Grosheide P M, Rothbarth P H, Gerards L J
Afd. Inwendige Geneeskunde II, Academisch Ziekenhuis Dijkzigt, Rotterdam.
Tijdschr Kindergeneeskd. 1990 Dec;58(6):203-11.
Central to immunization programmes is that hepatitis B virus infection in infancy is much more likely to result in the chronic carrier state than if infection occurs in adulthood. In areas of high endemicity like south-eastern Asia most infections occur when chronically infected women transmit hepatitis B virus to their newborns or when chronically infected children transmit the virus to other children. In the Netherlands, the endemicity is considered low; seroprevalence studies showed that 0.8% of the pregnant women are HBsAg-positive. To prevent mother to child transmission of hepatitis B a national immunization program has recently been implemented to prevent perinatal infection in approximately 450 neonates each year. Horizontal transmission of hepatitis B virus also seems possible in children since persistent carriers are found in (medical) centres and institutions for mentally handicapped. Since hepatitis B infections acquired during early childhood are likely to progress to chronicity and liver disease in adult life some risk factors for children in the Netherlands to contract hepatitis B infection are described and the immunization strategy is discussed.
免疫规划的核心在于，相较于成年期感染，婴儿期感染乙肝病毒更易导致慢性携带状态。在东南亚等乙肝高流行地区，大多数感染发生在慢性感染的女性将乙肝病毒传播给新生儿时，或者慢性感染的儿童将病毒传播给其他儿童时。在荷兰，乙肝流行率被认为较低；血清学流行率研究表明，0.8%的孕妇乙肝表面抗原呈阳性。为预防乙肝母婴传播，最近实施了一项国家免疫规划，以每年预防约450名新生儿的围产期感染。由于在智障（医疗）中心和机构中发现了持续性携带者，乙肝病毒在儿童中似乎也可能发生水平传播。鉴于儿童早期感染乙肝病毒很可能在成年后发展为慢性感染和肝病，本文描述了荷兰儿童感染乙肝病毒的一些风险因素，并讨论了免疫策略。
