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[实习护士中乙型肝炎病毒感染的血清流行病学:对疫苗接种政策的一些启示]

[Seroepidemiology of infection by hepatitis B virus in student nurses: some implications for vaccination policy].

作者信息

Maffei C, Renga G, David S, Brugia M, Manzin A, Clementi M

出版信息

Boll Ist Sieroter Milan. 1985;64(6):455-62.

PMID:3913450
Abstract

To estimate the risk of hepatitis B virus (HBV) infection among student nurses, we measured the prevalence of HBV infection in 218 student nurses (192 female and 26 male nurses) and the annual attack rate in a subgroup of 117 subjects. In both studies sera were tested with an enzyme immunoassay for the presence of HBsAg, anti-HBc and anti-HBs. In the prevalence study 24 student nurses (11.1%) had a marker of prior HBV infection; the presence of both anti-HBc and anti-HBs was the most prevalent serologic pattern. 2 student nurses were HBsAg positive (0.9%). Prevalence of infection was strongly related to increasing age, while the occupation of the head of the family showed no effect. In the incidence study 7 subjects seroconverted in a year (6.2%): 6 acquired only anti-HBc and 1 only anti-HBs. These data suggested the hypothesis that the presence of anti-HBc alone (a pattern usually associated with past infections in which anti-HBs is no more detectable) may represent false positive results. The implications of such hypothesis are discussed with particular reference to prevaccination screening policy.

摘要

为评估实习护士感染乙型肝炎病毒(HBV)的风险,我们测定了218名实习护士(192名女护士和26名男护士)的HBV感染率以及117名受试者亚组的年发病率。在这两项研究中,均采用酶免疫法检测血清中HBsAg、抗-HBc和抗-HBs的存在情况。在患病率研究中,24名实习护士(11.1%)有既往HBV感染标志物;抗-HBc和抗-HBs同时存在是最常见的血清学模式。2名实习护士HBsAg呈阳性(0.9%)。感染率与年龄增长密切相关,而家庭户主的职业则无影响。在发病率研究中,一年内有7名受试者血清学转换(6.2%):6名仅获得抗-HBc,1名仅获得抗-HBs。这些数据提示了这样一种假设,即单独存在抗-HBc(一种通常与既往感染相关的模式,其中抗-HBs不再可检测到)可能代表假阳性结果。本文特别参照接种疫苗前的筛查政策讨论了这一假设的意义。

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