Edmunds W J, Medley G F, Nokes D J, Hall A J, Whittle H C
Department of Biology, Imperial College of Science, Technology and Medicine, London, U.K.
Proc Biol Sci. 1993 Aug 23;253(1337):197-201. doi: 10.1098/rspb.1993.0102.
The relation between the age at infection with hepatitis B virus (HBV) and the development of the carrier state is examined by using data from a number of published and unpublished surveys. A remarkably consistent relation was found. Infants infected perinatally (within the first 6 months of life) were found to have a high probability of becoming carriers (0.885; 95% C.L. 0.84-0.93). Over the infant and early childhood age classes there was found to be a sharp decrease in the proportion of infections which lead to the carrier state. By adulthood (over 15 years) the probability of developing the carrier status was found to be about 0.1. A model was fitted to the data by using maximum likelihood, which provides a good empirical description of the observed data and can be used to predict the expected probability of developing the carrier state given the age at infection. It is postulated that, as a result of this rapid decline in the probability of becoming a carrier during early childhood, a mass childhood immunization campaign, which will tend to postpone the average age at infection in the unvaccinated community, will have a disproportionately large impact on the rate of generation of new carriers.
通过使用一些已发表和未发表调查的数据，研究了感染乙型肝炎病毒（HBV）的年龄与携带者状态发展之间的关系。发现了一种非常一致的关系。发现围产期（出生后6个月内）感染的婴儿成为携带者的可能性很高（0.885；95%置信区间0.84 - 0.93）。在婴儿和幼儿年龄段，导致携带者状态的感染比例急剧下降。到成年期（超过15岁），发展为携带者状态的概率约为0.1。通过最大似然法对数据进行拟合，该方法对观察到的数据提供了良好的经验描述，可用于预测在给定感染年龄的情况下发展为携带者状态的预期概率。据推测，由于幼儿期成为携带者的概率迅速下降，大规模儿童免疫接种运动往往会推迟未接种疫苗社区的平均感染年龄，这将对新携带者的产生率产生不成比例的重大影响。
