Alavian S M, Miri S M, Jazayeri S M
Baqiatollah Universityof Medical Sciences, Tehran, Iran.
Minerva Gastroenterol Dietol. 2012 Jun;58(2):167-78.
Hepatitis B virus (HBV) remains a serious public health problem worldwide, accounting for high morbidity and mortality rates as well as significant personal, societal, and economic costs. Hepatitis B is a preventable disease; a safe and effective vaccine has been available for 30 years. The World Health Organization aims to control HBV worldwide by integrating HB vaccination into infant, possibly adolescent, and at-risk adult routine immunization programs. In recent years, a drastic reduction in the mortality and morbidity of chronic HBV, including hepatocellular carcinoma, has occurred, particularly in hyperendemic areas. In addition, a therapeutic vaccine that enhances patient immune response has been considered as a possible alternative to antiviral agents. However, mutant HBV may infect individuals who are anti-HBs positive after immunization (vaccine-escape) and/or fail for detection of HBsAg (diagnostic-escape), which may lead to transmission through donated blood or organs. This review attempts to summarize the prophylactic, therapeutic, and diagnostic concerns on HBV vaccines.
乙型肝炎病毒（HBV）在全球范围内仍然是一个严重的公共卫生问题，导致高发病率和死亡率，以及巨大的个人、社会和经济成本。乙型肝炎是一种可预防的疾病；一种安全有效的疫苗已经问世30年了。世界卫生组织旨在通过将乙肝疫苗接种纳入婴儿、可能还有青少年以及高危成人的常规免疫计划，在全球范围内控制HBV。近年来，慢性HBV（包括肝细胞癌）的死亡率和发病率大幅下降，尤其是在高流行地区。此外，一种增强患者免疫反应的治疗性疫苗已被视为抗病毒药物的一种可能替代方案。然而，变异的HBV可能会感染免疫后抗-HBs呈阳性的个体（疫苗逃逸）和/或无法检测到HBsAg的个体（诊断逃逸），这可能导致通过献血或器官进行传播。本综述试图总结关于乙肝疫苗的预防、治疗和诊断方面的问题。
