Chang M H, Chen D S
Department of Pediatrics and Internal Medicine, College of Medicine, National Taiwan University, Taipei.
Baillieres Best Pract Res Clin Gastroenterol. 1999 Dec;13(4):511-7. doi: 10.1053/bega.1999.0044.
Hepatitis B virus infection is the most common cause of chronic hepatitis, liver cirrhosis and hepatocellular carcinoma worldwide. In areas hyperendemic for HBV infection, the related complications occur mostly during adulthood. However, nearly half of all primary infection in chronic carriers occurs in the perinatal period through maternal transmission, the other half arising from horizontal transmission mainly through intrafamilial spread or injection using unsterilized needles. A universal vaccination programme is better than immunization for at-risk groups. Hepatitis B vaccination should be integrated into the Expanded Programme on Immunization in children. Universal immunization against hepatitis B virus has proved to be effective in reducing the hepatitis B carrier rate to one-tenth of the prevalence before the vaccination programme in highly endemic areas, and the incidence of hepatocellular carcinoma in children has also been shown to be significantly reduced. Continued efforts to implement universal vaccination programmes worldwide will very likely reduce the incidence of hepatitis B virus-related diseases, particularly liver cirrhosis and hepatocellular carcinoma.
乙型肝炎病毒感染是全球慢性肝炎、肝硬化和肝细胞癌的最常见病因。在乙肝病毒感染高度流行地区，相关并发症大多发生在成年期。然而，慢性携带者中近一半的初次感染发生在围产期，通过母婴传播，另一半则主要通过家庭内传播或使用未消毒针头注射等水平传播途径感染。普遍接种疫苗计划优于针对高危人群的免疫接种。乙肝疫苗接种应纳入儿童扩大免疫规划。事实证明，在乙肝病毒高度流行地区，普遍接种乙肝疫苗可有效将乙肝携带者率降至疫苗接种计划实施前患病率的十分之一，儿童肝细胞癌的发病率也显著降低。在全球持续努力实施普遍接种疫苗计划很可能会降低乙肝病毒相关疾病的发病率，尤其是肝硬化和肝细胞癌的发病率。
