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1991 年至 2007 年间不列颠哥伦比亚省慢性乙型肝炎患者中急性疫苗可预防肝炎的鉴定。

Identification of acute vaccine-preventable hepatitis in individuals with chronic hepatitis in British Columbia between 1991 and 2007.

机构信息

BC Centre for Disease Control, Vancouver, British Columbia;

出版信息

Can J Infect Dis Med Microbiol. 2011 Spring;22(1):10-4. doi: 10.1155/2011/564290.

Abstract

BACKGROUND

In British Columbia (BC), hepatitis A virus (HAV) and hepatitis B virus (HBV) vaccines are provincially funded for persons with chronic hepatitis infections.

PURPOSE

To assess the effectiveness of BC public health follow-up of HBV and hepatitis C virus (HCV) cases and immunization policy by determining the number of vaccine-preventable acute hepatitis infections reported following a chronic HBV or HCV diagnosis, by examining demographic characteristics and by observing temporal trends.

METHODS

All newly identified cases of HAV, HBV and HCV between 1991 and October 2007 were extracted from the BC integrated Public Health Information System and linked to ascertain cases of hepatitis suprainfection.

RESULTS

Between 1991 and October 2007, 30 BC residents with chronic HBV and 104 with HCV were subsequently diagnosed with HAV. Acute HBV was identified in 162 persons previously diagnosed with HCV. Significantly more men than women developed hepatitis suprainfection (P<0.0001), but women were of a younger age when they were diagnosed with HAV (P=0.02) and acute HBV (P=0.0002). HAV suprainfection cases among those with HCV peaked in 1998 at 33 cases and declined to zero cases in 2007. In comparison, HBV suprainfection among individuals with chronic HCV peaked in 1996 at 26 cases and declined to two cases in 2007.

DISCUSSION

Cases of HAV and acute HBV have declined among HCV-infected individuals. However, despite the availability of publicly funded vaccines for high-risk groups, a substantial number of acute HBV infections post-HCV identification are still identified, indicating that follow-up and vaccination coverage should be improved in these populations.

摘要

背景

在不列颠哥伦比亚省(BC),甲型肝炎病毒(HAV)和乙型肝炎病毒(HBV)疫苗由省政府为慢性肝炎感染者提供资金。

目的

通过确定慢性 HBV 或 HCV 诊断后报告的可通过疫苗预防的急性肝炎感染数量,检查人口统计学特征并观察时间趋势,来评估 BC 公共卫生对 HBV 和丙型肝炎病毒(HCV)病例的随访和免疫政策的效果。

方法

从 1991 年至 2007 年 10 月的不列颠哥伦比亚省综合公共卫生信息系统中提取所有新发现的 HAV、HBV 和 HCV 病例,并将其与确定肝炎重叠感染病例相关联。

结果

在 1991 年至 2007 年 10 月期间,30 名患有慢性 HBV 的 BC 居民和 104 名患有 HCV 的居民随后被诊断患有 HAV。在先前被诊断患有 HCV 的 162 名患者中发现了急性 HBV。患有肝炎重叠感染的男性明显多于女性(P<0.0001),但女性被诊断患有 HAV(P=0.02)和急性 HBV(P=0.0002)时年龄较小。丙型肝炎感染者的 HAV 重叠感染病例在 1998 年达到峰值,为 33 例,到 2007 年降至零例。相比之下,慢性 HCV 感染者的 HBV 重叠感染病例在 1996 年达到峰值,为 26 例,到 2007 年降至 2 例。

讨论

在 HCV 感染者中,HAV 和急性 HBV 病例有所减少。然而,尽管为高风险人群提供了公共资金疫苗,但仍发现大量急性 HBV 感染后 HCV 确诊病例,这表明应在这些人群中改进随访和疫苗接种覆盖率。

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