The prevalence of serological markers to hepatitis A and hepatitis B in drug abuse personnel

A seroepidemiologic survey was conducted in 25 clinical and 31 nonclinical personnel engaged in substance abuse research and treatment. The antibody to hepatitis A virus (anti-HAV) was identified in 16 percent of the clinical employees and 39 percent of the nonclinical personnel, for a total prevalence of 29 percent. The prevalence of anti-HAV was age related, and the overall frequency was not greater than expected attack rates. Hepatitis B virus (HBV) markers were present in 16 percent of the clinical personnel tested but in only 3 percent of nonclinical personnel, for a total prevalence of 9 percent among the two groups. The nonclinical risk did not exceed the background prevalence of the disease, but the risk for clinical employees was three to five times greater. This risk appeared to be associated with exposure to blood and other potentially infectious body fluids; however, in no case could an employee with HBV markers recall a percutaneous injury, and covert means of transmission could not be excluded. Only one case (20 percent) of HBV infection manifested clinical symptomatology. Even though proper environmental safety measures may decrease the incidence of HBV infection in at-risk groups, some health care workers and researchers in the field of substance abuse may be at sufficiently increased risk of HBV infection to warrant immunization with hepatitis B vaccine.     

A study of the prevalence of markers of hepatitis B infection in hospital staff

Five hundred and sixty-one members of the nursing, dental and junior medical staff of a teaching hospital were tested for serological evidence of hepatitis B infection using the markers HBsAg, anti-HBs and anti-HBc. Overall marker prevalence rates, indicating both current and past infections, were: dental staff 1.1%; nursing staff 3.2%; junior medical staff 6.0%. These results reflect relative risk of occupational exposure.     

Etiological spectrum of viral hepatitis and prevalence of markers of hepatitis A and B virus infection in north India

The etiological spectrum of viral hepatitis and the prevalence of serological markers of hepatitis A and B virus infection in healthy persons in north India were studied. Hepatitis A virus was found to be the most common cause of acute hepatitis in children (67%). It was a less frequent cause of this disease in adults (14%). Hepatitis A virus was only rarely the cause of acute (12%) and subacute (4%) liver failure. It was recorded as the etiological agent in an epidemic among schoolchildren. Exposure to hepatitis A virus occurs in early childhood, and by the age of 10 years, 90% of healthy persons have serological evidence of hepatitis A virus infection.     

The prevalence of hepatitis B virus markers in dental personnel in Singapore

A seroepidemiological survey of the prevalence of hepatitis B virus (HBV) markers was conducted in a group of 693 dental personnel in Singapore where HBV infection is endemic. The overall prevalence of HBsAg (4.5%) and anti-HBc (29%) was no higher than that in the general population. However, dentists had a significantly higher HBsAg prevalence (11.4%) compared with that in the general population (4.2%) (P less than 0.01) and of other categories of dental personnel (3.1%) (P less than 0.001). Similarly, the anti-HBc prevalence of the dentists (45.6%) was significantly higher than that of the general population (29.7%) (P less than 0.01) and of other categories of dental personnel (25.7%) (P less than 0.0001). It appears that dentists in the endemic area have a definite occupational risk of acquiring HBV infection.     

Epidemiology of hepatitis B in Somalia: inference from a cross-sectional survey of serological markers

Hepatitis B markers were determined by radioimmunoassay in 383 adults from different areas of Somalia and in 135 pregnant females and 428 children from Mogadishu. The highest incidence of HBsAg among adults was among nomadic males (20/85; 23%). The frequencies were lower in males from the agricultural and coastal area, i.e. 16/93 (17%) and 14/98 (14%) respectively. The lowest frequency of HBsAg was among women from the coastal area (6/72; 8%). Among the pregnant women 14 were positive for HBsAg, none of whom had HBeAg. Low levels of positivity for HBsAg were found both among children under 4 years and among those between 4 and 13 years of age - 3/94 (3%) and 5/128 (4%) respectively. In the age group 15-19 years, 50% showed seroconversion from HBeAg to anti-HBe. 7 out of 41 HBsAg carriers of ages over 20 had HBeAg. Early seroconversion from HBeAg to anti-HBe and a low level of HBsAg positivity in children indicate that vertical transmission is not important in Somalia. The low frequency of HBsAg in Mogadishu children may have one of the following explanations: (i) the infection occurs during adolescence, (ii) Mogadishu is a low-prevalence area and the examined adults were not born in Mogadishu, or (iii) a change in hepatitis B epidemiology has taken place in the area during the last 2 decades and the relatively higher prevalence of HBsAg in adults might reflect higher rates of infection in their childhood.     

乙肝孕妇血清病毒标志物模式与宫内感染的关系

目的:检测乙肝感染孕妇的血清乙肝病毒标志物及所产新生儿脐血清HBV-DNA,探讨孕妇乙肝感染状况与新生儿宫内感染的关系,寻找有效阻断乙肝宫内感染的措施。方法:采用ELISA法检测302例乙肝感染孕妇血清乙肝病毒标志物,用Realtime-PCR法检测新生儿脐血清HBV-DNA。结果:"大三阳"和"小三阳"孕妇分别占64.90%和21.19%,"大三阳"组孕妇的新生儿脐血清HBV-DNA阳性率为46.88%,明显高于"小三阳"组的1.02%。孕妇血清HBeAg阳性组的新生儿脐血清HBV-DNA阳性率为46.27%,远高于阴性组的1.28%。结论:孕妇乙肝感染状况与新生儿宫内感染率密切相关,孕妇血清HBeAg可作为宫内感染发生的预测指标;HBeAg阳性妇女待HBeAg转阴后再妊娠,可大大减少宫内感染的发生。     

乙型肝炎血清标志物HBeAg与HBeAb同时阳性模式的相关研究

目的 分析乙型肝炎病毒(H BV)血清标志物HBeAg与HBeAb同时阳性患者的病毒复制、肝功能状况,并探讨该类模式的产生原因及其意义.方法 应用微粒子化学发光法检测HBV血清标志物,从中筛选出HBeAg与HBeAb同时阳性的标本,检测该类标本HBV-DNA定量值和肝功能结果及肿瘤标志物AFP值.结果 检测17 895例患者HBV血清标志物,HBeAg与HBeAb同时阳性73例,阳性率7.4％;73例HBeAg和HBeAb阳性患者中,HBV-DNA＞1×E+004拷贝/ml者占55.0％;肝功能指标的异常率为58.3％,肿瘤标志物AFP异常率21.9％.结论 乙型肝炎患者出现HBeAg与HBeAb同时阳性,提示乙型肝炎病毒复制处于低水平状态,体内病毒较少,传染性弱,但是也容易造成肝功能的慢性损伤,应当引起实验室和临床的高度重视.     

透明质酸等血清学指标在慢性乙型肝炎患者诊断中的意义

目的探讨血清透明质酸(HA)、层黏蛋白(LN)、丙氨酸氨基转移酶(ALT)联合检测在在慢性乙型肝炎患者诊断中的临床价值。方法对医院收治的42例慢性乙型肝炎患者HA、LN、ALT水平进行检测,并与同期36例健康体检者做对照。结果观察组HA、LN、ALT水平分别为(225.8±17.6)、(158.4±17.8)ng/ml及(88.1±11.5)U/L,对照组分别为(99.04±12.1)、(89.6±16.3)ng/ml及(25.3±6.4)U/L,两组差异有统计学意义(P<0.05);慢性肝炎轻度、中度、重度组间HA、LN、ALT与肝脏受损程度成正比(P<0.05),且肝硬化组与慢性肝炎重度组LN、ALT比较,差异有统计学意义(P<0.05)。结论透明质酸等血清学指标在慢性乙型肝炎患者诊断中具有重要临床价值,可以判断病情严重程度以及肝功能受损情况,为临床治疗提供进一步指导依据。     

慢性乙型肝炎病毒复制与肝纤维化血清学指标相关性分析

目的探讨慢性乙型肝炎患者(chronic hepatitis B,CHB)HBV DNA复制与肝纤维化血清学指标之间的相关性。方法 308例慢性乙型肝炎患者同时接受血清HBV DNA、HBeAg、透明质酸(HA)、Ⅲ型前胶原(PcⅢ)、Ⅳ型胶原(Ⅳ-C)和层粘连蛋白(LN)检测。结果 HBV DNA含量在105~107IU/ml、107IU/ml两组肝纤维化血清学四项指标值均高于103IU/ml组,差异均有统计学意义(P0.05);HBV DNA含量在105~107IU/ml、107IU/ml两组与103~105IU/ml组比较,HA、PcⅢ、Ⅳ-C三项指标值均高于103~105IU/ml组,差异均有统计学意义(P0.05),而LN差异无统计学意义(P0.05);HBV DNA含量103IU/ml与103~105IU/ml组比较、105~107IU/ml与107IU/ml组比较,肝纤维化四项血清学指标之间差异均无统计学意义(P0.05);当HBV DNA含量103IU/ml时,HBeAg阳性组与HBeAg阴性组比较肝纤维化四项指标之间差异无统计学意义(P0.05),当HBV DNA含量高于103IU/ml时,HBeAg阳性组HA、PcⅢ、Ⅳ-C三项指标值均高于HBeAg阴性组,差异有统计学意义(P0.05),而LN差异无统计学意义(P0.05)。结论慢性乙型肝炎患者乙肝病毒的复制与肝纤维化血清学指标之间存在一定的相关性,但不呈线性相关。     

围生期产妇血清、乳汁、唾液乙肝病毒标志物间的关联性

目的:研究围产期产妇血清、乳汁、唾液中乙肝病毒标志物及核酸DNA载量关联性,为科学指导新生儿母婴喂养、母婴接触方式提供循证医学证据。方法:在知情同意的原则下选择住院分娩产妇612例作为乙肝研究对象,根据产妇乙肝五项不同模式分为A、B、C、D、E 5组,采用ELISA法检测各组产妇血清、乳汁、唾液中HBV标志物HBsAg、HBsAb、HBeAg、HBeAb、HBcAb,同时应用实时荧光定量PCR检测其HBV-DNA载量。结果:各组的产妇血清、乳汁、唾液HBV-DNA阳性率分别是A组99.33%、89.15%、96.49%;B组20.00%、3.11%、54.24%;C组65.52%、27.66%、29.41%;D组13.56%、3.45%、0.00%;E组1.16%、0.00%、0.00%。A组与B组间血清与乳汁HBV-DNA差别有统计学意义(χ2=237.45,P<0.01);血清与唾液间HBV-DNA差别有统计学意义(χ2=289.49,P<0.01)。产妇乳汁、唾液HBV-DNA载量与其血液HBV-DNA载量呈正相关;研究证实A组产妇经母乳乙肝病毒传染性是乙肝"小三阳"产妇的87.45倍,乙肝病毒其他模式者乳汁传染性与乙肝"小三阳"产妇乳汁传染性相近。结论:①携带乙肝病毒的产妇乳汁、唾液有潜在传染性,其HBV-DNA载量远低于产妇血液HBV-DNA含量;②产妇乳汁、唾液中乙肝病毒DNA阳性率与母血中HBV-DNA载量呈正相关;③产妇血液HBV DNA≥1.00×103 copies/ml,建议人工喂养;④携带乙肝病毒的产妇不要对婴儿口对口喂食,亲吻等亲密接触方式,以防血液、唾液等途径传染乙肝病毒;⑤检测唾液可代替乳汁检查,唾液取材方便,唾液乙肝传染性比乳汁略强,孕期检测唾液HBV DNA载量,可提前为婴儿喂养方式、母婴接触方式、优生优育等提供循证医学证据;⑥携带乙肝病毒者哺乳期要定期检测产妇唾液、乳汁。     

Incidence and prevalence of hepatitis B. A community-based survey in the Philippines

In a rural village in the Philippines, sera were collected from 744 residents and tested for evidence of hepatitis B virus infection. In the subsequent year, every household was visited every other week for a period of three months in an attempt to identify clinically apparent cases. At the end of the year, sera were obtained from 78% of persons initially negative for hepatitis B virus and 97% of those initially positive for hepatitis B surface antigen (HBsAg). Overall, HBsAg was found in 8.8% of the population tested, of whom 86% were still HBsAg-positive at the end of the year. Susceptibility to hepatitis B virus infection declined significantly with age, to only 16% in the age group 50 years and older. No difference in the prevalence of markers by sex was observed. The risk of infection in children appeared to increase if one or both parents were infected, compared with both parents susceptible (odds ratio = 3.3 and 7.6, respectively); the risk increased if older siblings were infected, compared with all older siblings susceptible. The overall incidence rate of hepatitis B virus infection was 3.3% per year. For those aged five years or younger, the incidence rate was 9.2%. None of the seroconverters manifested acute symptoms of infection. Despite the evident clustering in families of persons with hepatitis B virus markers, which is suggested by the prevalence survey, only two of nine incident infections observed were in children with HBsAg-positive close relatives. The findings support the impression that in countries endemic for hepatitis B virus, most new cases occur in the young and are clinically inapparent. Furthermore, screening families of young children for chronic carriers in an effort to identify children at high risk for hepatitis B virus infection would have a low sensitivity in the Philippine setting.     

The prevalence of serological markers for the human immunodeficiency virus and the hepatitis B virus in a psychiatric hospital

OBJECTIVES: To estimate the prevalence of antibodies to human immunodeficiency virus (HIV), antibodies to hepatitis B core antigen (anti-HBc), hepatitis B surface antigen (HBsAg), and antibodies to delta virus (anti-DV). DESIGN: Cross-sectional (prevalence) study. A non-proportional (stratified by length of stay) random sample of 20% of admitted patients was selected. CLINICAL SETTING: The Hospital Psiquiátrico Nuestra Se?ora de Montserrat (Sant Boi de Llobregat, Barcelona, Spain) admits about 670 patients in its short-term, rehabilitation (mid-term) and long-term wards. SUBJECTS: 139 patients were selected: 91% were males, mean age was 55 years, and 10% belonged to an HIV risk group; mean length of hospitalization since last discharge was 13 years. MEASUREMENTS: Blood samples were drawn in October, 1988. Anti-HBc, HBsAg and anti-DV were determined by competitive enzyme immunoassay (EIA). Anti-HIV-1 were determined by sandwich EIA; negativity of results with high absorbency but below the cut-off point was confirmed by Western blot. RESULTS: None of the sampled patients had circulating anti-HIV-1 antibodies. Four cases showing high absorbency (below the "cut-off" point) were ruled out by Western-blot. Overall, the prevalence of anti-HBc was 52.8% (54.4% in long-term wards, 35.0% in mid-term wards, and 13.8% in short-term wards). The prevalence of HBsAg was 2.3%, of anti-DV 1.5%, and of HDAg 0%. CONCLUSIONS: Prevalence of anti-HIV is null in the studied institution. Current efforts to prevent HIV infection must continue; a hepatitis B vaccination program is highly warranted among patients and professionals of the studied hospital.     

青岛市居民甲、乙型病毒性肝炎的流行现状

为掌握青岛市甲、乙型病毒性肝炎(简称甲肝、乙肝)的感染状况,了解居民对该病的知识、行为、态度,为制定防治措施提供科学依据,笔者于2002年3月对青岛市1997～2001年的甲、乙型病毒性肝炎的发病情况进行了分析,同时随机抽取了638名正常人血清,对其甲、乙型肝炎的感染指标进行了检测,另外对135名居民进行了知识、态度、行为(KAP)调查,现将结果报告如下.     

母体注射乙型肝炎免疫球蛋白对乙型肝炎病毒宫内感染的影响及新生儿血清乙型肝炎病毒标志物的动态变化分析

目的研究母体注射乙型肝炎(乙肝)免疫球蛋白对乙肝病毒(HBV)宫内感染的影响及新生儿血清HBV标志物动态变化的分析。方法选取2014年6月-2015年2月该院收治的乙肝表面抗原及乙肝e抗原均阳性孕妇120例,按照孕妇是否愿意接受注射乙肝免疫球蛋白分成观察组62例及对照组58例。观察组单阳性(HBs Ag阳性)孕妇32例,双阳性(HBs Ag及HBe Ag阳性)孕妇30例;对照组中单阳性(HBs Ag阳性)29例,双阳性(HBs Ag及HBe Ag阳性)孕妇29例,4组分别记为Ⅰ组、Ⅱ组、Ⅲ组、Ⅳ组。Ⅰ组、Ⅱ组在妊娠第28周起,每周肌注乙肝免疫球蛋白400 U,直至生育新生儿。Ⅲ组、Ⅳ组则给予常规管理。结果 120例孕妇共生育134例新生儿,4组宫内感染率分别为2.63%、18.75%、21.21%、38.71%,相应地检测4组新生儿血清抗HBs产生情况,发现Ⅳ组与其他组比较,差异均具有统计学意义(χ~2=18.939 4,P0.05)。在新生儿第1年的不断检测下,Ⅰ组发生慢性HBV感染的比例为0.00%,而Ⅱ组、Ⅲ组、Ⅳ组逐渐升高,差异有统计学意义(χ~2=16.813 6,P0.05)。结论母体注射乙肝免疫球蛋白可有效降低HBV宫内感染概率,新生儿的HBs Ab阳性表达也明显提高,有助于HBV的防治。     

乙肝病毒基因型、耐药基因突变与血清病毒学指标的相关性

目的 调查湖北省十堰地区慢性乙型肝炎（CHB）患者HBV基因型、逆转录酶（RT）区耐药基因突变与血清病毒学指标的相关性。方法 对521例HBV - DNA定量阳性CHB住院患者进行基因分型、RT主要耐药性基因位点突变以及血清ALT和AST活性、HBsAg、HBV - DNA检测。结果 本地共检出B型323例（62.0%）、C型187例（35.9%）、D型3例（0.6%）、BC混合型8例（1.5%）。其中121例（23.2%）存在RT区主要耐药基因突变;272例有核苷（酸）类（NAs）用药史患者中C基因型突变率51.5%（68/132）,高于B型26.8%（37/138）（χ2 = 26.238, P＜0.001）。突变型患者血清ALT、AST、HBsAg、HBV - DNA均高于野生型（t = 2.514, 1.986, 4.851, 6.265; P = 0.012, 0.047, ＜0.001, ＜0.001）,主要突变模式M204V血清HBsAg和HBV - DNA水平亦高于野生型 （t = 3.247, 2.805; P = 0.001, 0.005）。结论 该地CHB住院患者主要以感染B型HBV为主,而C基因型较B型更易发生RT区耐药基因突变,且基因型、RT区耐药基因突变均与血清病毒学指标相关。     

Absence of a relationship between the prevalence of markers for hepatitis B virus and the moderate consumption of alcohol

The prevalence of 3 serological markers of hepatitis B virus was studied in a sample population of 481 men between the ages of 40 and 60 examined in the course of a routine medical checkup, whose acknowledged intake of pure alcohol was under 120 g per day. No statistically significant relationship was found between the frequency of the markers (HBs antigen, anti-HBs and anti-HBc antibodies) and the level of acknowledged alcohol consumption. The frequencies of the major potential risk factors in hepatitis B virus infection were similar among patients claiming to drink less than 20 g per day and those claiming an intake of between 20 and 80 g daily. Finally, the activities of some of the plasma enzymes most frequent in hepatology increased in a statistically significant way with acknowledged consumption of alcohol--this, in the absence of any contact with hepatitis B virus. No relationship was shown between enzyme levels and the presence--or absence--of hepatitis B markers, whatever the acknowledged alcohol consumption.