Hepatitis B immunisation in health care workers

Background: Hepatitis B virus (HBV) infection is an important occupational risk in health care workers (HCW). In spite of HBV vaccine availability in Armed Forces, the high prevalence of HBV infection in HCW continues to be a problem. The study was undertaken to study the HBV vaccine-compliance among HCW.     

Hepatitis B immunisation status among health care workers in two Kuala Lumpur hospitals

Health care workers (HCW) are at higher risk of acquiring blood borne infections such as hepatitis B virus, hepatitis C virus and human immunodeficiency virus from patients. To minimise exposure, Universal Precautions Policy guidelines were introduced. This study looked into one of the aspects of hepatitis B prevention among HCW in the Malaysian context. The objective of this study was to assess hepatitis B vaccine coverage among HCW. A cross sectional study involving pre-tested questionnaires was undertaken from February 2001 to August 2001. Hospital staff in Hospital Kuala Lumpur and Hospital Universiti Kebangsaan Malaysia as well as undergraduate students undergoing clinical attachments were randomly chosen. A total of 625 subjects were enrolled. Only 58.4% had taken a complete hepatitis B vaccination. However, 82.2% have taken at least one dose of the hepatitis B vaccine and were supposed to complete the schedule in due course. Not all HCW were protected against hepatitis B. Preventing hepatitis B in HCW should be one of the priorities of the hospital management as it is definitely cheaper than managing chronic hepatitis B cases.     

Hepatitis B antigen and polymyositis.

Concomitant polymyositis diagnosed by muscle biopsy developed in a 51-year-old man with hepatitis B surface antigen (HBsAg) hepatitis. Findings from immunofluorescent studies showed deposits of gamma-globulins and complement in both muscle and liver. The HBsAg and HBsAg-antibody complexes were detected in the liver by immunofluorescence using fluorescein-labeled antibody to hepatitis Bs.     

乙肝免疫球蛋白联合乙肝疫苗预防乙型肝炎母婴传播的疗效评价

目的：探讨乙肝免疫球蛋白联合乙肝疫苗预防乙肝病毒母婴传播的临床疗效。方法：将120例母亲乙肝表面抗原阳性的新生儿随机分为治疗组70例和对照组50例,对照组新生儿于出生后24 h内注射乙肝疫苗,治疗组新生儿母亲于孕28、32、36周分别注射乙肝免疫球蛋白,新生儿于出生后24 h内和出生后1个月分别注射乙肝免疫球蛋白。结果：治疗组和对照组新生儿脐血HBsAg阳性率分别为7.14%和22.0%,两组比较差异有统计学意义（P<0.05）;治疗组新生儿出生后1、6、12个月的HBsAg阳性率均明显低于对照组,差异均有统计学意义（P<0.05）。结论：乙肝免疫球蛋白联合乙肝疫苗可有效地阻断乙肝病毒母婴传播,对乙肝母婴传播的预防具有重要意义。     

乙型肝炎病毒大蛋白（LHBs）检测的临床价值

目的探讨乙型肝炎病毒大蛋白（LHBs）诊断乙型肝炎的意义。方法采用酶联免疫吸附测定（ELISA）检测乙型肝炎病毒大蛋白（LHBs）、乙肝病毒前S1（PreS1）,采用荧光定量PCR方法检测HBV DNA。结果 HBeAg阳性样本中乙型肝炎病毒大蛋白与HBV DNA的检出无显著性差异（χ2=2.46,P〉0.05）;乙肝病毒前S1与HBV DNA的检出有显著性差异（χ2=17.34,P〈0.01）;乙型肝炎病毒大蛋白吸光度值（OD值）与HBV DNA拷贝数相关系数r=0.912,P〈0.05。在HBeAg阴性样本中LHBs的吸光度均值和阳性率均呈线性增加,Pre S1的吸光度均值以及阳性率与HBV DNA拷贝数均不相关。结论乙型肝炎病毒大蛋白（LHBs）与HBV DNA有良好正相关,与乙肝前S1（Pre S1）相比,LHBs可更好反映临床乙肝病毒复制水平。     

Hepatitis types B and non-B. Epidemiologic background.

Two episodes of acute viral hepatitis occurred in each of 34 patients. One episode in each patient was serologically diagnosable as type B hepatitis on the basis of tests for hepatitis B surface antigen or antibody. The other episode was classified as "non-B" on the basis of seronegativity, reinforced by seropositivity in an alternate bout. An epidemiologic background appropriate to "serum" hepatitis, either transfusion (one bout) or illicit self-injection (46 bouts), was associated just as frequently with serologically non-B episodes as with identified type B disease. The diagnosis of type B hepatitis, therefore, should be made only on the basis of serologic tests specific for hepatitis B virus infection. Other cases of sporadic diseases in adults must be labeled "viral hepatitis, type unspecifiable."     

乙型肝炎病毒基因分型及对肝病的影响

乙型肝炎病毒(HBV)属于肝DNA病毒属,它的遗传变异性很高,可分为8种基因型,大多数基因型能进一步分成亚型。而HBV基因型之间的重组增加了HBV的变异性。本文概述了当前乙型肝炎DNA病毒属基因变异的流行病学知识,另外因为这一领域的快速进展,更新了一些有关HBV基因型和基因亚型的最近综述,并阐述了HBV基因型与肝病的关系。     

乙肝疫苗联合乙肝免疫球蛋白阻断乙肝母婴传播的效果评价

目的：评价乙肝疫苗联合乙肝免疫球蛋白（ HBIG）阻断乙肝母婴传播的综合治疗疗效。方法对186例孕检的孕妇HBsAg阳性者随机分为治疗组（93例）和对照组（93例）,治疗组分别于孕24周、28周、32周、36周肌肉注射HBIG共4次,每次200IU,同时在不同部位注射乙肝疫苗20μg,共4次;对照组在同时间、同剂量单用HBIG。采用酶联免疫吸附测定法,检测用药前、后孕妇血清及新生儿脐血清的乙肝两对半,采用核酸荧光定量法检测HBV-DNA含量。结果治疗组用药后HBV-DNA含量比对照组明显下降。治疗组新生儿脐血清HBsAb检测率69．89％（65／93）明显高于对照组45．16％（42／93）。治疗组和对照组宫内感染率分别为5．38％,12．90％,两组比较差异有显著性（P＜0．05）。结论孕期用乙肝疫苗联合HBIG阻断乙肝母婴传播的治疗效果优于单一注射HBIG的治疗,对减少乙肝母婴垂直传播宫内感染的发生有临床指导意义。