意大利强制接种疫苗后本地儿童与移民或领养儿童的乙肝病毒感染情况

Hepatitis B virus infection in native versus immigrant or adopted children in Italy following the compulsory vaccination.

作者信息

Giacchino R, Zancan L, Vajro P, Verucchi G, Resti M, Barbera C, Maccabruni A, Marcellini M, Balli F, Cascio A, Nebbia G, Crivellaro C, Bortolotti F, Clemente M G, Bragetti P, Valentini P, Mazzoni N, Losurdo G, Cristina E

机构信息

Infectious Diseases Unit Giannina Gaslini Children's Hospital, Genova, Italy.

出版信息

Infection. 2001 Aug;29(4):188-91. doi: 10.1007/s15010-001-1146-2.

DOI:10.1007/s15010-001-1146-2

PMID:11545477

Abstract

BACKGROUND

Compulsory vaccination of children against hepatitis B virus (HBV) infection was introduced in Italy in 1991.

PATIENTS AND METHODS

To evaluate the current importance of pediatric HBV infection, we studied 359 HBsAg-positive children admitted to 16 centers in Italy from 1991 to 1998. 185 patients were natives of Italy and 174 (39 immigrants and 135 adopted) came from highly endemic countries (eastern Europe: 60.9%, Asia: 16.7%, Africa: 14.9% and Central and South America: 5.7%).

RESULTS

Transaminase Levels were moderately altered in both Italian (mean 134 UI/L) and foreign children (mean 168 UI/L). In total, 77% of ItaLian children and 88% of foreign children tested HBeAg positive. High transaminase levels and HBeAg positivity were more frequent in adopted children. Follow-up of 317 patients showed that the incidence of HBeAg/anti-HBe serum conversion was similar in all cohorts, but in adopted children it occurred at an earlier age and was associated with HBsAg clearance in 5%.

CONCLUSION

HBV is not frequent in Italian children today, but it is common among children coming from highly endemic areas. The vaccination of nonimmune native populations must be strongly recommended.

摘要

背景

意大利自1991年起开始强制儿童接种乙肝病毒（HBV）疫苗。

患者与方法

为评估儿童HBV感染的当前重要性，我们研究了1991年至1998年间在意大利16个中心收治的359例HBsAg阳性儿童。185例患者为意大利本土儿童，174例（39例移民儿童和135例收养儿童）来自乙肝高流行国家（东欧：60.9%，亚洲：16.7%，非洲：14.9%，中美洲和南美洲：5.7%）。

结果

意大利本土儿童（平均134 UI/L）和外国儿童（平均168 UI/L）的转氨酶水平均有中度改变。总体而言，77%的意大利儿童和88%的外国儿童HBeAg检测呈阳性。收养儿童中谷丙转氨酶水平升高和HBeAg阳性更为常见。对317例患者的随访表明，所有队列中HBeAg/抗-HBe血清转换的发生率相似，但收养儿童中发生年龄较早，且5%的收养儿童血清转换与HBsAg清除相关。