Meheus A
Department of Epidemiology and Community Medicine, University of Antwerp, Belgium.
Vaccine. 1995;13 Suppl 1:S31-4. doi: 10.1016/0264-410x(95)80044-e.
In countries of low hepatitis B virus (HBV) endemicity, infection occurs mainly in adolescents and young adults (15-34 years old). The most important risk factors for infection are heterosexual activity, homosexual activity and intravenous drug use. In industrialized countries, therefore, HBV infection is classified among the major sexually transmitted infections, as more than 50% of infections are spread in this way. Transmission from mother to newborn and during infancy is of less importance, except in some countries of southern Europe and in some southern states of the USA. The highest concentrations of HBV are found in blood of infected individuals, but HBsAg is also present in semen and vaginal and cervical secretions, which forms the biological explanation for sexual transmission of the virus. In epidemiological studies, HBV is, in general, associated with indicators of sexual activity such as number of lifetime or recent sexual partners, years of sexual activity and a history or serological marker of other sexually transmitted infections. Providing immunity from infection before risk-taking behaviour is adopted should be the major control strategy for HBV infection. Just as for other sexually transmitted infections, this can be best achieved by universal vaccination of young adolescents or infants, or both groups.
在乙型肝炎病毒（HBV）低流行率国家，感染主要发生在青少年和青年（15 - 34岁）。感染的最重要风险因素是异性性行为、同性性行为和静脉注射吸毒。因此，在工业化国家，HBV感染被归类为主要的性传播感染之一，因为超过50%的感染是通过这种方式传播的。除了在南欧的一些国家和美国的一些南部州，母婴传播和婴儿期传播的重要性较低。HBV在受感染个体的血液中浓度最高，但乙肝表面抗原（HBsAg）也存在于精液、阴道和宫颈分泌物中，这构成了该病毒性传播的生物学解释。在流行病学研究中，一般而言，HBV与性活动指标相关，如终身或近期性伴侣数量、性活动年限以及其他性传播感染的病史或血清学标志物。在采取危险行为之前提供感染免疫力应是HBV感染的主要控制策略。与其他性传播感染一样，这可以通过对青少年或婴儿，或两组进行普遍接种疫苗来最好地实现。
