Hoofnagle J H, Blake J, Buskell-Bales Z, Seeff L B
J Clin Gastroenterol. 1980 Mar;2(1):65-9. doi: 10.1097/00004836-198003000-00010.
We prospectively investigated the possibility that type B hepatitis might be transmitted during fiberoptic endoscopy from hepatitis B surface antigen (HBsAg)-positive patients to others subsequently endoscoped. All 186 patients having upper gastrointestinal endoscopy during a 6-month period at the Washington, D.C., Veterans Administration Medical Center had a blood sample obtained at the time of the procedure. Three patients were found to be HBsAG-positive and 45 others to have either antibody to HBsAg (anti-HBs) or antibody to hepatitis B core antigen (anti-HBc). Follow-up evaluation for evidence of type B hepatitis and hepatitis B virus infection was possible in only 76% of patients. One patient developed type B hepatitis. This patient's endoscopy did not follow endoscopy of any known HBsAg-positive individual, but he had received five units of blood 5 months before hepatitis developed. No other patient showed clinical, biochemical, or serologic evidence of hepatitis during the follow-up period. These data suggest that transmission of type B hepatitis during fiberoptic endoscopy is rare, if it occurs at all, and support the current policy of not sterilizing the fiberoptic endoscope between procedures and of not routinely screening patients for HBsAg.
我们前瞻性地研究了在纤维内镜检查期间，乙型肝炎可能从乙肝表面抗原（HBsAg）阳性患者传播给随后接受内镜检查的其他人的可能性。在华盛顿特区退伍军人管理局医疗中心6个月期间接受上消化道内镜检查的186例患者，在检查时均采集了血样。发现3例患者HBsAg阳性，另外45例患者有乙肝表面抗原抗体（抗-HBs）或乙肝核心抗原抗体（抗-HBc）。只有76%的患者能够进行乙型肝炎和乙肝病毒感染证据的随访评估。1例患者发生了乙型肝炎。该患者的内镜检查并非在任何已知HBsAg阳性个体的内镜检查之后进行，但他在肝炎发生前5个月接受了5个单位的血液输注。在随访期间，没有其他患者出现肝炎的临床、生化或血清学证据。这些数据表明，纤维内镜检查期间乙型肝炎的传播即使确实发生也很罕见，并支持目前在不同检查之间不对纤维内镜进行消毒以及不常规筛查患者HBsAg的政策。
