Ansdell VE, Abou-Sayf F
Tropical and Travel Medicine, Kaiser Permanente, and Associate Professor, University of Hawaii, Honolulu, Hawaii, U.S.A.
J Travel Med. 1996 Mar 1;3(1):27-31. doi: 10.1111/j.1708-8305.1996.tb00692.x.
Background: Hepatitis A is the most frequent vaccine-preventable infection in travelers to developing countries. Hepatitis A vaccine and immune serum globulin (IG) offer safe, effective protection against hepatitis A. Some travelers are already immune, however, and it is useful to try to identify subgroups with an anticipated high prevalence of antibody to hepatitis A (anti-HAV). Screening for antibody in these groups would often be a cost-effective alternative to routine use of hepatitis A vaccine or IG prior to travel. Methods: Prospective travelers to developing countries from Hawaii (n = 476) were tested for anti-HAV. Total antibody was measured by an enzyme immunoassay. Age, sex, birthplace, previous travel experience, and past history of hepatitis or jaundice were recorded for each traveler. Results: Overall prevalence of anti-HAV was 35.3%. Antibody prevalence increased progressively with age and varied significantly with birthplace and travel experience. Antibody prevalence was particularly high in travelers with a history of hepatitis or jaundice. Conclusions: Screening for preexisting immunity to hepatitis A is often worthwhile in extended stay or repeat travelers. This study suggests that screening may also be a cost-effective alternative to routine use of hepatitis A vaccine or IG in those travelers (i) born in the United States (including Hawaii) before 1930; (ii) born in Europe, Australasia, or Japan before 1950, (iii) born in developing countries; (iv) with increased travel experience; and (v) with a history of hepatitis or jaundice.
甲型肝炎是前往发展中国家的旅行者中最常见的可通过疫苗预防的感染疾病。甲型肝炎疫苗和免疫血清球蛋白（IG）可提供安全、有效的甲型肝炎防护。然而，一些旅行者已经具有免疫力，因此，尝试识别甲型肝炎抗体（抗-HAV）预期高流行率的亚组人群是有用的。在这些人群中进行抗体筛查通常是在旅行前常规使用甲型肝炎疫苗或IG的一种具有成本效益的替代方法。方法：对来自夏威夷前往发展中国家的前瞻性旅行者（n = 476）进行抗-HAV检测。通过酶免疫测定法测量总抗体。记录每位旅行者的年龄、性别、出生地、既往旅行经历以及肝炎或黄疸病史。结果：抗-HAV的总体流行率为35.3%。抗体流行率随年龄逐渐增加，并且因出生地和旅行经历而有显著差异。有肝炎或黄疸病史的旅行者中抗体流行率特别高。结论：对于长期停留或多次旅行的旅行者，筛查是否预先存在甲型肝炎免疫力通常是值得的。本研究表明，对于以下旅行者，筛查也可能是常规使用甲型肝炎疫苗或IG的一种具有成本效益的替代方法：（i）1930年前出生在美国（包括夏威夷）的人；（ii）1950年前出生在欧洲、澳大拉西亚或日本的人；（iii）出生在发展中国家的人；（iv）旅行经历增加的人；以及（v）有肝炎或黄疸病史的人。
