Hepatitis B

Hepatitis B remains a major public health problem around the world. The discovery of the hepatitis C virus has diverted interest from hepatitis B to this new virus and the epidemic associated with it, but hepatitis B remains a significant pathogen for millions of people worldwide. The World Health Organization has suggested that universal vaccination of children against hepatitis B should be implemented in an attempt to reduce the enormous morbidity and mortality associated with infection of this virus group. The review seeks to identify all the newer discoveries relating to hepatitis B that have been made in the past decade. Reference is made to the appearance of hepatitis B mutants which are able to infect patients previously infected with the wild strain of the virus. The implications of mutants on vaccination programmes is raised, as are issues relating to treatment of hepatitis B infection.     

别让乙肝戕害生命

据中华医学会调查显示,目前我国约有1/10的人口即超过1．2亿人口是乙肝病毒携带者,全球4亿乙肝病毒携带者中有1/3来自中国,我们国家一直戴着“乙肝大国”这顶沉重的帽子,乙肝正在严重危害着人们的身体健康……[编者按]     

Hepatitis B carriage in children

Prevalance of hepatitis B surface antigen carriage amongst children in the Bay of Plenty was high, with rates in Maoris five times that found in Europeans. (12.0% versus 2.6%). Carrier rates were highest in children aged 6-10 years. This age group also had the peak incidence of acute hepatitis B. Infectivity was greatest amongst younger children and diminished with age. Transmission between children within family units may be a major route of spread of hepatitis B.     

Hepatitis B immune globulin

Hepatitis B immune globulin (HBIG) is a purified solution of human immunoglobulin that has high titers of antibody to hepatitis B surface antigen (anti-HBs). It is derived from plasma donated by individuals immune to hepatitis B viral infection. HBIG is widely administered to confer passive prophylactic immunity against the hepatitis B virus because of the ability of anti-HBs to neutralize hepatitis B virions. However, it is not indicated for the treatment of acute or chronic hepatitis B. The use of HBIG is recommended in the following clinical situations: i) Acute exposure to blood and secretions containing hepatitis B surface antigen (HBsAg); ii) sexual contact with HBsAg-positive persons; iii) household exposure to persons with acute hepatitis B; iv) perinatal exposure of infants born to HBsAg-positive mothers; v) liver transplantation.     

乙型肝炎及其预防

<正> 乙肝的严重性,根据世界不同地区人口数和乙肝表面抗原(HBsAg)携带率估算,全世界HBsAg带毒者有3.5亿;亚太地区有2.8亿;而中国就有1.2亿,占全世界HBsAg携带者的1/3,占亚太地区的1/2。HBsAg流行率地区差异很大,在亚太地区中国为4.5％～17.9％,新加坡13.6％,菲律宾9.0％～     

乙型肝炎疫苗Heplisav^TM

接种乙型肝炎病毒（hepatitis Bvirus,HBV）疫苗可有效降低HBV感染率。目前市售HBV疫苗多为以明矾为佐剂的重组HBV表面抗原（rHBsAg）疫苗,该类疫苗具有以下缺点：1）少数人群对其不产生应答;2）产生应答的人群中绝大多数首次免疫后的血清抗体水平较低,需要进行第2或第3次免疫,     

重型乙型肝炎的病毒复制状况与病情的关系

目的　了解重型乙型肝炎时乙型肝炎病毒 (HBV)的复制状况及其与病情的关系。方法　应用酶联免疫吸附实验和聚合酶链反应测定 172例乙型肝炎病人的HBV复制指标。结果　慢性重型肝炎病人的HBeAg和 /或HBVDNA阳性率明显低于非重型慢性肝炎 (P <0 0 1) ;HBV复制状态与血清转氨酶、总胆红素水平及预后无明显相关性。结论　HBV复制活跃不一定是重型肝炎发生的因素。     

慢性乙型肝炎应用拉米夫定停药后复发临床治疗效果

目的 探讨慢性乙型肝炎应用拉米夫定停药后复发临床治疗效果.方法 2007年1月至2010年1月诊治的符合入选标准慢性乙型肝炎应用拉米夫定停药后复发病例246例,再次抗病毒治疗,依据治疗药物不同分为阿德福韦酯组126例,拉米夫定组120例,观察两组与治疗前(0周)和治疗后8周、16周进行HBVDNA、ALT检测并进行比较.结果 两组0周检测内容比较P>0.05差异无统计学意义.两组治疗后8周、16周检测内容比较P<0.05差异有统计学意义.两组疗后8周、16周检测内容与0周比较P<0.01有显著差异性.结论 多数拉米夫定在治疗慢性乙型肝炎应用拉米夫定停药后复发中均有疗效,阿德福韦酯与拉米夫定不具有交叉耐药性,可以用于拉米夫定耐药或复发后的继续抗病毒治疗,效果更为突出.     

乙型肝炎病毒前S_1抗原在乙型肝炎诊断中的意义

目的探讨Pre S1-Ag在乙型肝炎诊断中的意义。方法采用酶联免疫法检测464例乙型肝炎患者血清标志物(HBV-M)和乙型肝炎前S1抗原(PreS1-Ag)采用荧光定量PCR法同时检测HBVDNA,分析PreS1-Ag与血清HBV-M和HBVDNA的关系。结果 HbeAg阳性的两组中,PreS1-Ag阳性率分别为88.62%和74.19%,HBVDNA的阳性率分别为94.01%和83.87%与:HbeAg呈明显的正相关,三者间差异无统计学意义(χ2=1.87,P<0.05)。结论 PreS1-Ag能敏感地反映出HBV复制与HBVDNA的一致性较好,在乙型肝炎诊断和治疗中具有重要临床意义。     

膦甲酸钠治疗伴有黄疸的慢性乙型肝炎及重型肝炎的效果观察

目的 :观察膦甲酸钠治疗伴有黄疸的慢性乙型肝炎和重型肝炎的疗效。方法 :治疗组80例 ,对照组42例 ,两组均给予综合治疗 ,治疗组另外加用膦甲酸钠2 4g 或3 0g,bid ,静脉滴注 ,疗程28d。结果 :HBeAg 阴转率治疗组为36 2 % ,对照组为11 8(P<0 025) ;HBV -DNA阴转率治疗组为26 6 % ,对照组为8 47 % (P<0 05) ;两组HBeAg及HBV -DNA未阴转者 ,治疗后其各自的半定量及定量检测水平 ,治疗组均显著地优于对照组 ;血清TBil复常率治疗组为27 5 % ,对照组为16 7 % (P<0 005) ;ALT、AST复常率治疗组分别为57 5 %、58 2 % ,对照组分别为23 8 %、19 1 % (P<0 005)。结论 :因膦甲酸钠具有抑制HBV复制及抑制免疫应答的作用 ,可用于治疗伴有黄疸的慢性乙型肝炎及重型肝炎。     

慢性乙型肝炎的治疗

乙型肝炎病毒感染是全球健康问题,目前已有20 亿人曾感染过乙肝病毒,其中约4亿人为慢性乙肝患者。乙型肝炎是慢性肝病的主要原因,约15％ -40％的乙肝感染者可能进一步进展为肝硬化、肝功能衰竭、肝细胞性肝癌。因此治疗慢性乙型肝炎对延缓病情进展,减少肝硬化、肝癌的发生率有重要意义。     

Hepatitis B infection in New Zealand children

Hepatitis B markers were tested for in 2001 samples of serum from those aged 0-21 years. There was a prevalence in Europeans of hepatitis B of 10% with a 2% of HBsAg carriage rate. For Maoris the prevalence was 25% with a 6% HBsAg carriage rate. The highest carriage rate was in the northern districts.