Yap S F
Department of Pathology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
Malays J Pathol. 2004 Jun;26(1):1-12.
"Parenteral" or "serum" hepatitis is known to have afflicted man for centuries. However, it was not until the mid-1960s that the causative agent of this infection, the hepatitis B virus, was discovered. Since then, the biology and the replication strategy of the virus, and the clinical features and the epidemiology of the hepatitis B infection have been determined. Knowledge about the virus and the infection it causes led to the development of firstly, a plasma-derived vaccine and later a recombinant vaccine for the prevention of the infection. Integration of the hepatitis B vaccine into newborn vaccination programmes on a worldwide basis represents a major step in the effort to eliminate this infectious disease and its complications. Laboratory tests are available for the diagnosis and monitoring of the disease. Therapies have been developed to halt the progress of the chronic infection in affected individuals. While these developments have resulted in a decrease of the frequency of infection in many countries, particularly those that have implemented universal immunization of newborns, the chronic infection remains a significant global problem. Worldwide, over 300 million individuals are infected and each year, an estimated 1 million persons die from chronic complications of the disease including hepatocellular carcinoma and hepatic failure. The therapies currently available result in elimination of the virus in only a relatively small proportion of subjects and carry with it serious side effects. Geopolitical, economic and other factors hinder the vision of elimination of the infection through immunization programmes. Nevertheless, work continues to clarify further the underlying pathological mechanism of the infection, the host and viral factors that promote elimination or persistence of the virus in the human host. It is hoped that such investigations will reveal viral targets for the design of newer and potentially more effective drugs to treat the infection.
“肠道外”或“血清型”肝炎已知困扰人类达数百年之久。然而，直到20世纪60年代中期，这种感染的病原体——乙型肝炎病毒才被发现。从那时起，该病毒的生物学特性、复制策略以及乙型肝炎感染的临床特征和流行病学情况都已明确。对该病毒及其所致感染的了解促使首先研发出了血浆源性疫苗，随后又研发出了重组疫苗用于预防感染。在全球范围内将乙型肝炎疫苗纳入新生儿疫苗接种计划是消除这种传染病及其并发症努力中的重要一步。有实验室检测方法可用于该疾病的诊断和监测。已经研发出了治疗方法来阻止受感染个体慢性感染的进展。虽然这些进展已使许多国家，特别是那些实施了新生儿普遍免疫的国家的感染率有所下降，但慢性感染仍然是一个重大的全球问题。在全球范围内，超过3亿人受到感染，每年估计有100万人死于该疾病的慢性并发症，包括肝细胞癌和肝衰竭。目前可用的治疗方法仅能使相对较少比例的患者体内病毒清除，且伴有严重的副作用。地缘政治、经济和其他因素阻碍了通过免疫计划消除感染的愿景。尽管如此，相关工作仍在继续，以进一步阐明该感染的潜在病理机制、促进病毒在人类宿主中清除或持续存在的宿主和病毒因素。希望此类研究能够揭示可用于设计更新且可能更有效的治疗该感染药物的病毒靶点。
