734例急性病毒性肝炎的病原学分析研究

目的研究急性病毒性肝炎病原学的特征,制定科学的预防措施。方法对2004年1月～2008年12月收治的734例急性病毒性肝炎患者,进行血清病原学分型及流行病学研究。结果 734例中,甲、乙、丙、戊型病毒性肝炎分别占15.7%、17.0%、2.4%和35.2%,未分型者占29.7%;发病年龄主要集中在30～69岁,占67.4%,甲型肝炎15～49岁为发病高峰期占62.7%,乙型肝炎发病年龄集中在15～69岁占96.0%,丙型肝炎发病年龄在15～69岁占94.5%,戊型肝炎30～69岁为疾病高发年龄段占61.3%,未分型年龄集中在50～69岁,占74.3%;男性患者519例,女性患者215例,男女性患者之比为2.4∶1,每年1～2季度为发病的高峰季节,分别占27.6%和36.4%;临床分型中急性黄疸型肝炎453例(61.7%),急性无黄疸型肝炎264例(36.0%),重型肝炎17例(2.3%)。结论急性病毒性肝炎以戊型和未分型肝炎类型为常见,急性黄疸型肝炎是主要的临床类型;注意个人卫生及改善卫生条件有助于预防甲型肝炎和戊型肝炎传播,接种甲型肝炎和乙型肝炎疫苗是有效的预防措施。     

烟台市市区2001年病毒性肝炎病人资料分析

[目的 ]探讨烟台市市区病毒性肝炎流行趋势 ,为肝炎防治提供科学依据。 [方法 ]对 2 0 0 1年市区肝炎病例疫情报告、实验室病原学检测、调查资料进行统计分析。 [结果 ] 2 0 0 1年报告病毒性肝炎 1 369例 ,占报告传染病病人总数的68.0 8% ;甲肝占肝炎总数的 46.97% ,发病高峰在 4～ 6月 ,2 0～ 2 9岁占 46.1 9% ;82 1例住院肝炎病人中 ,甲肝占57.0 0 %。 [结论 ]应以青壮年、流动人口为病毒性肝炎预防工作的重点人群 ,加强以甲肝疫苗与乙肝疫苗接种为重点的综合性防治措施 ,进一步降低肝炎的发病率     

161例病毒性肝炎病原学和传染病报告分析

目的了解农村地区的病毒性肝炎分型构成及基层单位病毒性肝炎诊断和传染病报告现状。方法选择2000年北京某郊区医院医生诊断的161例“急性病毒性肝炎”病人,ELISA测定病毒性肝炎血清感染标志,套式聚合酶链反应检测ELISA未能分型肝炎的HBVDNA和HCVDNA,并进行流行病学调查,收集传染病报告资料。结果急性甲肝、急性乙肝、急性丙肝、急性戊肝和慢性乙肝急性发作分别占7·5%(12/161)、19·3%(31/161)、5·6%(9/161)、13·0%(21/161)和44·1%(71/161),未分型占10·6%(17/161)。基层医生病原学分型比例为42·86%(69/161),其中分型正确率30·44%(21/69)。传染病报告率39·1%(63/161)。结论乙肝是当地病毒性肝炎防治重点,基层单位对病毒性肝炎的诊断能力及其传染病报告率均较低。     

2000-2006年福州市传染病院急性病毒性肝炎流行病学分析

[目的]了解2000—2006年福州市传染病医院收治的急性病毒性肝炎流行特征,总结防治经验。[方法]回顾性统计2000—2006年急性病毒性肝炎病例,数据用Excel整理与分析。[结果]报告急性病毒性肝炎2 887例;病毒分型为甲、乙、戊和病因未明型肝炎,分别占14.8%、25.0%、35.3%和22.2%;甲、戊肝在3~6月份呈高发性;甲、乙、戊型肝炎男性发病率高于女性;甲、戊和病因未明型肝炎发病年龄分别集中在21~39、30~59和20~59岁,乙肝年龄分布较均衡;地域以福州市为首的5区8县沿海地区为主;混合型肝炎主要以乙、戊肝为主。[结论]急性病毒性肝炎是福州地区主要的传染病之一,应根据其流行特征进行综合治理以减少急性病毒性肝炎的传播。     

解放军某部人群1993～2000年甲型肝炎发病特征分析

[目的 ]摸清部队人群病毒性肝炎与甲型肝炎实际发病水平及流行病学特征 ,为部队肝炎防治提供科学依据。[方法 ]以整群抽样方式抽取某部为观察对象 ,收集病毒性肝炎相关资料 ,采集血清标本用ELISA法检测肝炎病毒感染指标。 [结果 ] 1 993～ 2 0 0 0年某部肝炎发病率为 0 81‰ ;甲型肝炎发病率为 0 1 9‰ ,呈逐年下降趋势 ,在肝炎病例中甲肝占 36 36 %～ 7 69%。干部肝炎发病率 (1 63‰ )明显高于战士 (0 90‰ ) ,而战士甲肝发病率 (0 2 1‰ )高于干部(0 1 8‰ )。肝炎疫情以散发形式为主 ,肝炎与甲肝 2～ 4月发病数分别占全年的 51 54 %和 51 85 %。甲肝疫苗接种后36个月接种组抗 HAV阳性率仍高于未接种组。 [结论 ]肝炎严重危害部队人群的健康 ,应针对易感者进行甲肝疫苗接种 ,以进一步降低肝炎的发病率     

2004～2009年巴马县病毒性肝炎疫情分析

[目的]探讨巴马县病毒性肝炎的流行情况,为制定控制措施提供依据。[方法]对2004~2009年巴马县病毒性肝炎疫情资料进行分析。[结果]2004~2009年合计报告肝炎病例1 315例,年均发病率为86.77/10万,死亡1例,平均病死率为0.076%。肝炎发病率,2004年为32.75/10万,2005年为56.69/10万,2006年为92.67/10万,2007年为93.54/10万,2008年为101.46/10万,2009年为138.02/10万。年均发病率(/10万),甲肝为2.38,乙肝为75.94,丙肝为7.26,戊肝为0.20,未分型肝炎为0.99;男性为732,女性为583;0~14岁为104,15~34岁为652,35~54岁为388,55~74岁为155,≥75岁为16。年均发病率最高的为巴马镇、甲篆乡、东山乡、凤凰乡、燕洞乡。1 315例肝炎病例中,农民占69.89%,学生占7.22%,流动人口占1.29%。甲肝2、3、9、10月发病较多,乙肝主要在7~12月发病,丙肝高发在2~4月和8~9月,肝炎合计发病高峰在3~4月和7~12月。[结论]巴马县病毒性肝炎发病率逐年增高。     

32例妊娠期病毒性肝炎预后分析

我科1990～1995年收治妊娠期病毒性肝炎患者32例,按1990年(上海)全国病毒性肝炎学术会议修订的诊断标准分型,其中急性黄疸型26例,重型4例(急性及亚急性各2例).慢性活动型2例;甲肝10例.乙肝16例,丙肝4例,戊肝2例.     

谈谈重型肝炎

重型肝炎是指病毒性肝炎临床分型中的重型。按1990年5月上海第六次全国病毒性肝炎会议拟定的《病毒性肝炎防治方案》中诊断标准,重型肝炎分三个型:急性重型、亚急性重型及慢性重型。急性重型是指急性黄疸型肝炎起病后10天以内迅速出现肝性脑病而排除其他病因者,患者肝脏进行性缩小,黄疸逐日加深,肝功能严重损害;亚急性重型是指急性黄疸型肝炎起病10天以上8周以内出现上述症状体征者;慢性重型是指临床表现同亚急性重型肝炎,但既往有慢性活将病感染分可过变临床肝脏细胞的病     

9380例病毒性肝炎流行病学统计分析

[目的]分析江油市病毒性肝炎发病特征,为制订病毒性肝炎预防与控制措施提供依据.[方法]对江油市2004～2008年病毒性肝炎进行描述性分析.[结果]2004～2008年江油市共报告病毒性肝炎9 380例.总发病率213.20/10万.发病率呈逐年上升趋势,各年间病毒性肝炎发病率有差异(x2=1 700.34,P<0.01).型别以乙型肝炎为主(8 838例),占94.22%;季节以6～8月发病较高,占48.30%(4 052/9 380);发病年龄最小10个月,最大83岁,以青壮年(15～59岁)为主(7 833例),占83.51%;职业以农民为主(5 145例),占54.85%;男性发病多于女性,男女比为1.86:1.[结论]有计划地在重点人群中开展甲肝、乙肝疫苗的普种等综合防治措施是控制甲肝、乙肝暴发和流行的有效措施.     

上海市杨浦区2005—2007年病毒性肝炎流行病学分析

[目的]分析上海市杨浦区急性病毒性肝炎(急性肝炎)的流行特征,为完善肝炎防治策略和措施提供依据。[方法]对2005—2007年杨浦区网络直报的急性肝炎疫情、病原学分型及专题调查资料进行分析。[结果]2005—2007年杨浦区急性肝炎年均发病率为12.17/10万,其中常住人口年均发病率为11.79/10万,外来人口年均发病率为15.05/10万;五角场和殷行社区发病率最高,年均发病率分别为24.35/10万、23.50/10万;病原学分型显示,网络直报肝炎病例中乙肝比例较低,未定型肝炎比例较高。[结论]2005—2007年杨浦区急性肝炎发病率呈下降趋势,网络直报乙肝病例不全是急性乙肝病例;未定型病例多,主要由误诊、误报、分型信息未及时订正和疾控中心未及时对监测点医院分型情况进行督导等原因引起。     

Non-A, non-B viral hepatitis in Egypt.

A study was carried out on 200 patients of ages 20-40 years suffering from acute viral hepatitis. Sera were tested for markers of hepatitis B (HBsAg, and IgM anti-HBc) and hepatitis A (IgM-anti-HAV) by the ELISA technique. Sera negative for the markers of both viruses: Hepatitis A (HAV) and Hepatitis B (HBV) were subsequently tested for IGM Heterophil antibodies against Epstein-Barr virus (EBV) by the Monospot slide test to diagnose acute infectious mononucleosis and tested for anti-CMV (IgM) by ELISA technique for the diagnosis of acute Cytomegalovirus (CMV) infection. Non-A, non-B hepatitis (NANB) was diagnosed by exclusion. The results of the study showed that 133 (66.5%) patients had evidence of HBV infection, while only 9(4.5%) were diagnosed as HAV infection. EBV and CMV were the possible etiological agents of acute viral hepatitis in (3.5%) and 1%) respectively. Accordingly the Non-A, non-B hepatitis in this study amounts to (24.5%) of the acute viral hepatitis.     

Viral hepatitis in a Canadian street-involved population

BACKGROUND: Data on the prevalence and compliance with management of viral hepatitis in the street-involved population are limited. METHOD: Hepatitis A (HAV), B (HBV) and C (HCV) serology and compliance with HBV vaccination were documented in 533 street-involved individuals. RESULTS: The mean age of the study population was 25.7 years (range: 11-65) and 53% were female. Serologic evidence of HAV infection was present in 53%; HBV, 12% (3% ongoing infection); and HCV, 17%. HAV infections were associated with Aboriginal/Metis ethnicity and age over 25 years; HBV with injection drug use (IDU); and HCV with IDU, sex trade work and age over 25 years. Compliance with three-step HBV vaccination was 98%, 77% and 63%. CONCLUSIONS: HAV, HBV and HCV are common infections in urban street-involved persons. Successful HBV (and presumably HAV) vaccination can be achieved in the majority of this population, but concerns exist regarding compliance with more long-term, parenterally-based antiviral therapies.     

病毒性肝炎感染血清流行病学研究

报道了西昌市自然人群中病毒性肝炎感染流行状况和趋势。总感染率为９１．１６％，ＨＡＶ感染率８２．７３％，ＨＢＶ感染率４１．３７％，ＨＣＶ感染率１．６１％，ＨＥＶ感染率１４．０６％；未发现ＨＤＶ感染。各型肝炎病毒感染单一型占感染人数的５５．９５％，重叠感染占感染人数的９．２５％，混合染二型占感染人数的２５．８３％、三型占感染的人数的９．２５％。     

厦门市区居民五型病毒性肝炎流行特征

按照全国五型病毒性肝炎血清流行病学调查方案，我市于１９９２年在居民中进行调查，以家庭为单位整群抽样，将１－５９岁居民作为调查对象，共采血样４０３份，共１８０户。各型肝炎总感染率为：ＨＡＶ６８．４９％ＨＶＢ７５．４３％、ＨＣＶ４．２２％、ＨＤＶ５０％、ＨＥＶ２０．６０％，ＨＢｓＡｇ阳性率１１．１７％、抗－ＨＢｃ５７．５７％、抗－ＨＢｓ４１．９４％、ＨＢｅＡｇ１．９９％。调查提示市区居民病毒性肝炎血清     

Viral hepatitis in South African healthcare workers at increased risk of occupational exposure to blood-borne viruses

The prevalence of hepatitis A, B and C antibodies was measured in a group of healthcare workers (HCWs) at increased risk of occupational acquisition of blood-borne viruses (N=402) from a large, urban referral hospital in South Africa. The aims of this study were to determine the immunity of HCWs to these agents and to recommend policy for the protection of HCWs against occupational exposure to viral hepatitis in this country. Race, sex and age were shown to be important factors influencing the presence of hepatitis A (HAV) antibodies. Most black HCWs (96.2%) are protected from HAV infection. Females have significantly higher HAV antibodies compared with males and antibodies increase with increasing age. Hepatitis B antibodies (anti-HBs) were found in 30.6% of HCWs. Anti-HBs levels were significantly associated with a past history of HBV vaccination. However, only a small proportion of HCWs (21.2%) could remember ever being immunized against HBV. For those individuals that did receive HBV vaccination (N=83), the mean number of years since their last vaccine was 6.2 years (SD +/- 3.5). HCV antibodies were found in 1.8% of HCWs at increased risk of occupational exposure. It was not possible to define whether these infections were occupationally acquired but genotyping of the HCV (in two of seven cases) showed genotype 5, the predominant South African genotype. New recommendations for the prevention of viral hepatitis in HCWs in South Africa are made, including pre-employment screening for HAV based on self-selection criteria, universal anti-HBs screening with HBV booster vaccination. HCV recommendations are based on appropriate education of HCWs about this infection and its prevention and a standardized post-exposure testing protocol.     

3家大型建筑工地外来民工病毒性肝炎血清学调查

[目的]了解上海市杨浦区建筑工地外来民工病毒性肝炎感染状况。[方法]选择大型建筑工地3家,对所有的外来民工781人收集血标本,采用酶联免疫法(ELISA)检测抗-HAV IgG、抗-HEV IgG、HBsAg、抗-HBs、抗-HBc;对表面抗原阳性的血标本进一步检测HBeAg。[结果]781人中抗-HAV IgG阳性率为72.86%,高于本市居民61.40%的水平,抗-HEV IgG阳性率为3.33%。HBV感染率为55.31%,其中HBsAg阳性率(7.94%)和抗-HBc阳性率(24.58%)高于本市居民的3.94%和7.89%,抗-HBs阳性率为41.74%;HBsAg阳性合并抗-HBc阳性率为7.55%,HBsAg和HBeAg双阳性感染率为2.18%。各型肝炎病毒存在混合重叠感染,占27.14%,其中HBV混合感染HAV、HEV及HAV和HEV的分别占24.32%、0.64%和1.15%,HAV和HEV重叠感染占1.02%。[结论]外来民工存在水平不等的HAV、HEV、HBV感染,其中HAV和HBV感染率处于较高水平,相关部门应制定外来民工健康体检制度。     

Hepatitis A and B among young persons who inject drugs—Vaccination,past, and present infection

BackgroundOur study aims were to assess hepatitis A virus (HAV) and hepatitis B virus (HBV) susceptibility and infection among young persons who inject drugs (PWID) who may have been vaccinated as children and to evaluate self-report of HAV and HBV vaccination.MethodsWe recruited PWID aged 18–40 years-old in San Diego during 2009 and 2010 and collected demographic, socioeconomic, health, and behavioral factors. Participants were asked if they had been vaccinated against HAV and HBV, and serum samples were collected for HAV and HBV serologic testing.ResultsOf 519 participants, 365 (72%) were male, 252 (49%) were white non-Hispanic, 38 (7%) were Black non-Hispanic, 138 (27%) were White Hispanic, and 22 (4%) were born outside the U. S. Of the total participants, 245 (47%) had surface hepatitis B antibody (anti-HBs) titers <10 mIU/ml (i.e., HBV susceptible) and 325 (63%) had no detectable HAV antibodies (HAV susceptible). Hepatitis B surface antigen was detected in 7 (1%) of total participants; and 135 (26%) were anti-HCV-antibody positive. Compared to serologic findings, self-report of HBV and HAV vaccination was 71% and 41% sensitive, and 58% and 73% specific, respectively.ConclusionHAV and HBV antibodies in half or more of this young PWID population did not have levels indicative of protection, and about a quarter had HCV infection, putting them at risk for complications resulting from co-infection with HAV or HBV. Programs serving this population should vaccinate PWIDs against HAV and HBV and not rely on self-report of vaccination.     

江苏省沭阳县中小学生乙肝疫苗接种率与HBV感染率调查

目的为了解中小学生乙肝疫苗接种率及乙肝病毒（HBV）感染水平,探讨乙肝疫苗的免疫效果及持久性,为制定其他人群乙肝防制措施提供依据。方法调查分析江苏省沭阳县中小学生乙肝疫苗免疫史及检测其HBV血清标志物,并比较二者关系。结果乙肝疫苗接种率为84．79％,加强接种率为41．60％,未种率为1．66％,年龄越低接种率越高;HBSAg阳性率为2．67％,随年龄增长而增高;抗-HBs阳性率为55．66％,随年龄增长而下降;HBsAg阳性率与接种针次成反比,抗-HBs阳性率与接种针次成正比。结论接种乙肝疫苗是控制HBV感染的有效手段,在提高初免接种率的同时,应定期开展加强接种。     

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。