丁型肝炎病毒感染的血清流行病学观察

1987年4月至1988年10月间,本文应用酶联吸附法(EIA)对石家庄地区Ml例乙型肝炎病毒感染者进行了抗-HD的检测,共发现35例阳性,阳性率12.92%,其中男性阳性率14.06%(27/102),女性为10.13%(8/79),男女间差异无统计学意义(P>0.05),提示石家庄地区可能为丁型肝炎病毒感染的高发区.在这些人群中,慢性活动性肝炎、慢性迁延性肝炎和肝硬化的抗-HD阳性率明显高于HBsAg携带者,但三者相互间差异无统计学意义,表明合并或重香感染HDV对乙肝慢性化及肝硬化的形成具有重要的意义。本研究证明在乙型肝炎病毒感染人群中丁型肝炎病毐与年龄、性别、职业等因素关系不密切。     

杭州地区妊娠晚期孕妇病毒性肝炎感染的调查研究

目的:调查杭州市2958例妊娠晚期孕妇乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)、丁型肝炎病毒(HDV)、戊型肝炎病毒(HEV)的感染状况。方法:对杭州市2958例妊娠晚期孕妇的血清乙型肝炎标志物、HCV抗体、HDV抗体、HEV抗体的检测结果进行统计分析。结果:2958例妊娠晚期孕妇中乙型肝炎总感染率40.16%,HCV抗体阳性率0.40%,HDV抗体阳性率0.20%,HEV抗体阳性率2.60%。结论:杭州地区妊娠晚期孕妇病毒性肝炎的感染以乙型肝炎位居第一、戊型肝炎次之,丙型肝炎及丁型肝炎感染率较低。应加强育龄女性易感人群乙肝疫苗的预防接种,开展和实施有效的预防措施来防止病毒性肝炎的感染,提高新生人口的素质。     

乙型肝炎表面抗原阳性单采浆献血员HCV及HDV感染的调查

对ＨＢｓＡｇ的１２７例阳性单采浆献血员及１５２例非献血员的血清学调查发现，抗－ＨＣＶ检出率分别为４１．７％（５２／１２７）、２．６％（４／１５２），ＨＤＡｇ检出率分别为７９％（１０／１２７）、１．３％（２／１５２）；病毒性肝炎的现患率分别为１８．１％（２３／１２７）、４６％（７／１５２）。流行病学研究表明，ＨＢｓＡｇ阳性单采浆献血员中较高的ＨＣＶ和ＨＤＶ感染率以及肝炎的高现患率是因在单采浆还输血球过程中交叉感染引起的。     

不同人群HCV与其它肝病标志物阳性率的调查

目的了解江苏省启东地区不同人群的HCV等肝病标志物情况。方法采集肝癌病例、HBsAg阳性者及自然人群血清标本,用酶免法检测抗-HCV;同时检测ALT、抗-TTVIgG,HBVM标志物作参考比较。结果肝癌病人、HBsAg阳性者和自然人群的抗-HCV阳性率分别为5.11%、1.82%和2.42%,无显著性差异(P>0.05)。未见HCV感染与HBV感染间的联系,与年龄、性别、血型的关系也不大。9例抗-HCV阳性的肝癌患者中有6例伴有HBsAg阳性,有1例所有的HBVM均为阴性,且ALT和AFP均为阴性。有1例伴有抗-TTVIgG阳性。结论启东地区抗-HCV感染率不高,不同人群间的差别不大;与历史资料比,似有下降的趋势。     

Prevalence of hepatitis virus infections in Albanian refugees

A sample of 393 Albanian refugees, including both children and adults, was tested for serological HAV, HBV, HDV and HCV markers. A high prevalence of infection with both the hepatitis A and B viruses was found, while HDV and HCV infections were uncommon. The overall prevalence of anti-HAV was 96%; it was very high in children 0-10 years, suggesting that HAV infection is largely acquired during childhood and that poor ambiental conditions influence the spreading of this viral infection.One or more serological markers of HBV infection were found in 295 Albanians (75%), confirming the endemic nature of this virus in the Albanian community. The overall prevalence of HBsAg was 19%, and the carrier rate was higher in males than in females. The high HBsAg prevalence among children suggests that HBV infection is usually acquired in early childhood.The serological data obtained in the Albanian sample examined clearly indicate the urgent need for measures to reduce the incidence of HAV and HBV infections and to avoid the further spread of HDV and HCV infections.Finally, the high prevalence of type B hepatitis indicates the necessity of vaccination against HBV for all risk groups and for all children at birth.     

Search for hepatitis delta virus (HDV) infection in hepatitis C patients in north-eastern Poland. Comparison with anti-HDV prevalence in chronic hepatitis B

Hepatitis C virus and hepatitis D virus have been shown to suppress HBsAg synthesis. Thus it is possible that HDV infection occurs despite the lack of detectable HBsAg. The aim of our study was to (a) determine the prevalence of HDV infection in patients with chronic hepatitis C (b) compare it with the prevalence of HDV infection in HBsAg positive patients with hepatitis B. The study group consisted of 51 chronic hepatitis C patients, 30 HIV infected drug addicts (27 of them were also positive for anti-HCV) and 102 hepatitis B patients. The participants were tested for anti-HDV, anti-HCV and HBsAg. All anti-HCV positive patients were negative for anti-HDV. Four individuals with anti-HDV belonged to hepatitis B group and constituted 3.9% of all HBsAg positive subjects. We conclude that (a) there is currently no evidence of HDV infection among HCV infected patients in our region (b) hepatitis delta infection is rare in north-eastern Poland.     

Prevalence of hepatitis B markers in the population of catalonia (Spain). Rationale for universal vaccination of adolescents

The prevalence of hepatitis B markers was determined in a representative sample of the general population of Catalonia (Spain). HBsAg was found in 0.5% of children (less than 15 years of age) and in 1.7% of adults (more than 15 years of age), and anti HBs in 1.6% and 18%, respecitvely. Age-specific prevalence for both markers showed a low risk for hepatitis B before puberty, and a progressive rise since adolescence, suggesting that perinatal transmission and horizontal transmission in children are relatively uncommon in Spain. Prevalence of hepatitis B markers was significantly higher among subjects with low education level, residing in an urban area and born outside Catalonia, but in the stratified analysis, a statistical significant difference was only maintained in the prevalence of HBV markers between those who live in urban and rural areas, and between those who were born outside Catalonia and in Catalonia. These data may be used as a basis for a strategy of hepatitis B prevention in Spain which include universal vaccination of adolescents, passive-active immunization of newborns to HBsAg positive mothers and vaccination of susceptible adults subjects from high-risk groups.Preventive Medicine Unit.Liver Unit.Corresponding author.     

河南省人群丁型肝炎病毒感染的血清流行病学调查研究

为了了解河南省丁型肝炎病毒的人群感染情况，从１９９１－１９９３年对河南省十三个地区１１８２例ＨＢｓＡｇ阳性的各型乙肝病人及无症状ＨＢｓＡｇ携带者血清标本进行ＨＤＡｇ、抗ＨＤＶ和ＩｇＭ－抗－ＨＤＶ三项标志检测。结果表明，河南省人群ＨＤＡｇ、抗－ＨＤＶ、ＩｇＭ－抗－ＨＤＶ的总感染率分别为３．０％、３．５％、３．５％、８．１％。     

Hepatitis B virus infection in children in Sardinia,Italy

Possible hepatitis B immunization of all newborns, regardless of the mother's HBsAg status, is a strategy under consideration for selected hyperendemic areas in Italy. Sardinia is one such area. However, in 1987 in Sardinia, the prevalence of hepatitis B markers in children under 11 years was estimated at 1.7% and the prevalence of hepatitis B surface antigen (HBsAg) at 0.2%. A much higher prevalence of HBsAg was recently observed among adults in this area: 8.7% among men and 5.2% among pregnant women. This contrasting pattern is unlikely to be due to bias: the sampling procedures adopted were appropriate and the percentage of refusals was very low (2.2%). The observed low hepatitis B marker prevalence in young age groups might be the result of a cohort effect due to the improved socio-economic conditions and changes in behaviour that have occurred in Sardinia over the last few years.The finding of only 3 HBsAg+ individuals out of 1,826 children tested, in spite of the 5.2% HBsAg prevalence among pregnant women in that region, is probably attributable to the low proportion of HBeAg positive individuals among the HBsAg+ carrier mothers in this area.At present, immunization of all newborns in Sardinia cannot be recommended.     

我国四个地区肝炎病毒感染与肝癌的病例对照研究

为研究乙型、丙型和庚型肝炎与原发性肝癌的关系，对我国江苏海门、福建同安、广西扶绥和河北石家庄四地，进行了以人群或医院为基础的肝癌病例对照研究。在四个地区病例与对照中，ＨＢｓＡｇ阳性率分别为６６．３％（２３８／３５９）和２３．４％（８４／３５９），其ＯＲ值为６．６０；抗－ＨＣＶ阳性率分别为１７．９％（６１／３４０）和６．５％（２２／３４０），ＯＲ＝３．３１；合并乙丙型肝炎感染其肝癌危险度大大增加（ＯＲ＝１１０．０８）。另对海门病例对照各５０例进行ＨＧＶ－ＲＮＡ检测，阳性率分别为２２％和１０％。结果说明：在我国乙型肝炎感染与肝癌关系更为密切     

Hepatitis B,C, and D Virus Infections and AFP Tumor Marker Prevalence Among the Elderly Population in Mongolia: A Nationwide Survey

ObjectivesInfections with hepatitis B, C, and D virus (HBV, HCV, and HDV) are a major public health problem and lead to serious complications such as cirrhosis and hepatocellular carcinoma. We aimed to determine the seroprevalence of hepatitis B surface antigen (HBsAg), anti-HCV, anti-HDV immunoglobulin G, alpha-fetoprotein (AFP), and dual and triple hepatitis virus infections in Mongolia.MethodsA total of 2313 participants from urban and rural regions were randomly recruited for this cross-sectional study. A questionnaire was used to identify the risk factors for hepatitis virus infections, and the seromarkers were measured using immunoassay kits.ResultsAmong all participants, the prevalence of HBV, HCV, and HDV was 15.6%, 36.6%, and 14.3%, respectively. The infection rates were significantly higher in females and participants with a lower education level, rural residence, older age, and a history of blood transfusion. HBV and HCV co-infection was found in 120 (5.2%) participants and HBV, HCV, and HDV triple infection was detected in 67 (2.9%) participants. The prevalence of elevated AFP was 2.7%, 5.5%, and 2.6% higher in participants who were seropositive for HBsAg (p=0.01), anti-HCV (p<0.001), and anti-HDV (p=0.022), respectively. Elevated AFP was more prevalent in participants co-infected with HBV and HCV (5.8%, p=0.023), HBV and HDV (6.0%, p<0.001), and triple-infected with HBV, HCV, and HDV (7.5%) than in uninfected individuals.ConclusionsNearly half (49.8%) of the study population aged ≥40 years were infected with HBV, HCV, or HDV, and 22.4% had dual or triple infections.     

Seroepidemiology of hepatitis B virus infection among adults in Singapore: A 12-year review

We undertook a national hepatitis B seroprevalence study to assess the seroprevalence of hepatitis B virus (HBV) markers in the adult population in Singapore in 2010 and make comparisons with the seroprevalence in 1998 and 2004. The study involved residual sera from national health surveys conducted every six years since 1998. The tests for HBV markers were carried out using commercial chemiluminescent microparticle immunoassay. In 2010, the prevalence of hepatitis B surface antigen (HBsAg) among 3293 Singapore residents aged 18–79 years was 3.6% (95% confidence interval [CI] 2.9–4.2%). Hepatitis B e antigen (HBeAg) was detected in 4.2% of those who were HBsAg positive. About 22.5% (95% CI 21.1–23.9%) were positive for antibody to hepatitis B core antigen (anti-HBc). The overall population immunity to HBV, as determined by antibody to hepatitis B surface antigen (anti-HBs) ≥ 10 mIU/mL, was 43.9% (95% CI 42.2–45.6%). Among young adults below 30 years of age, HBsAg prevalence (1.1%) was half that in 1998 and 2004, and in those positive for HBsAg, none was positive for HBeAg in 2010, compared to 20.8% in 1998 and 15.8% in 2004. In this age group, anti-HBc prevalence also decreased significantly from 22.1% in 2004 to 4.4% in 2010, while anti-HBs (≥10 mIU/mL) prevalence increased significantly from 27.9% in 1998 to 43.3% in 2010 (p < 0.001). The national childhood HBV immunisation and catch-up programmes implemented in 1987 and 2001–2004, respectively, had a significant impact in reducing HBV infection and in raising the immunity of the adult population 18–29 years of age.     

Hepatitis B and Delta virus infection among heterosexuals,homosexuals and bisexual men

The hepatitis B virus (HBV) and hepatitis Delta virus (HDV) infection rates were estimated in patients attending a venereal disease outpatient clinic: 759 heterosexuals and 154 homosexual-bisexual men. The anti-HBC prevalence was higher in homo-bisexual men (68.8 per 100) than in heterosexuals (41.8 per 100), whereas HBsAg was roughly the same in the two groups (about 6 per 100). The anti-HBc prevalence rate among heterosexuals was higher than that estimated in hospital personnel from the same geographical area. A positive association between anti-HBc prevalence and present or past sexually transmitted diseases (STD) was found among homo-bisexual men. Anti-HBc was also positively associated with herpes simplex type 2 antibodies in both heterosexuals and homo-bisexual men. These data are consistent with the hypothesis that sexual behavior also plays a role in the spread of infection among heterosexuals. Ten of the 46 HBsAg-positive subjects were anti-HDV positive: 6 of the 36 heterosexuals and 4 of the 10 homosexuals. All HDV-positive subjects had present or past STDs. These findings suggest sexual transmission of HDV infection.     

山西省原发性肝癌丙型肝炎病毒、乙型肝炎病毒感染状况分析

目的　探讨山西地区原发性肝癌（ＰＨＣ） 中丙型肝炎病毒（ＨＣＶ） 和乙型肝炎病毒（ＨＢＶ） 感染状况。方法　选择以山西省肿瘤医院为主的省级４ 所医院ＰＨＣ患者９８ 例,检测抗－ＨＣＶ、ＨＢｓＡｇ、抗－ ＨＢｓ、ＨＢｅＡｇ、抗－ ＨＢｅ、抗－ ＨＢｃ、抗－ ＨＢｃＩｇＭ 等指标,均采用ＥＬＩＳＡ 法进行测定。结果　ＰＨＣ 组抗－ ＨＣＶ 阳性率８．１６ ％ ,ＨＢＶ 感染率６８ ．３７％ ,均显著高于对照组的阳性率（ Ｐ＜０ ．０５） 。两者的病因分值（ＡＲＰ） 分别为９４％ 和９１ ％ 。经１∶２ 条件ｌｏｇｉｓｔｉｃ 多元回归分析,抗－ ＨＣＶ、ＨＢｓＡｇ 和抗－ ＨＢｃ 均作为独立的危险因素进入了回归方程,其ＯＲ值分别为５５ ．０６、１０ ．１８ 和９．８５ 。叉生分析结果表明,抗－ ＨＣＶ和ＨＢｓＡｇ 双阳性的ＯＲ值为６１ ．３７,较两指标单一阳性的ＯＲ值明显为高,亦高于两者单独阳性的ＯＲ值之和。结论　ＨＣＶ 和ＨＢＶ 感染均是ＰＨＣ发生的主要病原学因素。ＨＣＶ感染在致肝癌作用中,是当地不可忽视的重要因素,ＨＢＶ 仍是肝癌发生的主要因素。ＨＢＶ和ＨＣＶ双重感染对肝癌的发生具有协同作用。     

Trend in incidence of hepatitis B virus infection during a decade of universal childhood hepatitis B vaccination in Saudi Arabia

Since 1990, the national strategy to eliminate hepatitis B virus (HBV) infection in Saudi Arabia has included universal administration of HBV vaccine to all infants. From 1990 to 1995 this vaccine was also routinely administered to children at school entry. The prevalence of hepatitis B surface antigen (HBsAg) among children before this programme was reported to be 6.7%. The objective of this study was to describe the trend in incidence of HBV infection over a decade of surveillance following the introduction of this programme. From January 1990 to December 1999 a total of 30,784 cases of HBV infection (positive for HBsAg) were reported. The total number of HBV infections among children <15 years of age was 4180 cases, with a prevalence of 0.05%. The total number of HBV infections among adults was 26,604 cases, with a prevalence of 0.22%. The prevalence varied by region, ranging from 0.03% to 0.72% with a mean prevalence of 0.15%. There was a clear decline in incidence among children whereas the incidence in adults slightly rose, perhaps owing to population growth estimated to be 3.3% annually. This study showed that the universal childhood HBV vaccination programme had an enormous positive impact on HBsAg seroprevalence among children in Saudi Arabia.     

广东省乙型肝炎血清流行病学调查研究

目的了解广东省人群乙型肝炎（乙肝）病毒（HBV）感染现状,评价乙肝疫苗免疫策略的效果。方法采取多阶段随机抽样方法,对全省6县区3 927名1-59岁人群进行乙肝血清流行病学研究,用ELISA方法检测乙肝表面抗原（HBsAg）、乙肝表面抗体（抗-HBs）和乙肝核心抗体（抗-HBc）,并调查1-14岁儿童乙肝疫苗接种情况。结果广东省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15.46%、61.51%、49.46%和66.20%。1-14岁人群HBsAg阳性率和HBV感染率明显低于15-59岁人群。1-4岁人群HBsAg阳性率和HBV感染率低于5-14岁人群,而抗-HBs阳性率高于5-14岁人群。HBsAg阳性率和HBV感染率：男性高于女性,农村高于城市,城市人群抗-HBs阳性率高于农村。1-4岁儿童乙肝疫苗接种率为91.90%,全程接种率89.01%,首针及时接种率为58.38%,明显高于5-14岁人群。结论广东省仍是乙肝高流行区;乙肝疫苗纳入儿童免疫策略效果显著,1-14岁人群HBsAg携带率和HBV感染有不同程度下降,1-4岁下降尤为明显。     

HBsAg subtype distribution among different populations of HBsAg carriers in Spain

Data concerning the HBsAg subtype distribution in Spain are out-of-date and confined to a restricted geographical area. Furthermore, the complex distribution observed in the countries surrounding Spain prevents any prediction. To obtain further data on HBsAg subtype distribution among Spanish HBsAg carriers, subtyping analysis (d andy determinants) was performed in 670 samples from subjects belonging to various epidemiological risk groups and coming from different geographical areas of the country. Similar frequencies were found for both mutually exclusived/y subtype determinants among non-risk, normal HBsAg carriers from almost all geographical areas studied. In contrast, the ay subtype was clearly predominant (79–87%) among intravenous drug users, irrespective of their geographical origin. Thirteen different institutions for mentally retarded patients behaved as closed communities for HBV circulation, showing independent subtype distributions. Thus, no significant geographical variations were found for HBsAg subtype distribution in Spain. The prevalence of each particular subtype is mainly dependent on the epidemiological characteristics of the carriers studied. Subtype distribution was independent of the presence of HBeAg or HDV infection serum markers when homogeneous groups were considered separately. Atypical HBsAg phenotypes, either with coexistence or absence of both subtype determinants, were found in some cases.     

贵州省1～29岁健康人群乙型肝炎病毒血清标志物的变化趋势分析

目的 了解贵州省1～29岁人群乙型肝炎（乙肝）病毒（Hepatitis B Virus, HBV）血清标志物的变化趋势。方法 对贵州省1992、2006、2014 年1～29岁人群乙肝血清流行病学调查资料进行比较分析。结果 贵州省1～29岁人群HBV流行率从1992年的51.78%%降至2014年的12.87%,下降75.14%,乙肝病毒表面抗原（HBV Surface Antigen,HBsAg）流行率从2006年的3.42%降至2014年的2.17%,下降36.55%。2014年1～4岁、5～14岁、15～29岁HBV流行率分别为1.33%、9.32%和34.50%,较1992年同年龄组的29.92%、44.89%、59.73%分别下降95.55%、79.24%、42.24%;2014年1～4岁、5～14岁、15～29岁HBsAg流行率分别为0.66%、1.69%、5.00%,较2006年同年龄组的2.72%、2.94%、6.47%下降75.74%、42.52%和22.72%;2014年男、女HBsAg流行率分别为2.88%和1.40%,与2006年相比均呈下降趋势;2014年城市、农村人群HBV流行率和HBsAg流行率分别为4.88%、17.96%和0.70%、3.10%,与2006年相比分别下降66.20%、40.11%和21.35%、42.16%;2014年1～4岁、5～14岁、15～29岁组乙肝疫苗接种率分别为100%、82.63%和26.00%,与2006年同年龄组相比分别提高26.73%、179%和248%。结论 贵州省15岁以下人群乙肝疫苗接种率明显提高,HBsAg流行率明显下降处于低流行水平;15～29岁、农村、男性HBsAg流行率仍处于中流行水平,为贵州省HBV感染防控的重点人群。     

延边农村地区朝鲜族HBV、HCV、HDV感染状况调查

为摸清延边农村地区朝鲜族人群乙、丙、丁型肝炎病毒(HBV、HCV、HDV)感染状况,用ELISA法对585名朝鲜族成年人进行了HBV、HCV和HDV感染标志物的检测.HBV、HCV标化感染率与HBsAg标化阳性率分别为50.91%、4.85%和8.57%,年龄组间差异无显著性.HBV、HCV双重感染率为2.56%,HBV与HCV的感染相关无显著性.42例HBsAg阳性者中HDV感染率4.76%.HBV感染模式有15种,其中以单项抗-HBs阳性多见,人群中占31.97%.表明人群中HBV、HCV和HDV感染的流行情况不同.     

2004-2010年某部食品和公共场所从业人员乙肝病毒感染状况分析

[目的]掌握某部食品、公共场所从业人员HBV感染情况及其动态变化,为开展乙肝防治工作提供依据。[方法]对2004～2010年在某部防疫队体检的解放军某部食品和公共场所从业人员血清HBV感染标志物检测资料进行分析。[结果32004-2010年累计检测某部食品和公共场所从业人员19008名,检出HBV感染者7569人,年均感染率为39．82％,各年感染率分别为52．81％、52．66％、45．76％、42．95％、28．73％、28．25％、27．62％（P〈0．01）。HBsAg、抗-HBs、HBeAg、抗-HBe、抗HBc年均阳性率分别为5．12％、35．23％、2．08％、5．96％、6．01％。HBV年均感染率,男性、女性分别为45．88％、28．58％,农村籍、城镇籍的分别为43．47％、25．10％,公共场所、食品从业人员分别为45．92％、21．02％,有、无乙肝疫苗接种史者分别为12．36％、53．55％,差异均有统计学意义（P〈0．01）;HBV感染率随着年龄的增长而降低（P〈0．01）;12672名无乙肝疫苗接种史者中,单纯HBsAg阳性的占6．91％,单纯HBeAg阳性的占2．71％,单纯抗-HBe阳性的占7．40％,单纯抗HBc阳性者占6．64％,抗-HBe、抗-HBc阳性的占4．60％,“小三阳”占2．51％,“大三阳”占2．11％。[结论]某部食品和公共场所从业人员HBV感染状况不严重。