Deinhardt F
Pettenkofer Institut, München, Germany.
Vaccine. 1992;10 Suppl 1:S10-4. doi: 10.1016/0264-410x(92)90532-o.
Before hepatitis A virus (HAV) was identified, spread of hepatitis A was prevented by public health measures. The first specific, preventive measure for hepatitis A was passive protection with standard, pooled human immune globulins. Human immune globulin contained sufficient HAV neutralizing antibodies for short-term, prophylactic passive protection and for control of the spread of local outbreaks. After many unsuccessful attempts, HAV was propagated in cell cultures and the development of vaccines for active immunization began. Formalin-inactivated, whole HAV induced protective immunity, and such formalin-inactivated hepatitis A vaccines are now being evaluated in large-scale clinical trials. HAV attenuated by serial propagation in cell culture has been used for several, live, attenuated hepatitis A vaccines and results of clinical trials are reassuring. Future approaches to protection against hepatitis A are likely to include vaccination with: hybrid viruses; hepatitis A antigen-expressing, genetically-engineered bacteria; purified hepatitis A antigens produced by molecular biological techniques and incorporated into slow or pulse-releasing systems; synthetic peptides or idiotypes.
在甲型肝炎病毒（HAV）被发现之前，甲型肝炎的传播通过公共卫生措施得以预防。甲型肝炎的首个特异性预防措施是使用标准的混合人免疫球蛋白进行被动保护。人免疫球蛋白含有足够的甲型肝炎病毒中和抗体，可提供短期预防性被动保护并控制局部疫情的传播。经过多次失败的尝试后，甲型肝炎病毒在细胞培养中得以繁殖，用于主动免疫的疫苗研发也随之开始。甲醛灭活的全甲型肝炎病毒可诱导保护性免疫，目前此类甲醛灭活甲型肝炎疫苗正在大规模临床试验中进行评估。通过在细胞培养中连续传代减毒的甲型肝炎病毒已用于数种甲型肝炎减毒活疫苗，临床试验结果令人放心。未来预防甲型肝炎的方法可能包括接种：杂交病毒；表达甲型肝炎抗原的基因工程细菌；通过分子生物学技术生产并整合到缓释或脉冲释放系统中的纯化甲型肝炎抗原；合成肽或独特型。
