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日本甲型肝炎病毒感染的血清流行病学:一个低流行地区。

Seroepidemiology of hepatitis A virus infection in Japan: An area of very low endemicity.

作者信息

Kiyohara Tomoko, Ishii Koji, Satake Masahiro, Matsubayashi Keiji, Suzuki Ryosuke, Sugiyama Ryuichi, Sunagawa Tomimasa, Muramatsu Masamichi

机构信息

Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan.

Department of Quality Assurance and Radiological Protection, National Institute of Infectious Diseases, Tokyo, Japan.

出版信息

Microbiol Immunol. 2023 Jan;67(1):14-21. doi: 10.1111/1348-0421.13035. Epub 2022 Nov 27.

Abstract

The incidence of hepatitis A virus (HAV) infection has declined significantly worldwide, including in Japan. A nationwide seroepidemiological study on hepatitis A in Japan has taken place almost every 10 years since 1973, and the last study was performed in 2003. In the present study, we describe the latest seroepidemiological pattern of hepatitis A in Japan using 7867 serum specimens obtained from healthy individuals collected between 2013 and 2017, approximately 10 years after the last study. Among them, 223 were anti-HAV positive. About 68% of individuals aged 60 years and older had anti-HAV antibodies, whereas only 1.1% of those aged below 60 years old had immunity; thus, almost all individuals younger than 60 years of age were HAV susceptible. In comparison with previous investigations, the susceptible population has increased and aged. According to data from the National Epidemiological Surveillance of Infectious Diseases (NESID) program, between 1989 and 2016, the proportion of patients with hepatitis A aged 60 years and older continuously increased with each year. The NESID data also suggested that recently, typical large foodborne outbreaks of hepatitis A have become rare, and cases tend to be reported among at-risk groups; overseas travelers contributed to 25% of hepatitis A cases, and in 2018, the first nationwide hepatitis A outbreak that affected mostly men who have sex with men was reported. The purpose of this study was to determine the current status of HAV infection in Japan, based on both seroepidemiology and the national surveillance data from the NESID.

摘要

甲型肝炎病毒(HAV)感染的发病率在全球范围内已显著下降,在日本亦是如此。自1973年以来,日本几乎每10年进行一次全国性的甲型肝炎血清流行病学研究,上一次研究于2003年开展。在本研究中,我们使用2013年至2017年间从健康个体采集的7867份血清标本描述了日本甲型肝炎的最新血清流行病学模式,此次采集时间距上次研究约10年。其中,223份标本抗-HAV呈阳性。60岁及以上个体中约68%具有抗-HAV抗体,而60岁以下个体中只有1.1%具有免疫力;因此,几乎所有60岁以下个体对HAV易感。与之前的调查相比,易感人群有所增加且年龄更大。根据国家传染病流行病学监测(NESID)项目的数据,1989年至2016年间,60岁及以上甲型肝炎患者的比例逐年持续上升。NESID数据还表明,最近,典型的甲型肝炎大型食源性暴发已变得罕见,病例往往在高危人群中报告;出国旅行者占甲型肝炎病例的25%,并且在2018年,首次报告了主要影响男男性行为者的全国性甲型肝炎暴发。本研究的目的是基于血清流行病学和NESID的国家监测数据确定日本HAV感染的现状。

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