Passive immunoprophylaxis of hepatitis B virus infections in newborn infants

Newborn infants of mothers who were chronic carriers of hepatitis Bs antigen (HBsAg) were randomly allocated to be treated or not treated with hyperimmune hepatitis B immunoglobulin (HBIg) at birth and six weeks and were then followed up to one year with sequential blood tests. Ninety percent of all untreated infants born of mothers positive for both HBsAg and hepatitis Be antigen became chronic carriers of HBsAg at one year. In contrast only 9% of infants treated with HBIg became HBsAg positive. Mothers who were HBsAg positive but hepatitis Be antigen negative only uncommonly infected their infants, with 6% being HBsAg positive at one year. Nearly all infections were in Pacific Islanders, Maoris or Asians. It is recommended that antenatal testing of these groups most at risk for hepatitis B virus spread, be initiated, followed by passive immunoprophylaxis with HBIg of infants born of HBsAg, HBeAg positive mothers.     

A study of street heroin lots for the presence of the hepatitis B surface antigen

Hepatitis B surface antigen (HBsAg) of subtype ay predominates among narcotic addicts infected with hepatitis B virus (HBV) in Europe, Australia and the United States. However, the ad subtype predominates among the non-addict carriers of HBsAg. We investigated the possibility that heroin lots were contaminated with HBV at a source of opium production, the Middle East, a geographical region where HBsAg/ay predominates in the general population. One hundred and nine lots of street heroin were assayed for HBsAg by radioimmunoassay. None of the lots tested was reproduceably HBsAg positive. These results suggest that the heroin itself is not responsible for the high incidence of HBV infection or for the predominance of HBsAg/ ay in the addict population. The predominance of HBsAg/ay among addicts in Europe and Australia as well as the United States might be due to extensive needle sharing among a mobile population of drug abusers, although such worldwide dissemination of one subtype by these means is unlikely.     

194例海洛因依赖者乙、丙肝炎病毒感染情况

采用ELISA法检测验194例海洛因依赖者HCV ,HBsAg 的感染情况 ,结果显示海洛因依赖者HBsAg,HCV的感染率分别是23.2 %和33.5 % ,显著高于对照组。尤其是iv滥用者感染率更高。本文认为HBsAg 和HCV的高感染率与iv海洛因有明显关系。     

Relationship between HBV markers and heroin as a cause of liver injury in drug addicts

Fifty liver biopsies from heroin addicts on methadone maintenance were studied for histological features. The relationship between hepatic damage, HBV markers and the length of drug abuse was analysed. Infiltration was found in 95.6% of hepatitis B surface antigen (HBsAg) positive patients and in 50% of hepatitis B surface antibody (HBsAb) positive and HBV negative patients. The length of drug abuse showed a strong direct correlation with vacuolar degeneration (P less than 0.001) and an inverse correlation with fibrosis (P less than 0.05).     

249例海洛因依赖者感染HBV和HCV及肝功能分析

目的：调查分析郴州市海洛因依赖者中感染乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）及肝功能状况,了解吸毒人群经血传播疾病的危险因素,为这组人群的疾病预防控制提供科学依据。方法：用酶联免疫吸附试验（ELISA）分别检测249例海洛因依赖者的血清标志物即：HBsAg、抗-HCV,同时用全自动生化分析仪检测丙氨酸氨基转移酶（ALT）。结果：249例海洛因依赖者的HBsAg阳性率为18．88％、抗-HCV阳性率为73．9％、ALT异常率为37．8％。IDU组与nIDU组进行比较抗-HCV阳性率、ALT异常率差异有显著意义或极显著意义。结论：吸毒是HBV、HCV感染的高危险因素,静脉吸毒更是导致HCV高感染率的最主要因素,同时会导致肝功能异常。     

A histological and serological study of persistent hepatitis B antigenaemia

A population of persistent hepatitis B antigen positive persons was investigated in north Taranaki. Over a period of three years, 0.17 percent of blood donors and 7.7 percent of patients investigated for acute infection, possibly hepatitis, had a positive test for hepatitis B surface antigen (HBsAg). Repeat testing was performed at approximately four months in 65 persons and 18 (28 percent) remained positive and of these 15 were males. Liver biopsy in 17 of these patients revealed chronic persistent hepatitis in 30 percent, non-specific changes in 11 percent and in the remainder no significant abnormalities were found. There was no correlation of histology with a wide variety of hepatitis B serological markers. Forty-seven percent of the persistent carriers were Maoris and this group may be more susceptible to chronic hepatitis B infection. Long term follow up of HBsAg carriers is recommended to ascertain the prognosis of this condition.     

聚合酶链反应在慢性乙型肝炎病毒感染者中的实用意义

应用聚合酶链反应检测51例慢性肝炎,19例慢性HBsAg携带者(ASC)和26例HBV感染后的健康者血清中的HBV DNA。结果14例HBeAg阳性患者HBV DNA全部阳性,37例HBeAg阴性者中24例阳性(64.9％)。其中HBV·M阴性9例,有6例阳性。5例抗-HBs阳性者3例阳性。ASC和健康者PCR-HBV DNA检出率分别为36.8％和26.9％,明显低于慢性肝炎的74.5％。结果提示,慢性肝炎患者HBeAg阴性甚至HBV·M阴性时,往往大部分仍有HBV复制,且可能与病变活动有关。ASC和健康者总体病毒复制水平较低,可能与无明显的肝脏病表现有关。     

新生乙型肝炎疫苗接种者无应答调查分析

目的通过新生入学体检测HBsAg和HBs-Ab,了解学生携带乙型肝炎病毒的状态和乙型肝炎疫苗接种者无应答情况。方法用酶联免疫吸附试验(ELISA)测定入学新生人群的HBsAg和HBs-Ab。结果体检总人数为1178人,其中HBsAg阳性170人,占14.43%,HBs-Ab阴性人数为246,占20.88%,经调查接种后抗体阴性者仍然有144人,占16.04%。结论通过调查了解新生中HBsAg携带者和接种乙肝疫苗后无应答者,有助于学生和学校采取必要的措施,尽可能减少乙型肝炎病毒在校园内传播,对乙型肝炎疫苗接种无应答者提出合理的建议,让学生了解自己的免疫状态,以便采取进一步的补救措施。     

Hepatitis B surface antigen and antibody among Samoans living in Christchurch.

Ninety-six Western Samoan volunteers were examined for the presence of hepatitis B surface antigen (HBsAg) and antibody (anti-HBs). Seventy-two volunteers were full blooded Samoans and four were found to be asymptomatic carriers of HBsAg. No mixed blood volunteers had detectable HBsAg by either haemagglutination or radioimmunoassay techniques. Fifty of the 72 full blooded Samoans had anti-HBs detectable by radioimmunoassay. Eight of these reactions were only weakly positive. Seventeen of the 24 mixed blood volunteers had detectable anti-Hbs. All were Samoan born. This study suggests that Samoan born Somoans should provide a valuable source of anti-HBs if New Zealand preparation of this antibody is contemplated.     

海洛因依赖者丙肝病毒感染及其相关危险因素的调查与分析

目的··:了解海洛因依赖者丙型肝炎病毒(HCV)感染情况及其与相关危险因素的关系。方法·· :将198例海洛因依赖者的HCV检测结果与一般资料、临床特点、乙肝三系结果及肝功能检查结果通过Logistic回归模型进行回顾性分析、比较。结果·· :海洛因依赖者抗 -HCV阳性率为9.1 %。其阳性率与静脉注射(iv)海洛因、丙氨酸转氨酶(ALT)有显著的正相关性。结论··:iv海洛因依赖者可能是HCV感染的高危人群,HCV可能较HBV更易通过iv海洛因传染和引起ALT变化 ,HCV应是海洛因依赖者肝炎预防和医务人员保健的重点     

中小学生乙肝疫苗免疫接种效果观察

目的 了解中小学生乙肝病毒的携带状况和乙肝疫苗的免疫效果。方法 对商丘市渠园区、虞城县5740名中小学生调查接种史及检测HBsAg及抗-HBs。结果 乙肝疫苗的接种率为78．76％。接种乙肝疫苗学生的抗-HBs阳性率为74．96％,HBsAg阳性率为4．47％;未接种乙肝疫苗的学生抗-HBs阳性率为20．59％,HBsAg阳性率为20．42％。不同接种年限的HBsAg阳性率无差别。全市学生HBsAg阳性率为7．68％。结论 本市学生对乙肝疫苗应答良好,但仍需提高疫苗接种质量。     

Serum hepatitis B surface antigen levels in the natural history of chronic hepatitis B infection

BACKGROUND The production of hepatitis B surface antigen (HBsAg) may evolve during long-lasting virus-host interactions in chronic hepatitis B (CHB). The impact of age on HBsAg production remains unclear. AIM To determine the age-specific distribution patterns of HBsAg and related factors during the natural course of CHB infection. METHODS Seven hundred and sixty-eight untreated HBsAg carriers were enrolled in the study. The parameters and distribution patterns of HBsAg were evaluated in relation to age and immune phases. RESULTS The HBsAg levels were significantly lower in the HBeAg-negative stage, with the lowest levels in inactive carriers. The HBsAg tended to decrease from hepatitis to cirrhosis and to hepatocellular carcinoma, and from Child-Pugh class A to B and to C. Age and HBV DNA were independently associated with HBsAg levels. In HBeAg-positive patients, the HBsAg levels were distributed in a triphasic-like decline pattern by 2 logs across age strata. For HBeAg-negative patients, the titres in inactive carriers exhibited a 2-log reduction, but remained unchanged over age strata in patients with HBeAg-negative hepatitis. The ratios of HBsAg/HBV-DNA were highest, but steadily decreased with age in inactive carriers, whereas the levels remained largely unchanged over the entire age strata in patients with HBeAg-negative hepatitis. CONCLUSIONS Age and HBV DNA levels are independent parameters of HBsAg levels. During the natural course of CHB infection, HBsAg levels decrease with age and disease progression, but the patterns are significantly different between the immune phases of CHB. This information may contribute to our understanding of the immunopathogenesis of chronic hepatitis B and management involving HBsAg quantification.     

抗结核药物性肝炎与乙型肝炎病毒感染的相关性研究

目的探讨抗结核药物性肝炎与乙型肝炎病毒（HBV）感染的相关性，了解HBsAg阳性患者发生抗结核药物性肝炎的临床特点。方法观察81例抗结核药物性肝炎及其中14例急性、亚急性暴发型肝炎患者中HBsAg阳性率，比较HBsAg阳性和HBsAg阴性两组抗结核药物性肝炎患者的临床特点。结果在结核病化学治疗过程中出现肝功能损害的患者，HBsAg阳性者占48％（39／81）；急性、亚急性暴发型肝炎患者中，HBsAg阳性者占64％（9／14）。肝功能指标凝血酶原活动度（PTA）比较，HBsAg阳性组明显低于阴性组。结论HBV感染或携带者肝脏更易受到抗结核药物的损害，甚至可引发致死性肝衰竭。     

Epidemiological investigations on viral hepatitis in preschool and school communities. Note III. Sources of infection for HBsAg carriers and former viral hepatitis patients

HBsAg carriers and viral hepatitis B patients detected in preschool and school communities as well as members of their families were subjected to thorough epidemiological investigations. The source of infection was represented by the community in 33.3% of the preschool children and in 26.5% of the schoolchildren and by the family in 10% of the former and 29.4% of the latter.     

海洛因依赖者肝功能损害与各型肝炎病毒感染标志及其相关临床因素

目的··:了解海洛因依赖者肝功能损害与各型肝炎病毒感染标志及其它有关临床因素的相关关系。方法··:将198例海洛因依赖者肝功能丙氨酸转氨酶 (ALT)检查结果与各型肝炎病毒感染标志、梅毒检测的结果及临床特点通过Linear多因素回归模型进行回顾性分析、比较。结果··:海洛因依赖者ALT的变化与抗 -HCV、梅毒测定结果和HB sAg的阳性结果呈显著正相关 ,而与抗 -HBe的阳性结果呈显著负相关 ,而ALT的变化与抗 -HAV、HBeAg、抗 -HBc和抗 -HBs及临床特点未显示出显著的相关关系。结论··:海洛因依赖者ALT的高低依次取决于抗 -HCV、抗-HBe、梅毒测定结果和HBsAg,抗 -HCV是引起ALT变化的主要因素 ,其次是抗 -HBe。海洛因依赖者中HCV较HBV更易引起其ALT变化 ,对于抗 -HCV、抗 -HBe阳性的海洛因依赖者尤其应该注意其肝功能的损害。     

海洛因依赖者肝功能损害与各型肝炎病毒感染标志及其？…

目的：了解海洛因依赖者肝功能损害与各型肝炎病毒感染标志及其它有关临床因素的相关关系。方法：将１９８例海洛因依赖者肝功能丙氨酸转氨酶（ＡＬＴ）检查结果与各型肝炎病毒感染标志、梅毒检测的结果及临床特点通过Ｌｉｎｅａｒ多因素回归模型进行回顾性分析、比较。结果：海洛因依赖者ＬＡＴ的变化与抗－ＨＣＶ、梅毒测定结果和ＨＢ－ｓＡｇ的阳性结果呈显著正相关,而与抗－ＨＢｅ的阳性结果呈显著负相关,而ＡＬＴ的变化与抗－     

1516例海洛因依赖者HCV筛查结果及相关因素分析

目的：了解海洛因成瘾者接受美沙酮药维持治疗患者丙型肝炎病毒感染现状及特点,为制定相应的干预措施提供科学的依据。方法：对兰州市七里河美沙酮维持治疗门诊（MMT）2007年1月至2009年5月入组的1516名海洛因依赖者进行筛查,经采集静脉血检测抗-HCV抗体。结果：1516名吸毒者中,抗-HCV阳性率为19．5％。静脉注射吸毒者有317人,抗-HCV阳性率为59．9％,高于非静脉注射者的8．8％;有38人曾共用过注射器具,共用注射器具的感染率为39．5％,非共用注射器具的感染率为62．7％。结论：海洛因成瘾人群HCV感染率明显高于其他人群,相关危险行为突出。     

The association of hepatitis B viral infection and hepatocellular carcinoma in New Zealand

Eighty-eight patients presented to the Auckland hospitals with proven hepatocellular carcinoma between 1970 and 1981. The clinicopathological characteristics were analysed according to the racial and ethnic background of the patients. The cancer incidence for Auckland resident Polynesians (Pacific Islanders) was 5.8/100 000/year, that for the native Maori was 2.8/100 000/year and for the European was 0.6/100 000/year. The mean age in presentation of the hepatocellular carcinoma was 44, 49 and 63 years for Pacific Islanders, Maori and Europeans respectively. In general (non-tumorous) population, the hepatitis B surface antigen (HBSAg) carrier rate was 7.0% for the Pacific Islander and Maori and 0.5% for the Europeans. In the tumour patients where HBSAg were tested, 66% of Pacific Islanders, 100% of Maori and 0% of Europeans had positive antigenaemia. Histological sections were studied by orcein staining. Positive staining for viral particles were found mainly (80%) in hepatocytes of Pacific Island and/or Maori patients. These data indicated that within the same area, Pacific Islanders and Maori had a higher HBSAg carrier rate, higher incidence of hepatocellular carcinoma and presented at a younger age, and in the tumour-bearing patients had a higher incidence of HBSAg antigenaemia as well as viral particles in their liver.     

Liver disease in drug addicts: clinical course-toxicological and clinical pharmacological aspects.

Drug addicts admitted to the hospital had acute hepatitis in 44%, chronic hepatitis in 34%, toxic liver injury in 16%. About 50% of the patients with acute hepatitis were HAA positive. Patients with intravenous drug abuse acquired acute hepatitis after a mean period of 1.8 years. Acute hepatitis in drug addicts shows a prolonged course in the majority of the cases. Biochemically increases in serum bilirubin and transaminase levels are less pronounced as compared to non-addicted persons. 30-35% of the patients develop chronic hepatitis. Speed abuse promotes the tendency to cholestasis in acute episodes of liver disease. A toxic effect of the drug preparations upon the liver cells is assumed. Chronic hepatitis in drug addicts mainly develops from earlier acute hepatitis with prolonged course. In our material, the percentage of chronic hepatitis at present is 47.5%. Besides toxic effects, also repeated infections have to be discussed with regard the etiology and pathogenesis of the disease.