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[病毒性肝炎的预防性疫苗接种]

[Preventive vaccination for viral hepatitis].

作者信息

Jilg W

机构信息

Institut für Medizinische Mikrobiologie und Hygiene, Universität Regensburg.

出版信息

Z Gastroenterol. 1997 Jul;35(7):585-90.

PMID:9340933
Abstract

Viral hepatitis A-E belong to the most important infectious diseases worldwide. Viral hepatitis is highly endemic in most developing countries in Africa, South East Asia, and southern America; however also in industrialized countries as Germany hepatitis A, B and C represent a thread which should not be underestimated. In Germany, there are about 20,000 to 40,000 hepatitis A infections every year, most of them acquired abroad; about 50,000 new hepatitis B infections and about 5,000 to 8,000 infections with hepatitis C virus occur every year. About 500,000 individuals are chronic carriers of hepatitis B virus and roughly the same number is supposed to be chronically infected with hepatitis C virus. As possibilities for therapeutic intervention in chronic hepatitis B and C are still limited, immunoprophylactic measures are of particular importance. Passive and active immunization is available for hepatitis A and B but so far not for hepatitis C. Passive immunization by application of specific immunoglobulins gives protection which is effective within a few hours but is limited according to the amount of immunoglobulin to six to twelve months. Active immunization on the other hand induces a specific immune response starting after a delay of usually days or sometimes weeks but nevertheless lasting for at least several years. The combination of both methods, passive-active immunization, has the advantage of immediate protection due to the immunoglobulin which lasts until the active immunization induces an endogenous antibody production.

摘要

甲型至戊型病毒性肝炎属于全球最重要的传染病。在非洲、东南亚和南美洲的大多数发展中国家,病毒性肝炎高度流行;然而在工业化国家如德国,甲型、乙型和丙型肝炎也是不可低估的威胁。在德国,每年约有2万至4万例甲型肝炎感染病例,其中大多数是在国外感染的;每年约有5万例新发乙型肝炎感染病例以及约5000至8000例丙型肝炎病毒感染病例。约50万人是乙型肝炎病毒的慢性携带者,丙型肝炎病毒慢性感染者的数量大致相同。由于对慢性乙型和丙型肝炎的治疗干预手段仍然有限,免疫预防措施尤为重要。甲型和乙型肝炎可进行被动和主动免疫,但丙型肝炎目前尚无此类措施。通过应用特异性免疫球蛋白进行被动免疫可提供保护,这种保护在数小时内有效,但根据免疫球蛋白的量,其有效期为6至12个月。另一方面,主动免疫会引发特异性免疫反应,通常在数天或有时数周的延迟后开始,但持续至少数年。被动 - 主动免疫这两种方法相结合,具有因免疫球蛋白而立即获得保护的优势,这种保护会持续到主动免疫诱导内源性抗体产生。

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