Kiire C F
Department of Medicine, University of Zimbabwe, Harare.
Vaccine. 1990 Mar;8 Suppl:S107-12; discussion S134-8. doi: 10.1016/0264-410x(90)90229-f.
Hepatitis B virus (HBV) infection and its sequelae are extremely common in sub-Saharan Africa. The overall hepatitis B surface antigen (HBsAg) carrier rate in the general population is 5-20%, which is amongst the highest in the world. Although perinatal infection occurs with an incidence of 1-5%, the predominant form of transition is horizontal among infants and young children; most infections are acquired between 6 months and the pre-school age (5-6 years). Thus, the traditional concept of 'high-risk groups' is of limited importance in Africa and all children should be regarded as being at risk. Hepatitis B-associated hepatocellular carcinoma is probably the most common tumour affecting males in sub-Saharan Africa, with Mozambique having the highest incidence rate of 103.8 per 100,000 males. Cost-benefit analysis shows that, in sub-Saharan Africa, the most effective way of controlling hepatitis B infection is through mass neonatal vaccination programmes integrated within the Expanded Programme on Immunization without prior testing for HBV markers.
乙型肝炎病毒（HBV）感染及其后遗症在撒哈拉以南非洲极为常见。普通人群中乙肝表面抗原（HBsAg）的总体携带率为5%-20%，是世界上最高的地区之一。虽然围产期感染的发生率为1%-5%，但在婴幼儿中主要的传播形式是水平传播；大多数感染发生在6个月至学龄前（5-6岁）。因此，“高危人群”这一传统概念在非洲的重要性有限，所有儿童都应被视为有感染风险。乙肝相关肝细胞癌可能是撒哈拉以南非洲影响男性最常见的肿瘤，莫桑比克的发病率最高，每10万名男性中有103.8例。成本效益分析表明，在撒哈拉以南非洲，控制乙肝感染最有效的方法是通过纳入扩大免疫规划的大规模新生儿疫苗接种计划，而无需事先检测HBV标志物。
