Department of Medicine, Alice Ho Miu Ling Nethersole Hospital, Chinese University of Hong Kong, Room 65, J6, 11 Chuen On Road, Tai Po, NT, Hong Kong SAR, China,
Hepatol Int. 2009 Dec;3 Suppl 1(Suppl 1):24-31. doi: 10.1007/s12072-009-9142-1. Epub 2009 Jul 9.
Hepatitis B virus (HBV) infection is a serious clinical problem affecting approximately 2 billion people worldwide. An estimated 350 million live with chronic hepatitis B (CHB) infection and are at an increased risk for serious liver sequelae and death from acute or chronic consequences of CHB infection. Individuals with CHB have a 20-30% risk of early death from complications, including liver cirrhosis and hepatocellular carcinoma. In the Asia-Pacific region, half of the CHB burden results from vertical or mother-to-child transmission, with early childhood horizontal transmission accounting for the remaining half. Screening and vaccination are key factors in the successful prevention and control of HBV infection. Over the last 20 years, the implementation of screening programs and universal HBV vaccination for all individuals born in endemic areas have reduced the prevalence of HBV infection and HBV-related liver diseases among individuals younger than 30 years. Women of childbearing age are key stakeholders in preventing HBV infection and, as such, play a critical role in reducing the vertical and horizontal transmission of HBV. Further efforts are needed to implement screening and educational programs for women of childbearing age, particularly those with CHB, to prevent the transmission of HBV to newborns, spouses, other household members, and sexual partners. In addition, healthcare workers need to learn how to avoid iatrogenic transmission in the healthcare setting. This article reviews these issues and highlights areas in which their engagement with public health efforts serves to improve quality of life and society as a whole.
乙型肝炎病毒(HBV)感染是一个严重的临床问题,影响着全球约 20 亿人。据估计,全球有 3.5 亿人患有慢性乙型肝炎(CHB)感染,并且因急性或慢性 CHB 感染的后果而面临严重肝脏后遗症和死亡的风险增加。患有 CHB 的个体因并发症(包括肝硬化和肝细胞癌)而早期死亡的风险为 20-30%。在亚太地区,CHB 负担的一半是由垂直或母婴传播引起的,而早期儿童水平传播占剩余的一半。筛查和疫苗接种是成功预防和控制 HBV 感染的关键因素。在过去的 20 年中,实施筛查计划和对所有流行地区出生的个体进行乙型肝炎疫苗接种,已经降低了 30 岁以下个体中 HBV 感染和 HBV 相关肝病的流行率。育龄妇女是预防 HBV 感染的关键利益相关者,因此,她们在减少 HBV 的垂直和水平传播方面发挥着关键作用。需要进一步努力,为育龄妇女,特别是患有 CHB 的妇女,实施筛查和教育计划,以防止 HBV 传播给新生儿、配偶、其他家庭成员和性伴侣。此外,医护人员需要了解如何在医疗保健环境中避免医源性传播。本文综述了这些问题,并强调了他们参与公共卫生工作的领域,这些领域有助于提高生活质量和整个社会的水平。