Bryan J A, Gregg M B
Am J Med Sci. 1975 Sep-Oct;270(2):271-82.
Morbidity and surveillance data on viral hepatitis cases in the United States since 1970 has revealed plateauing of case rate, continued failure to observe seasonal variation, more general geographic distribution of cases, and persistence, although at progressively lower levels, of highest rates in males 15-29 years of age. Based on results of HBS Ag testing, as much as 24 per cent of hepatitis B may be misdiagnosed by physicians and from 18 to 46 per cent of reported cases can be classified hepatitis B, thus suggesting that hepatitis B may account for up to one-half the recognized viral hepatitis in this country. HBS Ag-negative hepatitis still seems commonly acquired through close personal contact; hepatitis B patients 15-29 years of age also commonly have personal contact association. Parenteral drug abuse and transfusion of blood and blood products continue to play a role in dissemination of hepatitis B, but hepatitis B seems to account for only about one half of all reported transfusion-associated hepatitis. Case fatality rates for reported cases appear to increase with age but are not higher for HBS Ab positive patients than for negative patients.
自1970年以来美国病毒性肝炎病例的发病率和监测数据显示，病例率趋于平稳，未观察到季节性变化，病例的地理分布更为广泛，15至29岁男性的发病率持续保持最高水平，尽管呈逐渐下降趋势。根据乙肝表面抗原（HBS Ag）检测结果，高达24%的乙型肝炎可能被医生误诊，报告病例中有18%至46%可归类为乙型肝炎，这表明在该国，乙型肝炎可能占已确认病毒性肝炎病例的一半。乙肝表面抗原阴性的肝炎似乎仍通常通过密切的个人接触传播；15至29岁的乙肝患者也通常有个人接触关联。静脉注射毒品以及输血和血液制品在乙型肝炎传播中仍起作用，但乙型肝炎似乎仅占所有报告的输血相关肝炎病例的约一半。报告病例的病死率似乎随年龄增长而增加，但乙肝表面抗体（HBS Ab）阳性患者的病死率并不高于阴性患者。
