hepatitis B virus markers were studied in 2,842 Philippine rural subjects from four villages in 1979-1982. The prevalence of hepatitis B surface antigen (HBsAg) and all markers for hepatitis B virus averaged 12% and 58%, respectively, in these rural populations. It is estimated that five million Filipinos are HBsAg positive. The rural age-specific HBsAg prevalence shows an "early peak" (in persons 3-4-years-old) in two communities and a "late peak" (in persons 30-40-years-old) in the other two communities. Family studies suggest that the prevalence of HBsAg and hepatitis B e antigen (HBeAg) among parents of the young children in an "early peak" and a "late peak" village cannot fully account for the difference in the patterns of prevalence of all markers, or the HBsAg marker. Horizontal intrafamilial and extrafamilial transmission may also be significant. Further research is needed on risk factors for hepatitis B virus infection.     

重组乙型肝炎疫苗(中国仓鼠卵巢细胞)临床效果综述

中国仓鼠卵巢细胞(CHO细胞)系是真核表达系统,其制备重组乙型肝炎(乙肝)疫苗的发展前景较之原核的酵母细胞系更好。该文综述了国产重组乙肝疫苗(CHO细胞)的临床效果,认为重组乙肝疫苗(CHO细胞)具有良好的安全性;无论是新生儿、儿童或是成人易感者接种3剂重组乙肝疫苗(CHO细胞)后,乙肝病毒表面抗体(抗-HBs)阳转率都可达到90%以上,抗体几何平均浓度(GMC)约为200毫国际单位/毫升(mIU/ml);以20μg/ml剂量为乙肝病毒表面抗原(HBsAg)和乙肝病毒e抗原(HBeAg)双阳性母亲的新生儿做母婴阻断,阻断率可达90%以上;将重组乙肝疫苗(CHO细胞)用于人群乙肝免疫预防,可将新一代人的HBsAg阳性率降到1%以下。这些研究结果提示,重组乙肝疫苗(CHO细胞)的效果与重组乙肝疫苗(酵母)相当,可用于中国的乙肝预防。     

盱眙县2009-2013年乙型肝炎流行病学特征分析

目的了解盱眙县乙型肝炎的发病情况及流行病学特征,为制定预防措施提供科学依据。方法采用描述性流行病学方法,对盱眙县2009--2013年乙型肝炎疫情资料进行分析。结果盱眙县2009---2013年共报告乙型肝炎1155例,年平均报告发病率为29．64／10万。全年均有发病,病例集中在20～59岁年龄组,占84．24％。职业分布以农民为主,占总病例数的71．60％。乡村高于城区。结论以加强乙型肝炎疫苗免疫接种为主的综合性防制措施对降低盱眙县乙型肝炎的发病率会起到较好的效果。     

Hepatitis B and C Viruses Infections and Their Association with Human Immunodeficiency Virus: A Cross-Sectional Study among Blood Donors in Ethiopia

Background

Since the introduction of Highly Active Anti-Retroviral Therapy and the dramatic improvement in the prognosis of individuals with Human Immunodeficiency Virus, liver disease due to chronic viral hepatitis has become as important cause of morbidity and mortality in co-infected individuals. The objective of the study was to determine the Sero-prevalence of Hepatitis B Virus, Hepatitis C Virus and Human Immunodeficiency Virus and the association of the virus with Hepatitis B Virus and Hepatitis C Virus infection. As Human Immunodeficiency Virus and Hepatitis B Virus infections are highly prevalent and they are among the major public health concern in developing countries including Ethiopia investigating this problem is of paramount benefit. Although studies on co-infection of Hepatitis C Virus and Human Immunodeficiency Virus have clearly identified adverse effects of co-infection, the prevalence of Hepatitis C Virus infection and the association with Human Immunodeficiency Virus in developing countries including Ethiopia has not been know for sure.

Method

A cross sectional study was conducted from January 1 to 31, 2010, in Jimma University specialized hospital Blood Bank. The inclusion criteria of the study was adult who donated blood to Jimma University specialized hospital blood bank any time from establishment of the unit until January 2010 and whose record was retrieved. Accordingly 9,204 adults were included of which 6,063 were selected by lottery method. Data on socio-demographic variables (age and sex), laboratory test result for Hepatitis B surface Antigen, anti-Hepatitis C Virus antibody, anti-Human Immunodeficiency Virus 1 antibody, and Rapid Plasma Reagin tests were collected using structured questionnaire. After the data were collected, they were entered into a computer and analyzed using SPSS -16 for windows. P-Value of < 0.05 was taken to be statistically significant.

Results

The prevalence rate of Hepatitis B Virus, Hepatitis C Virus, Human Immunodeficiency Virus and syphilis infection were 2.1%, 0.2%, 2.1% and 0.7%, respectively. Sex and age had statistically significant association with Human Immunodeficiency and Hepatitis B virus infections where females were less likely to be infected. As age increases above 20 years, the risk of infection with Human Immunodeficiency Virus or Hepatitis B Virus increases. There was no association between Hepatitis B Virus, Hepatitis C Virus and Human Immunodeficiency Virus.

Conclusion

the prevalence rate of Hepatitis B Virus, Hepatitis C Virus and Human Immunodeficiency Virus infections among blood donors in Jimma University specialized hospital were lower as compared to previous studies, in addition there was no association between Hepatitis B Virus, Hepatitis C Virus and Human Immunodeficiency Virus. Thus, community based study should be conducted to confirm the relationship of Hepatitis B Virus, Hepatitis C Virus and Human Immunodeficiency Virus.     

上海市长江路社区1994～2008年乙型病毒性肝炎疫情监测分析

目的分析近15年来长江路社区乙型病毒性肝炎的疫情,为完善防制措施提供依据。方法对长江路社区1994～2008年乙型病毒性肝炎疫情资料进行统计分析。结果 1994～2008年,长江路社区共报告乙肝病例134例,年平均发病率为15.60/105,男性发病率高于女性;复发年龄以30～59岁年龄组为主,占复发总数的75.88%;急性病毒性肝炎发病率呈总体下降趋势,但乙肝发病率占急性肝炎发病总数的比例逐年增高,且复发率、罹患率均呈上升趋势。结论男性、30～59岁年龄组为乙肝复发重点人群。应采取综合防制措施,加大宣传力度,对高危人群进行早期筛查及进行乙肝疫苗接种;对已报告的乙肝病人定期家访,督促其定期复查,进行正规的抗病毒治疗;动员其家属及时进行乙肝筛查及疫苗接种。     

湖州市病毒性肝炎血清流行病学调查

目的了解湖州市自然人群病毒性肝炎感染情况与流行病学特征。方法在湖州市按农村山区、平原水乡、城镇,随机抽取1 666名健康人为研究对象,用酶联免疫吸附试验检测血清甲型肝炎(甲肝)病毒抗体(抗-HAV)、乙型肝炎(乙肝)病毒表面抗原(HBsAg)、乙肝病毒表面抗体(抗-HBs)、乙肝病毒核心抗体(抗-HBc)、乙肝病毒e抗原(HBeAg)、乙肝病毒e抗体(抗-HBe)、丙型肝炎(丙肝)病毒抗体(抗-HCV)、戊型肝炎(戊肝)病毒抗体(抗-HEV),同时调查相关危险因素。结果湖州市自然人群的HAV、乙肝病毒(HBV)、HEV标化流行率分别为53.93%、36.47%、38.88%,抗-HCV阳性2例,未发现丁型肝炎病毒(HDV)感染者;HAV流行率与年龄呈正相关(r=0.944),城镇、平原水乡HAV流行率的差异有非常显著的统计学意义(P<0.01);HBV流行率<10岁儿童最低,为4.93%;HBsAg携带率为4.14%,<10岁儿童携带率为0;人群HBV标志物存在11种不同组合模式。HEV流行率随年龄增长而逐渐升高(r=0.993),城镇和平原水乡与山区HEV流行率的差异有非常显著的统计学意义(P<0.001),且存在家庭聚集性现象。结论湖州市病毒性肝炎主要流行型别为甲、乙、戊型,流行病学特征各不相同;HEV流行率较高,HBV流行率较低,HCV流行率低,未发现HDV感染者;HBsAg携带率低;乙肝疫苗接种效果明显。     

中国乙型肝炎疫苗免疫策略及新生儿以外人群接种乙型肝炎疫苗的可行性分析

中国是乙型肝炎(乙肝)病毒(Hepatitis B Virus,HBV)高感染率国家,实施国家乙肝疫苗(Hepatilis B Vac-cine,HepB)预防接种后,乙肝病毒表面抗原(HBsAg)携带率在免疫人群中显著下降,控制乙肝取得显著成就.然而,要进一步降低HBV的感染率,需不断完善国家的免疫策略,在落实新生儿HepB免疫规划的基础上,将HepB预防接种向儿童和成人高危人群扩大.     

Seroprevalence of hepatitis B and C virus in two institutions caring for mentally handicapped adults.

Hepatitis B virus infection is common in institutions caring for the mentally handicapped. Hepatitis B virus and hepatitis C virus share routes of transmission but the prevalence of hepatitis C virus infection in this population is unknown. We have tested 101 patients from two institutions in South-East England caring for adults with mental handicap for the presence of hepatitis C antibody, hepatitis B core antibody, and if necessary hepatitis B surface antigen. None tested positive for hepatitis C antibody, but 43 had hepatitis B core antibody of whom 14 were chronic carriers positive for hepatitis B surface antigen. Unlike hepatitis B virus, hepatitis C virus infection appears to be uncommon in UK institutions.