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乙型肝炎病毒感染流行病学的新趋势

Emerging Trends in Epidemiology of Hepatitis B Virus Infection.

作者信息

Stasi Cristina, Silvestri Caterina, Voller Fabio

机构信息

Observatory of Epidemiology, Regional Health Agency of Tuscany, Florence, Italy.

Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.

出版信息

J Clin Transl Hepatol. 2017 Sep 28;5(3):272-276. doi: 10.14218/JCTH.2017.00010. Epub 2017 May 30.

Abstract

Although a vaccine against hepatitis B virus (HBV) has been available since 1982, the prevalence of adults with chronic HBV infection in sub-Saharan Africa and East Asia is still estimated at 5-10%. A high rate of chronic infections is also found in the Amazon and the southern parts of eastern and central Europe. In the Middle East and the Indian subcontinent, the prevalence is 2-5%. Less than 1% of the population of Western Europe and North America is chronically infected. Given the high prevalence of infections (such as hepatitis) among inmates, prison is considered a reservoir for facilitating such infections. Based on these premises, this current review examines and discusses emerging trends in the epidemiology of HBV infection, with particular attention to HBV infection in prison. The hepatitis B surface antigen (HBsAg) prevalence in prisoners in west and central Africa is very high (23.5%). The Centers for Disease Control and Prevention has highlighted the importance of HBV blood screening and subsequent anti-HBV vaccination in the prison population. The vaccination was recommended for all inmates, representing an opportunity to prevent HBV infection in a high-risk population. In these subjects, an accelerated hepatitis B immunisation schedule may result in rapid seroconversion for early short-term protection. Therefore, it is necessary to seek collaboration among public health officials, clinicians and correctional authorities to implement a vaccination programme.

摘要

尽管自1982年以来就有针对乙型肝炎病毒(HBV)的疫苗,但撒哈拉以南非洲和东亚地区慢性HBV感染的成年人患病率估计仍为5%-10%。在亚马逊地区以及东欧和中欧南部也发现了高慢性感染率。在中东和印度次大陆,患病率为2%-5%。西欧和北美不到1%的人口受到慢性感染。鉴于囚犯中感染(如肝炎)的高患病率,监狱被认为是促进此类感染的一个源头。基于这些前提,本综述审视并讨论了HBV感染流行病学的新趋势,尤其关注监狱中的HBV感染情况。西非和中非囚犯中的乙肝表面抗原(HBsAg)患病率非常高(23.5%)。美国疾病控制与预防中心强调了对监狱人群进行HBV血液筛查及后续接种乙肝疫苗的重要性。建议对所有囚犯进行疫苗接种,这是在高危人群中预防HBV感染的一个契机。在这些人群中,加速乙肝免疫接种程序可能会导致快速血清转化,从而实现早期短期保护。因此,有必要寻求公共卫生官员、临床医生和惩教当局之间的合作,以实施疫苗接种计划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be3a/5606973/29ba69775652/JCTH-5-272-g001.jpg

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