乙型肝炎病毒宫内感染的分子流行病学研究

目的为了掌握乙型肝炎病毒宫内感染的发生率和危险因素,探讨HBV相关抗体在胎儿体内产生的作用。方法用ELISA法筛选出HBsAg阳性孕妇及引产胎儿153例 ,HBsAg阴性孕妇及胎儿65例 ,共218例。然后用多聚酶链技术对孕妇 -引产胎儿HBV宫内感染进行检测。结果HBsAg阳性孕妇HBVDNA宫内感染率为53.59 %(82/153) ,HBsAg阴性孕妇静脉血中6.15%(4/65)检出HBVDNA阳性 ,两者相比有显著性差异 (P<0.01) ;母亲血中HBsAg、HBeAg、抗 -HBc同时阳性其相应胎儿HBVDNA感染率为92.5%(74/80) ,46例抗 -HBs阳性的胎儿血有5例检出HBVDNA阳性。结论HBV宫内感染率较高 ,HBsAg阴性孕妇也可能发生HBV宫内感染 ,应引起人们的重视     

结核病患者HIV、梅毒及HBV感染状况调查

[目的]调查了解结核病患者中人类免疫缺陷病毒(HIV)、梅毒及乙型肝炎病毒(HBV)感染的状况。[方法]采用酶联免疫吸附试验(ELISA)检测结核病患者血清HIV抗体、梅毒螺旋体(TP)抗体及乙肝表面抗原(HBsAg)。若抗-HIV为阳性按要求复检和送省疾控中心确诊;TP抗体阳性血清作TPPA以确定梅毒感染,并作TRUST检测;HBsAg阳性者再作乙肝病毒标志物(HBVM)5项检查。[结果]共检测了313例结核病患者,未发现抗-HIV阳性者;检出TP抗体阳性8例,经TPPA确定为梅毒感染者7例(2.24%),其中TRUST阴性1例,6例阳性,滴度分别为1︰1～1︰8;HBsAg阳性17例(5.43%),共检出3种HBVM感染模式。[结论]结核病患者中梅毒感染较高,HBV感染不容忽视,同时也应加强HIV感染的监测。     

江西省乙型肝炎病毒表面抗原阳性孕产妇感染模式及其新生儿乙型肝炎疫苗接种调查

目的了解江西省乙型肝炎病毒(HBV)表面抗原(HBsAg)阳性孕产妇HBV感染模式及其新生儿乙型肝炎疫苗(HepB)接种率。方法选取2018年1-11月在江西省2个县医疗机构住院分娩的HBsAg阳性孕产妇及其新生儿,检测孕产妇血清HBsAg、抗HBsAg抗体(HBsAb)、HBV e抗原(HBeAg)、抗HBeAg抗体(HBeAb)和抗HBV核心抗原抗体(HBcAb),调查新生儿首剂HepB(HepB1)、HepB1及时(HepB1t)、HepB全程(HepB1-3)和乙肝免疫球蛋白(HBIG)接种率。结果共纳入1 427对HBsAg阳性孕产妇及其新生儿。孕产妇HBV感染模式有11种,其中小三阳(HBsAg+HBeAb+HBcAb)孕产妇占60.76%,大三阳(HBsAg+HBeAg+HBcAb)孕产妇占13.74%。新生儿出生后HepB1、HepB1t、HepB1+HBIG、HepB1-3接种率分别为99.86%、99.09%、99.65%、99.16%;新生儿HepB1未及时接种原因主要是早产/低出生体重(46.15%,6/13)。结论江西省HBsAg阳性孕产妇以传染性较强的HBV感染模式为主,新生儿HepB1t接种率高。需加强育龄妇女HBV感染重点人群的管理,规范早产/低体重儿的HepB接种。     

阜阳市人群HBV感染的血清流行病学调查

目的了解某地自然人群乙型肝炎病毒(HBV)感染情况。方法调查2005年3-12月在某疾病预防控制中心进行健康体检人群的HBV血清标志物检测结果。HBV血清标志物检测采用酶联免疫吸附试验。结果单纯检测乙型肝炎表面抗原(HBsAg)的2 802人中,阳性255人,阳性率9.10%;各年龄组人群以31~40岁组HBsAg阳性率最高,占12.16%(71/584)。1 907例检测HBV5项血清标志物者中,HBsAg阳性者238例(12.48%),以HBsAg阳性合并抗HBe、抗HBc阳性为主(44.96%),HBsAg阳性合并HBeAg、抗HBc阳性次之(38.24%);5项全阴性者占总人群的46.88%。结论该地区自然人群HBV感染水平较高,近一半人没有保护性抗体,应加强健康宣教,推广普及乙肝疫苗的接种,改善环境卫生。     

2006年盐城市盐都区部分2～10岁儿童乙型肝炎病毒感染状况调查

[目的]了解2～10岁儿童乙型肝炎病毒(HBV)感染状况、感染原因及将乙肝疫苗纳入计划免疫管理后的效果.[方法]2006年4～6月,对盐城市盐都区4个乡镇1 646名2～10岁儿童进行HBV感染情况血清学调查,并对乙肝病毒表面抗原(HBsAg)阳性儿童检测与其父母的DNA同源性.[结果]调查1 646名儿童,HBsAg阳性率为0.67%,乙肝病毒表面抗体(抗-HBs)阳性率为72.66%.乙肝病毒核心抗体(抗-HBc)阳性率为2.19%.抗一HBs阳性率·2～10岁为69.68%～75.41%(P>O.05).11名HBsAg阳性儿童中.8名接种过乙肝疫苗,DNA序列同源性分析,7名感染来自母亲,1名感染来自父亲.[结论]盐都区2～1O岁儿童HBV感染率较低,保护性抗体各年龄段均无下降趋势;HBsAg阳性儿童的感染多来源于垂直感染.     

济宁市金融系统员工HBV感染血清流行病学调查

[目的]了解济宁市金融行业人员HBV感染状况。[方法]选择金融系统健康体检者590名,用ELISA法检测HBsAg、抗-HBs、HBeAg、抗-HBe、抗-HBc 5项指标。[结果]HBV感染率52.2%,HBsAg携带率12.0%,男女感染情况类似(P>0.05)。HBV感染率50~60岁组高于40~49岁组(2=6.12,P<0.05)。感染模式有7种,以抗-HBs和抗-HBc、抗-HBc、HBsAg与抗-HBe和抗-HBc阳性模式多见,分别占60.4%、24.7%和8.4%。抗-HBs总阳性占总检人数50.5%,单项抗-HBs阳性占总检出人数占17.9%。[结论]①HBV感染在自然人群中男女类似;②本组人群具有较高的抗体保护水平;③HBV感染率随年龄增长呈升高趋势。     

住院肿瘤患者HBV、HCV、HIV、梅毒抗体检测结果分析及意义

目的 了解住院肿瘤患者乙肝病毒(HBV)、丙肝病毒(HCV)、艾滋病病毒(HIV)和梅毒的感染情况及乙型肝炎表面抗体(HBsAb)水平.方法 对13 471例住院肿瘤患者的血清,用时间分辨荧光免疫分析技术(TRFIA)定量检测乙肝两对半(HBsAg、HBsAb、HBeAg、HBeAb、HBcAb);用酶联免疫吸附法(ELISA)定性检测丙肝抗体(抗-HCV)、抗艾滋病抗体(抗-HIV)、梅毒螺旋体抗体(抗-TP).结果 HBsAg阳性率为15.22%,抗-HCV阳性率为1.69%,抗一TP阳性率为3.27%,抗-HIV阳性率为0.07%,该4项检测共检出2 730例阳性,总阳性检出率为20.26%;HBsAb含量在0～10 mIU/ml的患者为51.68%,含量在10～100 mIU/ml的患者为27.37%,含量大于100 mIU/ml的患者为20.95%.结论 检测住院肿瘤患者血液传染性相关指标,了解住院肿瘤患者的感染情况,对预防医源性感染,减少医患纠纷,防止医务人员因职业暴露而感染相关传染病,加强医务人员的自我保护意识有重要意义;住院肿瘤患者HBsAb含量偏低,不能有效抵抗HBV感染,应采取相应措施,提高免疫力,有效预防HBV感染.     

丙型肝炎病人HBV重叠感染的血清学分析

目的:探讨丙型肝炎HBV重叠感染的血清状况。方法:用RtPCR及ELISA测定方法,对110例丙型肝炎病人血清进行HCVRNA及抗-HCV检测,并用ELISA方法与对照组一同进行抗-HCV、HBsAg、抗-HBc、HBeAg检测。结果:丙型肝炎的HBV重叠感染率为78.18%(86/110)和正常人群的HBV感染率24.60%(33/125)相比,P<0.001,OR(观测率)值为9.99,ARP为90%;丙型肝炎的HBV重叠感染和单一HCV感染的抗-HCV水平(S/Co比值)均值比,P<0.20,差异无显著性;HBV和HCV重叠感染其HBeAg感染率很低,和正常人群相比差异无显著性,P>0.05。而且,HBeAg的(S/Co比值)均值比差异也无显著性,P>0.05。结论:丙型肝炎病人极易重叠感染HBV;丙型肝炎病人抗-HCV抗体水平较低,重叠感染后其HCV抗体水平不受影响;HCV与HBV重叠感染干扰抑制HBV的复制。     

吉首市2013年人群乙型肝炎血清学标志物检测结果分析

目的了解吉首市人群乙型肝炎( 乙肝) 病毒( HBV) 感染现状,评价乙肝疫苗免疫策略的效果。方法采用多阶段随机抽样方法,对吉首市1078名1~ 59岁人群血清,用酶联免疫吸附测定法（ELISA）检测乙肝表面抗原( HBsAg) 、乙肝表面抗体(抗-HBs)和乙肝核心抗体(抗-HBc),比较不同年龄、性别人群指标变化。结果吉首市2013年1~ 59岁人群HBsAg阳性率、抗-Hbs阳性率、抗-HBc阳性率和HBV 感染率经标化后分别为6.14%、54.6%、11.68% 和12%。1~ 14岁人群HBsAg 阳性率和HBV感染率明显低于15~ 59岁人群。HBsAg 阳性率和HBV感染率：男性高于女性。结论吉首市为乙肝中流行区;乙肝疫苗纳入儿童免疫策略效果显著;要进一步加强对20~59岁组青壮年人群的乙肝干预措施。     

患者输血或介入性检查前4种病原体检测

目的了解某院患者输血或介入性检查前乙型肝炎表面抗原(HBsAg)、丙型肝炎病毒抗体(抗 HCV)、梅毒螺旋体抗体(抗 TP)和人免疫缺陷病毒抗体(抗 HIV)的感染情况。方法对该院2010年1月-2013年1月临床各科收治的33 683 例拟输血及介入性检查前患者的上述4项感染指标进行检测。结果33 683例患者上述4项感染指标总阳性4 056例,阳性率为12.04%。其中HBsAg、抗 HCV、抗 TP和抗 HIV阳性率分别为8.94％(3 011例)、1.20％(405例)、1.86％（628例)和0.04％(12例)。32例患者合并感染乙型肝炎病毒（HBV）和HCV,1例抗HIV阳性的患者合并感染HBV和TP。结论患者血液传播性疾病感染率较高,术前检测有助于控制医院感染,减少纠纷。     

A seroepidemiological study of the prevalence of hepatitis B infections in a hyperendemic New Zealand community

The prevalence of hepatitis B surface antigen (HBsAg) and its antibody (anti-HBs) were studied in 93% of the population of the New Zealand township of Kawerau. Sera were collected from 7901 subjects over six months old, and 3318 (42%) had markers of hepatitis B virus (HBV) infections. Five hundred and nineteen (6.6%) were positive for HBsAg and 485 (96.4%) of 503 retested were confirmed as chronic carriers. HBsAg prevalence was 5.4% in the 0-4 years age group but only 1 of 66 children under one year old was positive suggesting that later cross infection, rather than perinatal transmission was the major factor responsible for the high pre-school carrier rate. Total HBV marker prevalence increased dramatically in early school years and peak marker prevalence was 67.7% in the 15-19 year age group. Prevalence of HBsAg was more than four times higher in non-europeans than in Europeans (Caucasians). Other factors significantly associated with hepatitis B virus marker prevalence in children were: number of years spent in Kawerau, which was associated with anti-HBs prevalence; and size of household, which was associated with HBsAg prevalence. Number of siblings was not a significant risk factor over and above the effect of size of household. Factors associated with marker prevalence in adults were: number of years spent in Kawerau, which was associated with anti-HBs; birth in the Northern half of the North Island, which was associated with both HBsAg and anti-HBs; size of household, which was more strongly associated with HBsAg prevalence; and amateur tattoos, which were associated with anti-HBs prevalence but not with HBsAg prevalence.     

HBV and HCV infection among non-European Union immigrants in North-East Italy.

The status of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection among non-European Union (non-EU) immigrants in North-East Italy was evaluated. Among the 1683 individuals tested the prevalence of HBsAg was 8.9% (150 subjects) and of HBV antibodies (anti-HBc with/without anti-HBs) was 38.9% (654 subjects). The distribution of HBV serological markers showed significant differences according to region of origin; the highest prevalence of infection (76.9%) and carriage (16.1%) was found in immigrants from sub-Saharan Africa. Among the 933 individuals screened for HCV infection, prevalence of antibody was much lower (0.9%) than that observed in the Italian general population (3.2-12.6%). The large number of HBV carriers among immigrants could increase the number of new adult infections due to life-style habits or professional risks in the host population. In contrast, the risk of HCV spread from non-EU immigrants is very low.     

The seroepidemiology of hepatitis A and B in a Japanese town.

Sera collected from 1,118 healthy children and adults aged between four years and 90 years during the period 1989 to 1990, were tested for serological markers of hepatitis A virus (HAV) [antibody to HAV (anti-HAV)] and hepatitis B virus (HBV) [hepatitis B surface antigen (HBsAg) and antibody to hepatitis B surface antigen (anti-HBsAb)]. The overall prevalence rates of anti-HAV, HBsAg, and anti-HBV were 20.2%, 0.36%, and 5.1%, respectively. No body was found to be positive for anti-HAV below 30 years of age but more than 70% of the adults aged 50 years or over were positive for anti-HAV. The level of exposure of HAV infection is declining in Japan and paradoxically at the same time a vast majority of people are becoming susceptible to more severe illness. The fall in prevalence of HBsAg possibly represents the positive impact of ongoing vaccination programs and other preventive measures against HBV.     

贵州少数民族人群乙肝流行率及流行模式分析

摘要:目的　了解贵州少数民族人群乙肝流行率及流行模式,为制定乙肝防治策略提供依据。方法　采用多阶段整群随机抽样方法,于2013年11-12月抽取贵州省3个少数民族自治州中的2个县8个村共1629名常住居民,进行问卷调查同时采集血样,用时间分辨免疫荧光法（TRFIA）检测血清中乙肝表面抗原（HBsAg）、乙肝表面抗体（HBsAb）、乙肝核心抗体（HBcAb）,分析乙肝流行模式。结果　1629名调查对象中,HBV 感染者825例,总感染率为 50.6%;共有 6种血清标志物模式组合,按照血清标志物模式分布特征将乙肝流行模式分为三类,其中以易感模式为主占45.9%、免疫模式占31.9%、感染模式占22.2%;不同民族、一起生活的人有无表面抗原阳性、不同婚姻状态、不同年龄、家庭HBV感染人数、是否接种乙肝疫苗、家庭人口数、是否饮酒、文化程度在3组流行模式间差异均有统计学意义（P＜0.05）;是否外出打工过、性别、是否共用牙刷、过去1年家庭总收入不同、是否吸烟在3组流行模式间差异均无统计学意义（P＞0.05）。结论　贵州少数民族人群乙肝流行模式以易感模式（3项全阴）为主,不同特征人群流行模式存在差异;易感模式流行的人群应加强免疫接种,提高该人群的乙肝特异性免疫力;对感染模式流行人群加强健康宣教,减少其乙肝的传播。     

HBV infection among pre-school children in naples (Italy) and the role of intrafamily contact

In the Neapolitan area the prevalence of adult HBsAg carriers ranges from 4-7%. Moreover, hepatitis B virus (HBV) is responsible for most of the chronic hepatitis cases in childhood. Since the chronic carrier state in our area is acquired by early horizontal contact, we investigated the prevalence of HBV infection among 207 pre-school children and of HBsAg carriers among their family members. None of the children was found to be HBsAg positive and 3.9% of them had anti-HBs. HBsAg was positive in 29 out of 892 (3.3%) of the family members. There was a clear age-related distribution of the carriers, their prevalence reaching 6.7% among the elderly members. On the whole, 19 out of the 207 index cases had at least one HBsAg carrier in their family. The results suggest that in our area a decline of HBV endemia may be under way and that early intrafamily contact is no more a common pathway in acquiring an HBsAg carrier state.     

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.     

Sero-epidemiology of hepatitis B infection in an urban paediatric population in Turkey

The hepatitis B virus (HBV) seroprevalence rate is known to be 25-60% in Turkey with the highest prevalence in the east and south-east. There are insufficient data on sero-epidemiology of HBV infection in children living in East Turkey. The objective of this study was to estimate the seroprevalence of HBV infection in 6-17 year olds living in the largest city in East Turkey, and to correlate the serological results with epidemiological data. A total of 1091 serum samples were tested for hepatititis B surface antigen (HBsAg), antibody to HBsAg (anti-HBs) and antibody to hepatitis B core antigen (anti-HBc) using a commercially available enzyme-linked immunosorbent assay. The overall seroprevalence rate was 9.7% and was correlated with age (P = 0.011). No statistical difference was detected between subjects with or without risk factors (P = 0.77). The seroprevalence of HBsAg was 1.8%, and it was higher in children with a low socio-economic status (P = 0.047). The educational status of the parents and sibling size did not affect the rate of total seroprevalence or HBsAg seroprevalence. Although we found that the HBV seroprevalence rate in East Turkey was not as high as reported previously, we emphasize the importance of screening children in order to identify asymptomatic patients in Turkey until HBV infection is entirely eradicated with vaccination programmes.     

万名学生乙型肝炎疫苗免疫后效果评价

为了解大学生乙型肝炎疫苗接种后 ,乙型肝炎病毒 (HBV)感染率、患病率的变化趋势 ,对 94级到 98级五届新生 1 2 0 2 2人 ,在入学时抽血检测肝功能及HBsAg ,并对符合接种要求者进行全部免疫接种 ,首针接种率为 95 3 % ,全程接种率为 91 9%。免疫后 (45个月 )采取整群随机抽样的原则 ,从五届学生中抽取完成全程接种的 8742人 ,再检测肝功能 (ALT)、HBsAg、抗 -HBc、抗 -HBs,将HBV感染率、患病率与免疫前进行对照。结果显示 ,免疫后HBV感染率呈逐年下降趋势 ,HBV感染率、患病率免疫前分别为 1 0 42 %、1 0 7% ,免疫后分别为 6 0 9%、0 39% ,免疫后低于免疫前 ,经统计学检验 ,有显著性差别。免疫后第 45个月抗 -HBs仍维持在 60 %左右 ,95 %的可信区间为 58 0 6 %～ 60 1 2 %。显示乙肝疫苗有良好的免疫效果 ,是降低乙肝感染率、患病率及控制乙肝流行的有效措施。     

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.     

Incidence of hepatitis B virus infection among an Italian military population: Evidence of low infection spread

In 1990, a prospective serological survey to estimate the rate of clinical and inapparent infection with hepatitis B virus was performed in a cohort of 1324 soldiers, 18–24 years old, during an eight month period in Italy. At the time of enrollment the prevalence of hepatitis B markers was 4.6% (0.7% subjects positive for hepatitis B surface antigen [HBsAg], 3.0% positive for antibody to hepatitis B surface antigen [anti-HBs], and 0.9% positive for antibody to hepatitis B core antigen [anti-HBc] alone. Among the 1263 susceptible subjects who were followed-up, only 2 (0.24/100 person-years of exposure) had seroconversion for HBV markers, none of which was associated with clinical illness. Among the 9 subjects HBsAg-positive at the time of enrollment, 1 (11.2%) had lost HBsAg at the end of follow-up. These data show a low spread of HBV infection among Italian young generations.