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乙肝疫苗接种:实现消除和根除乙肝的关键。

Hepatitis B vaccination: The key towards elimination and eradication of hepatitis B.

作者信息

Chen Ding-Shinn

机构信息

Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University College of Medicine and Hepatitis Research Center, National Taiwan University Hospital, Taipei.

出版信息

J Hepatol. 2009 Apr;50(4):805-16. doi: 10.1016/j.jhep.2009.01.002. Epub 2009 Feb 3.

Abstract

Hepatitis B virus infection is a global health problem. Worldwide, about 360 million people are chronically infected with the virus. They continue to spread the virus to others and are themselves at risk of chronic liver diseases and hepatocellular carcinoma. The infection can now be treated by antivirals or interferons and the transmission route can be interrupted. Nevertheless, the most effective means is to immunize all susceptible individuals, especially young children, with safe and efficacious vaccines. The combined efforts of vaccination, effective treatment and interruption of transmission make elimination of the infection plausible and may eventually lead to eradication of the virus. Because hepatitis B vaccination has a key role in the control of hepatitis B, properties of this vaccine, its effectiveness in pre-exposure and post-exposure settings, duration of protection after vaccination and the need of booster doses are discussed. Mass hepatitis B vaccination in children decreases the carriage of the virus, and the diseases associated with acute and chronic infection, including hepatocellular carcinoma. Challenges that need to be solved to expand mass vaccination, and the strategies towards elimination and eventual eradication of hepatitis B in the world are also discussed.

摘要

乙型肝炎病毒感染是一个全球性的健康问题。在全球范围内,约有3.6亿人长期感染该病毒。他们会继续将病毒传播给他人,自身也面临患慢性肝病和肝细胞癌的风险。目前,这种感染可以通过抗病毒药物或干扰素进行治疗,传播途径也可以被阻断。然而,最有效的方法是用安全有效的疫苗为所有易感人群,尤其是幼儿进行免疫接种。疫苗接种、有效治疗和传播阻断的共同努力使得消除这种感染成为可能,并最终可能导致病毒的根除。由于乙型肝炎疫苗接种在控制乙型肝炎方面起着关键作用,本文将讨论该疫苗的特性、其在暴露前和暴露后环境中的有效性、接种疫苗后的保护持续时间以及加强剂量的必要性。儿童大规模乙型肝炎疫苗接种可减少病毒携带率,以及与急慢性感染相关的疾病,包括肝细胞癌。本文还讨论了扩大大规模疫苗接种需要解决的挑战,以及在全球消除并最终根除乙型肝炎的策略。

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