Poovorawan Y
Department of Paediatrics, Faculty of Medicine, Chulalongkorn Hospital, Bangkok, Thailand.
Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1998 May-Jun;39(3):139-45.
Hepatitis A virus infection is a world-wide public health problem and commonly found in many developing countries, especially in areas where the infection pattern is changing from hyperendemic to hypoendemic. Due to improvement of living standard, infections during childhood have been deferred towards adulthood. Hepatitis A infection in early childhood is usually subclinical, while symptomatic hepatitis A occurs with increasing age. In Southeast Asia, hepatitis A antibody prevalence had considerably declined among the children and adolescents. These data probably reflect the remarkable improvement of hygienic conditions and of effective health education. An increase in the number of susceptible populations could result in an outbreak and become a problem in the near future, particularly in schools, communities and among high risk groups. Therefore, preventive measures are essential in reducing the infection rate. In addition to personal hygiene, immunoprophylaxis represents another promising measure. The hepatitis A vaccines have proven to be safe and efficacious in several clinical trials and are available in many countries. However, the vaccine is very expensive for those residing in developing countries. If possible, reducing the usage of vaccine to one single dose and thus lowering the price would facilitate the implementation of mass vaccination campaigns and thus contribute to the control and possibly to the eventual eradication of the disease.
甲型肝炎病毒感染是一个全球性的公共卫生问题，在许多发展中国家普遍存在，尤其是在感染模式正从高度流行向低度流行转变的地区。由于生活水平的提高，儿童期感染已推迟至成年期。儿童期的甲型肝炎感染通常为亚临床感染，而有症状的甲型肝炎感染则随着年龄增长而出现。在东南亚，儿童和青少年中甲肝抗体的流行率已大幅下降。这些数据可能反映出卫生条件和有效健康教育的显著改善。易感人群数量的增加可能导致疫情爆发，并在不久的将来成为一个问题，特别是在学校、社区和高危人群中。因此，预防措施对于降低感染率至关重要。除个人卫生外，免疫预防是另一项有前景的措施。甲型肝炎疫苗在多项临床试验中已证明是安全有效的，并且在许多国家都有供应。然而，对于居住在发展中国家的人来说，这种疫苗非常昂贵。如果可能的话，将疫苗用量减至单剂从而降低价格，将有助于大规模疫苗接种运动的实施，进而有助于控制并可能最终根除该疾病。
