Michos A, Terzidis A, Kalampoki V, Pantelakis K, Spanos Th, Petridou E Th
1st Pediatric Department, Division of Infectious Diseases, University of Athens, Athens, Greece.
J Med Virol. 2008 May;80(5):791-7. doi: 10.1002/jmv.21134.
The prevalence and risk factors of hepatitis A, B, and C (HAV, HBV, and HCV) markers were compared in non-Roma and Roma children who lived in a deprived suburb of Athens, Greece. The study included 216 children, 118 Roma and 98 non-Roma of 9 years median age (range 5-15 years). Among Roma children 98.3% had detectable antibodies to HAV, compared with 32.7% among non-Romas (P < 0.0001). Regarding HBV, 22% Roma children were identified with evidence of past infection (anti-HBc(+)), among whom five (4% of the total) were chronic carriers (HBsAg(+)), whereas no past infection was detected among the non-Romas (P < 0.0001). Markers of past HBV vaccination (anti-HBs(+), anti-HBc(-)) were detected in only 14% Roma but 96% non-Roma children (P-value < 0.0001). There was some indication for intrafamilial transmission of HAV and HBV in Roma school children. Unfavorable living conditions, frequent residency change, lack of child insurance and primary healthcare delivery were significantly associated with seroprevalence of HBV infection among Romas. No child in either group was found positive for HCV markers. These findings document high socioeconomic differentials with regards to preventable communicable diseases, such as HAV and HBV and underline the need for enhancing health policy action targeting pockets of minority childhood populations. Whereas, uptake of HBV vaccination is rather optimal in this general population, the high seroprevalence of HAV among Romas, also calls for implementing general vaccination for HAV, early in life.
在居住于希腊雅典一个贫困郊区的非罗姆族和罗姆族儿童中，对甲型、乙型和丙型肝炎（HAV、HBV和HCV）标志物的流行情况及危险因素进行了比较。该研究纳入了216名儿童，其中118名罗姆族儿童和98名非罗姆族儿童，中位年龄为9岁（范围5 - 15岁）。在罗姆族儿童中，98.3%检测到抗HAV抗体，而非罗姆族儿童中这一比例为32.7%（P < 0.0001）。关于HBV，22%的罗姆族儿童有既往感染证据（抗HBc(+)），其中5名（占总数的4%）为慢性携带者（HBsAg(+)），而非罗姆族儿童中未检测到既往感染（P < 0.0001）。仅14%的罗姆族儿童检测到HBV既往疫苗接种标志物（抗HBs(+)，抗HBc(-)），但非罗姆族儿童中这一比例为96%（P值< 0.0001）。有迹象表明罗姆族学童中存在HAV和HBV的家庭内传播。不利的生活条件、频繁更换居住地址、缺乏儿童保险和基本医疗服务与罗姆族中HBV感染的血清流行率显著相关。两组中均未发现儿童HCV标志物呈阳性。这些发现表明在可预防的传染病如HAV和HBV方面存在巨大的社会经济差异，并强调需要加强针对少数族裔儿童群体的健康政策行动。虽然在这一总体人群中HBV疫苗接种率相当理想，但罗姆族中HAV的高血清流行率也呼吁在生命早期实施HAV普遍接种。
