Zoulim F
Service d'Hépatogastroentérologie, l'Hôpital Hôtel Dieu, Lyon, France.
Med Trop (Mars). 1999;59(4 Pt 2):503-7.
Infection by hepatitis B virus remains a major health problem in the world despite the availability of effective vaccines. Although vaccination programs targeting high risk groups have been pushed to their limits, high prevalence rates persist especially in endemic zones. More recently mass vaccination programs conducted on Taiwan have demonstrated the efficacy of this approach with a decrease in the number of chronic hepatitis B virus carriers in the general population in association with a decrease in the incidence of hepatocellular carcinoma, one of the most serious complications of chronic hepatitis B virus infection. Side effects have been reported including the risk of central nervous system demyelination. However studies have shown no evidence of a significant correlation between vaccination and this type of disease. Occurrence of hepatitis B in properly vaccinated subjects could result from selection of mutant viral strains able to escape detection by the immune system. The recently revised benefit-to-risk ratio remains highly favorable for vaccination. Current data indicates that the policy of mass vaccination of the population should be pursued.
尽管有有效的疫苗，但乙肝病毒感染仍是全球主要的健康问题。尽管针对高危人群的疫苗接种计划已发挥到极致，但高流行率仍然存在，尤其是在流行地区。最近在台湾实施的大规模疫苗接种计划已证明了这种方法的有效性，随着慢性乙肝病毒携带者在普通人群中的数量减少，肝细胞癌（慢性乙肝病毒感染最严重的并发症之一）的发病率也有所下降。已报告有副作用，包括中枢神经系统脱髓鞘的风险。然而，研究表明没有证据表明疫苗接种与这类疾病之间存在显著相关性。接种疫苗后仍感染乙肝可能是由于选择了能够逃避免疫系统检测的突变病毒株。最近修订的效益风险比仍然非常有利于疫苗接种。目前的数据表明应推行对人群进行大规模疫苗接种的政策。
