Department of Internal Medicine, National Taiwan University College of Medicine, Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan.
J Gastroenterol Hepatol. 2010 Jan;25(1):19-25. doi: 10.1111/j.1440-1746.2009.06165.x.
Hepatitis B virus (HBV) causes important human health problems. It has infected one-third of the world's population and approximately 360 million people are chronic carriers. Worldwide, 0.5-1.2 million deaths are attributed to HBV infection annually. Therefore, global control of HBV infection is important. HBV infection can be intervened by interrupting routes of transmission, treating the chronically infected, and preventing the susceptibles with immunoprophylaxis. All these measures are effective. Nevertheless, although pegylated interferons or nucleos(t)ide analogs are effective for the treatment of chronic hepatitis B, chronic carriage of HBV is not easy to eliminate, as revealed by the frequent persistence of hepatitis B surface antigen, despite satisfactory responses to these treatments. On the other hand, hepatitis B vaccination has been shown to preclude HBV infection effectively. This is particularly true for pre-exposure prophylaxis. Worthy of note is the universal vaccination of newborn infants. This is the most effective means of preventing HBV infection, especially for those born to HBV carrier mothers. To eliminate and eradicate hepatitis B, first, HBV in the chronically infected should be eradicated or strongly and efficiently suppressed, so that the infection does not spread rampantly. Second, all the transmission routes should be interrupted. Lastly, but most effectively, is to immunize all susceptibles. The difficulties and possible solutions of each approach are discussed. In conclusion, the existing means to prevent and treat HBV infection render our goal toward eliminating and eradicating hepatitis B possible, although it will take much time and effort to achieve this objective.
乙型肝炎病毒 (HBV) 引起重要的人类健康问题。它已感染了世界人口的三分之一，约有 3.6 亿人为慢性携带者。全球每年有 0.5-1.2 万人死于 HBV 感染。因此，全球控制 HBV 感染非常重要。HBV 感染可以通过阻断传播途径、治疗慢性感染者和免疫预防易感者来干预。所有这些措施都是有效的。然而，尽管聚乙二醇干扰素或核苷（酸）类似物对慢性乙型肝炎的治疗有效，但由于这些治疗方法的良好反应后仍经常持续存在乙型肝炎表面抗原，因此慢性 HBV 携带不易消除。另一方面，乙型肝炎疫苗接种已被证明能有效地预防 HBV 感染。对于暴露前预防尤其如此。值得注意的是对新生儿进行普遍接种。这是预防 HBV 感染最有效的方法，特别是对于 HBV 携带者的母亲所生的婴儿。要消除和消灭乙型肝炎，首先要消灭或强烈有效地抑制慢性感染者中的 HBV，使其感染不会猖獗传播。其次，要阻断所有传播途径。最后但最重要的是，对所有易感者进行免疫接种。讨论了每种方法的困难和可能的解决方案。总之，预防和治疗 HBV 感染的现有手段使我们有可能实现消除和消灭乙型肝炎的目标，尽管要实现这一目标还需要付出很多时间和努力。
