Zuckerman Jane N
Academic Centre for Travel Medicine & Vaccines and the WHO Collaborating Centre for Reference, Research & Training in Travel Medicine, Royal Free & University College Medical School, London, UK.
Curr Opin Infect Dis. 2006 Oct;19(5):456-9. doi: 10.1097/01.qco.0000244051.23511.09.
Current issues in immunization against hepatitis A and B are discussed, including the need to abandon risk-based approaches in favour of universal vaccination, the use of combined hepatitis A and B vaccines and multivalent vaccines, the development of third-generation triple antigen hepatitis B vaccines and polyvalent vaccines.
The emergence of hepatitis B surface antigen mutants remains a concern in diagnostic work and immunoprophylaxis and horizontal transmission of the G145R variant stresses the need for surveillance programmes. The more recent and unfounded concerns about the safety of hepatitis B vaccines are noted. Innovative approaches to vaccine production including DNA vaccines and the expression of hepatitis B antigen components in plants (edible vaccines) are reviewed.
This review describes further evidence to support the introduction of universal immunization against hepatitis B in those countries where this has yet to be implemented. Immunization programmes will continue to evolve to include the administration of polyvalent vaccines in order to best protect populations against infectious diseases.
讨论甲型和乙型肝炎免疫接种的当前问题，包括摒弃基于风险的方法而采用普遍接种疫苗的必要性、甲型和乙型肝炎联合疫苗及多价疫苗的使用、第三代三联抗原乙型肝炎疫苗和多价疫苗的研发。
乙型肝炎表面抗原突变体的出现仍是诊断工作和免疫预防中的一个问题，G145R变异体的水平传播强调了监测计划的必要性。注意到最近对乙型肝炎疫苗安全性毫无根据的担忧。综述了疫苗生产的创新方法，包括DNA疫苗以及在植物中表达乙型肝炎抗原成分（可食用疫苗）。
本综述描述了进一步的证据，以支持在尚未实施普遍乙型肝炎免疫接种的国家引入该措施。免疫接种计划将继续发展，包括使用多价疫苗，以便更好地保护人群免受传染病侵害。
