McMahon B J, Rhoades E R, Heyward W L, Tower E, Ritter D, Lanier A P, Wainwright R B, Helminiak C
Alaska Area Native Health Service, Indian Health Service, Anchorage 99510.
Lancet. 1987 Nov 14;2(8568):1134-6. doi: 10.1016/s0140-6736(87)91557-1.
In 1983, a comprehensive programme was introduced to halt the spread of hepatitis B virus (HBV) infection and to reduce mortality from hepatocellular carcinoma (HCC) in Alaskan Natives, in whom the incidence of HBV infection was high. This programme includes: serological screening of all Alaskan Natives; immunisation of susceptible persons, including all newborn babies, with hepatitis B vaccine; and testing HBsAg-positive carriers twice a year for alpha-fetoprotein (AFP) to detect HCC at an early stage. By October, 1986, over 53,000 Alaskan Natives (84% of the total Native population) had been tested for HBV serological markers and 80% of the identified susceptibles had been or were being vaccinated against HBV. After complete immunisation of 90% of the susceptibles in the area with the highest infection rates in Alaska, the annual incidence of acute symptomatic HBV infection decreased from 215 to 14 cases per 100,000 population. After the introduction of AFP screening, the 1-year-case-fatality rate for HCC fell, from 100%, to 50%.
1983年，阿拉斯加原住民中乙肝病毒（HBV）感染率很高，为阻止HBV感染传播并降低肝细胞癌（HCC）死亡率，实施了一项综合计划。该计划包括：对所有阿拉斯加原住民进行血清学筛查；用乙肝疫苗对易感人群（包括所有新生儿）进行免疫接种；以及每年对HBsAg阳性携带者检测两次甲胎蛋白（AFP）以便早期发现HCC。到1986年10月，超过53000名阿拉斯加原住民（占原住民总人口的84%）接受了HBV血清学标志物检测，已确认的易感人群中80%已接种或正在接种乙肝疫苗。在阿拉斯加感染率最高地区90%的易感人群完成免疫接种后，急性症状性HBV感染的年发病率从每10万人215例降至14例。引入AFP筛查后，HCC的1年病死率从100%降至50%。
