Bowden F J, Currie B J, Miller N C, Locarnini S A, Krause V L
Northern Territory Department of Health and Community Services, Darwin.
Med J Aust. 1994 Sep 19;161(6):372-3. doi: 10.5694/j.1326-5377.1994.tb127490.x.
To determine the level of immunity to hepatitis A virus infection in rural Australian Aboriginal populations in the "Top End" of the Northern Territory.
A total of 344 sera, for which details of donors' age, sex and domicile were available, were collected and tested for hepatitis A total antibody in a delinked seroprevalence study.
Overall, 337/344 samples (97.97%) tested positive for hepatitis A total antibodies--18/20 samples (90%) in the 1-5 year age group; 85/88 (96.6%) in the 6-10 year age group; 98/98 (100%) in the 11-15 year age group; 32/33 (97.0%) in the 16-20 year age group and 104/105 (99%) in the older than 20 year age group.
Hepatitis A is hyperendemic in the rural Aboriginal communities studied and the virus is acquired predominantly in the first five years of life. Symptomatic hepatitis A infection is uncommon in this population. We suggest that hepatitis A vaccination for rural Aboriginal children is not indicated as it would not reduce clinical disease rates and may produce a cohort whose immunity could decrease over the following 10 years. Although vaccination is appropriate for non-immune individuals working in remote communities, emphasis must be placed on the inequities in health infrastructure and education underlying the high transmission rates in Aboriginal children.
确定北领地“顶端地区”澳大利亚农村原住民群体中甲型肝炎病毒感染的免疫水平。
在一项非关联血清流行率研究中，收集了344份血清，这些血清提供了捐赠者的年龄、性别和住所细节，并检测了甲型肝炎总抗体。
总体而言，344份样本中有337份（97.97%）甲型肝炎总抗体检测呈阳性——1 - 5岁年龄组中20份样本有18份（90%）呈阳性；6 - 10岁年龄组中88份样本有85份（96.6%）呈阳性；11 - 15岁年龄组中98份样本全部（100%）呈阳性；16 - 20岁年龄组中33份样本有32份（97.0%）呈阳性；20岁以上年龄组中105份样本有104份（99%）呈阳性。
在所研究的农村原住民社区中，甲型肝炎呈高度地方性流行，该病毒主要在生命的头五年获得感染。在这一人群中，有症状的甲型肝炎感染并不常见。我们认为，农村原住民儿童无需接种甲型肝炎疫苗，因为这不会降低临床疾病发生率，而且可能会产生一个在接下来10年中免疫力可能下降的队列。虽然疫苗接种适用于在偏远社区工作的非免疫个体，但必须强调原住民儿童高传播率背后的卫生基础设施和教育方面的不平等问题。
