Department of Infectious Diseases, Aarhus University Hospital, 8200 Aarhus N, Denmark.
J Infect. 2012 Apr;64(4):399-408. doi: 10.1016/j.jinf.2011.12.013. Epub 2011 Dec 23.
To assess journey length and other predictors of travel-related acute hepatitis A (HAV) and B (HBV) virus infection among native Danes and determine the sensitivity and specificity of current pre-travel vaccination guidelines.
A nationwide case-control study was perfomed involving 60 Danes with HAV and 14 with HBV who acquired hepatitis in non-western countries from 2000 to 2010. Non-immune travellers from a nationwide survey (1188 HAV and 1709 HBV) served as controls.
The odds ratios (ORs) for HAV and HBV increased with increasing journey length (p<0.0001). However, 90% of HAV and 62% of HBV cases travelled for less than 4 weeks, and the daily infection rate did not increase with journey length; rather, for HAV it decreased. Increasing age (p<0.0001) and journeys to Africa (OR 6.1 (3.2-11)) raised the risk of acute HAV. Travelling alone or with friends as compared to travelling with a partner/family (OR: 15 (3.2-134)) strongly predicted HBV risk. Danish vaccination guidelines had HAV/HBV sensitivities of 86%/31%, and specificities of 27%/95%, respectively. Incidence rates were 12.8 (HAV) and 10.2 (HBV) per 100,000 non-immune travel months, and acute disease severity affected HAV and HBV cases equally.
These results may support revision of current pre-travel vaccination guidelines.
评估丹麦本国人旅行相关甲型肝炎（HAV）和乙型肝炎（HBV）病毒感染的旅行距离及其他预测因素，并确定当前旅行前疫苗接种指南的灵敏度和特异性。
进行了一项全国性病例对照研究，涉及 60 名在 2000 年至 2010 年期间在非西方国家感染 HAV 和 14 名感染 HBV 的丹麦人。来自全国性调查的非免疫旅行者（1188 名 HAV 和 1709 名 HBV）作为对照。
HAV 和 HBV 的比值比（OR）随着旅行距离的增加而增加（p<0.0001）。然而，90%的 HAV 和 62%的 HBV 病例的旅行时间不到 4 周，且每日感染率并未随旅行距离的增加而增加；相反，HAV 的感染率下降。年龄增加（p<0.0001）和前往非洲的旅行（OR 6.1（3.2-11））增加了急性 HAV 的风险。与伴侣/家人相比，单独或与朋友旅行（OR：15（3.2-134））强烈预测了 HBV 的风险。丹麦疫苗接种指南对 HAV/HBV 的灵敏度分别为 86%/31%，特异性分别为 27%/95%。未免疫旅行者每 100,000 个旅行月的发病率分别为 12.8（HAV）和 10.2（HBV），急性疾病严重程度对 HAV 和 HBV 病例的影响相同。
这些结果可能支持修订当前的旅行前疫苗接种指南。
