Pavli P, Bayliss G J, Dent O F, Lunzer M R
Department of Gastroenterology, Royal North Shore Hospital of Sydney.
Med J Aust. 1989 Jul 17;151(2):71, 74-5. doi: 10.5694/j.1326-5377.1989.tb101163.x.
In order to determine the prevalence of hepatitis B virus infection in Royal Australian Navy personnel and to formulate policies for their education, screening and vaccination, a voluntary survey was undertaken. Seven hundred and forty-eight subjects completed a questionnaire that provided details of age, sex, rank, ethnic origin, service abroad, length of service, history of tattooing, liver disease and blood transfusions. Serum was assayed by radioimmunoassay for the presence of hepatitis B surface antigen (HBsAg), antibody to hepatitis B surface antigen (antiHBs) and antibody to hepatitis B core antigen (antiHBc). The presence of markers of hepatitis B virus infection was correlated with "risk factors" by means of the chi 2 test of independence. Fourteen (74%) of 19 personnel from the Pacific Islands, Asia and Africa who were excluded from analysis showed one-or-more such markers. The prevalence of any marker of hepatitis B virus infection was 4.4% (95% confidence interval [CI], 2.9%-5.9%). The individual markers HBsAg, antiHBs and antiHBc were found in 0.4% (95% CI, 0.1%-1.2%), 3.6% (95% CI, 2.2%-4.9%) and 3.9% (95% CI, 2.5%-5.3%) of subjects, respectively. The annual attack rate was estimated to be less than 1%. Factors which had a significant correlation with an increased prevalence of markers of hepatitis B virus infection included tattooing (especially if this had been performed in Asia), age, the duration of service and service abroad. Based on these data, and given the reduced cost of hepatitis B vaccines, vaccination now is considered worth while. A policy of vaccinating all personnel who may be required for service at sea, and others at risk, now is in effect. Educational programmes that are aimed at minimizing the risk of exposure to hepatitis B and other viral infections have been instituted.
为了确定澳大利亚皇家海军人员中乙肝病毒感染的流行情况，并制定针对他们的教育、筛查和疫苗接种政策，开展了一项自愿调查。748名受试者填写了一份问卷，问卷提供了年龄、性别、军衔、种族、海外服役情况、服役时长、纹身史、肝脏疾病史和输血史等详细信息。通过放射免疫分析法检测血清中乙肝表面抗原（HBsAg）、乙肝表面抗原抗体（抗-HBs）和乙肝核心抗原抗体（抗-HBc）的存在情况。采用独立性卡方检验将乙肝病毒感染标志物的存在情况与“危险因素”进行关联分析。从分析中排除的19名来自太平洋岛屿、亚洲和非洲的人员中有14名（74%）显示出一种或多种此类标志物。乙肝病毒感染任何标志物的流行率为4.4%（95%置信区间[CI]，2.9%-5.9%）。受试者中，单独的标志物HBsAg、抗-HBs和抗-HBc分别在0.4%（95%CI，0.1%-1.2%）、3.6%（95%CI，2.2%-4.9%）和3.9%（95%CI，2.5%-5.3%）的人群中被发现。年发病率估计低于1%。与乙肝病毒感染标志物流行率增加显著相关的因素包括纹身（尤其是在亚洲进行的纹身）、年龄、服役时长和海外服役。基于这些数据，考虑到乙肝疫苗成本降低，现在认为接种疫苗是值得的。目前正在实施一项为所有可能需要海上服役的人员以及其他有风险的人员接种疫苗的政策。已经制定了旨在将接触乙肝和其他病毒感染风险降至最低的教育计划。
