Objective To review the implementation of mass vaccination of hepatitis B vaccine and its critical role in prevention of hepatitis B virus infection in China.Data sources The data were mainly from PubMed, China Hospit...Objective To review the implementation of mass vaccination of hepatitis B vaccine and its critical role in prevention of hepatitis B virus infection in China.Data sources The data were mainly from PubMed, China Hospital Knowledge Database, and other popular Chinese journals published from 1980 to 2008. The search term was ＂hepatitis B vaccine＂.Study selection Original studies conducted in China and critical reviews authored by principal investigators in the field of hepatology in China were selected.Results Chinese investigators started to develop hepatitis B vaccine in late 1970s. The first home-made plasma-derived vaccine became available in 1986, which has been completely replaced by the domestically produced recombinant （yeast or Chinese hamster ovary cell） vaccine since 2001. China health authority recommended vaccinating all infants in 1992. From then on, China has put tremendous efforts in implementation of mass vaccination. The overall coverage of hepatitis B vaccine in infants has increased steadily and reached more than 95.0% in urban and 83.0%-97.0% in rural areas. The chronic HBV carrier rate in children 〈10 years of age decreased from 10.0% before the mass vaccination to 1.0%-2.0% in 2006, and that in general population decreased from 10.0% to 7.2%; overall, the nationwide mass hepatitis B vaccination has reduced more than 30 million of chronic HBV infections and HBV related severe sequlae.Conclusion The Chinese successful experience in control of hepatitis B by mass vaccination offers an example for any unindustrialized country whoever is committed to control this disease.展开更多
中国是乙型肝炎(乙肝)慢性感染者数量最多的国家,每年约有100万例乙肝病毒(hepatitis B virus,HBV)表面抗原(HBsAg)阳性孕妇需要生育,其中约26万例为乙肝病毒e抗原(HBeAg)阳性孕妇。对HBsAg阳性孕妇实施科学的母婴阻断措施,减少新发感...中国是乙型肝炎(乙肝)慢性感染者数量最多的国家,每年约有100万例乙肝病毒(hepatitis B virus,HBV)表面抗原(HBsAg)阳性孕妇需要生育,其中约26万例为乙肝病毒e抗原(HBeAg)阳性孕妇。对HBsAg阳性孕妇实施科学的母婴阻断措施,减少新发感染是当前我国进一步控制乙肝面临的主要工作。无论母亲感染状态如何,实施新生儿出生后24 h内接种乙肝疫苗(HepB)是最重要和最根本的策略。对于HBV感染的高病毒载量的孕妇的抗病毒治疗,需要考虑起始时间节点、纳入标准、服药持续时间和停药时间等。做好我国HBV感染母婴阻断,主要策略包含4种:(1)对孕妇进行HBsAg筛查;(2)对HBsAg阳性母亲的新生儿出生12 h内接种HepB和乙肝免疫球蛋白(HBIG),然后完成全程乙肝疫苗免疫;对HBsAg阴性母亲的新生儿出生24 h内接种HepB,然后完成全程乙肝疫苗免疫;(3)仅对HBV DNA高载量的孕妇实施抗病毒预防;(4)对母亲HBsAg阳性的新生儿进行接种后监测并评价阻断效果。展开更多
目的评价免疫预防措施在实际应用中阻断乙型肝炎病毒（hepatitis B virus，HBV）母婴感染的效果，阐明孕妇孕晚期使用乙肝免疫球蛋白（hepatitis B immunoglobulin，HBIG）能否减少HBV母婴感染。方法将2002年7月至2004年8月江苏省14个...目的评价免疫预防措施在实际应用中阻断乙型肝炎病毒（hepatitis B virus，HBV）母婴感染的效果，阐明孕妇孕晚期使用乙肝免疫球蛋白（hepatitis B immunoglobulin，HBIG）能否减少HBV母婴感染。方法将2002年7月至2004年8月江苏省14个县市的419例乙型肝炎表面抗原（hepatitis Bsurfaceantigen，HBsAg）阳性孕妇所分娩子女作为研究组，同地区同期的453例HBsAg孕妇分娩的子女作为对照组，于2009年10月至2010年3月期间对2组研究对象进行随访，调查母亲孕期HBIG使用情况以及子女出生后HBIG和乙型肝炎疫苗接种情况，检测儿童HBV血清标志物。率的比较采用7。分析或者Fisher精确概率法，均数的比较采用t检验。结果研究组实际随访298例（71．12％），其中11例（3．69％）HBsAg＋；而随访的328例（72．41％）对照组中，HBsAg阳性率为0．00（x2=12．32，P〈0．01）。共11例儿童HBsAg＋，其母亲均为HBsAg和HBeAg同时阳性，除1例具体情况不详外，9例儿童在出生时明确没有使用HBIG或延迟接种疫苗，仅1例同时规范使用了HBIG和乙型肝炎疫苗。2组儿童抗HBs阳性率分别为69．46％和69．21％（x2=0．01，P=0．95）。孕晚期注射HBIG的92例孕妇中，2例（2．17％）儿童HBsAg＋；未使用HBIG的197例孕妇中，9例（4．57％）儿童HBsAg＋（x2=0．98，P=0．51）。结论江苏省常规免疫预防措施在阻断母婴HBV感染方面取得了良好的效果，但对HBV携带孕妇（特别是HBeAg＋者）的新生儿仍需强调及时注射HBIG。孕妇孕晚期使用HBIG不能减少母婴HBV感染。展开更多
There are no standard guidelines to follow when a patient with chronic hepatitis B infection becomes pregnant or desires pregnancy. Topics to consider include which patients to treat, when to start treatment, what tre...There are no standard guidelines to follow when a patient with chronic hepatitis B infection becomes pregnant or desires pregnancy. Topics to consider include which patients to treat, when to start treatment, what treatment to use and when to stop treatment. Without any prophylaxis or antiviral therapy, a hepatitis B surface antigen and E antigen positive mother has up to a 90% likelihood of vertical transmission of hepatitis B virus(HBV) to child. Standard of care in the United States to prevent perinatal transmission consists of administration of hepatitis B immune globulin and HBV vaccination to the infant. The two strongest risk factors of mother to child transmission(MTCT) of HBV infection despite immunoprophylaxis are high maternal HBV viral load and high activity of viral replication. The goal is to prevent transmission of HBV at birth by decreasing viral load and/or decreasing activity of the virus. Although it is still somewhat controversial, most evidence shows that starting antivirals in the third trimester is effective in decreasing MTCT without affecting fetal development. There is a growing body of literature supporting the safety and efficacy of antiviral therapies to reduce MTCT of hepatitis B. There are no formal recommendations regarding which agent to choose. Tenofovir, lamivudine and telbivudine have all been proven efficacious in decreasing viral load at birth without known birth defects, but final decision of which antiviral medication to use will have to be determined by physician and patient. The antivirals may be discontinued immediately if patient is breastfeeding, or within first four weeks if infant is being formula fed.展开更多
目的了解我国华北、东北、华东、中南、西南和西北地区,2006年1～59岁人群乙型肝炎(乙肝)病毒(Hepatitis B Virus,HBV)感染现状及乙肝疫苗(Hepatitis B Vaccine,HepB)接种情况。方法系统分析2006年全国乙肝血清流行病学调查资料。结果...目的了解我国华北、东北、华东、中南、西南和西北地区,2006年1～59岁人群乙型肝炎(乙肝)病毒(Hepatitis B Virus,HBV)感染现状及乙肝疫苗(Hepatitis B Vaccine,HepB)接种情况。方法系统分析2006年全国乙肝血清流行病学调查资料。结果华北、东北、华东、中南、西南和西北地区,2006年1～59岁人群HepB接种率分别为50.81%、53.78%、50.02%、47.93%、31.21%和47.60%;乙肝病毒表面抗原(HBV Surface Antigen,HBsAg)流行率分别3.83%、5.56%、7.76%、9.12%、7.92%、4.87%;抗乙肝病毒表面抗原抗体(Antibody to HBsAg,Anti-HBs)流行率分别42.79%、46.44%、48.76%、57.36%、49.74%、46.42%。结论我国六个区域2006年1～59岁人群HBsAg流行率均有不同程度下降,Anti-HBs流行率有所上升,我国自1992年HepB纳入儿童计划免疫管理效果显著。展开更多
目的了解云南省1～59岁人群乙型肝炎(乙肝)病毒(Hepatitis B Virus,HBV)感染状况和乙肝疫苗(Hepatitis B Vaccine,HepB)预防接种效果。方法 2006年9月,在云南省采用多阶段分层抽样方法,分别调查6个县(区)1～4岁、5～14岁、15～59岁492人...目的了解云南省1～59岁人群乙型肝炎(乙肝)病毒(Hepatitis B Virus,HBV)感染状况和乙肝疫苗(Hepatitis B Vaccine,HepB)预防接种效果。方法 2006年9月,在云南省采用多阶段分层抽样方法,分别调查6个县(区)1～4岁、5～14岁、15～59岁492人、764人、1287人的HBV感染和HepB接种状况。结果云南省1～59岁人群HBV感染率为17.15%,乙肝病毒表面抗原(HBV Surface Antigen,HBsAg)阳性率为3.11%,抗乙肝病毒表面抗原抗体(Antibody to HBsAg,Anti-HBs)阳性率为35.71%,5项指标[HBsAg、Anti-HBs、抗乙肝病毒核心抗原抗体(Antibody to HBV CoreAntigen,Anti-HBc)、乙肝病毒e抗原(HBVe Antigen,HBeAg)、抗乙肝病毒e抗原抗体(Antibody to HBeAg,Anti-HBe,下同)]全阴性率为46.72%;HepB接种率为41.01%;农村HBV感染率高于城市;HBV感染率、HBsAg阳性率、5项指标全阴性率均为15～59岁高于5～14岁人群,5～14岁高于1～4岁人群;HepB接种率高的地方Anti-HBs阳性率也高,且HBV感染率和HBsAg阳性率呈下降趋势。结论云南省1～59岁人群HBV感染率呈下降趋势,尤其是≤14岁儿童,应加强农村与边远贫困及少数民族地区乙肝预防控制工作。展开更多
AIM To develop a safe and effective DNAvaccine for inducing humoral and cellularimmunological responses against hepatitis Bvirus surface antigen(HBsAg).METHODS BALB/c mice were inoculated withNV-HB/s,a recombinant pla...AIM To develop a safe and effective DNAvaccine for inducing humoral and cellularimmunological responses against hepatitis Bvirus surface antigen(HBsAg).METHODS BALB/c mice were inoculated withNV-HB/s,a recombinant plasmid that had beeninserted S gene of hepatitis B virus genome andcould express HBsAg in eukaryotes.HBsAgexpression was measured by ABC immunohis-tochemical assay,generation of anti-HBs byELISA and cytotoxic T lymphocyte(CTL),byMTT method,existence of vaccine DNA bySouthern blot hybridization and activation ofoncogene C-myc by in situ hybridization,RESULTS With NV-HB/s vaccination byintramuscular injection,anti-HBs was initiallypositive 2 weeks after inoculation while all micetested were HBsAg positive in the muscles.Thetiters and seroconversion rate of anti-HBs weresteadily increasing as time went on and weredose-dependent.All the mice inoculated with100 μg NV-HB/s were anti-HBs positive onemonth after inoculation,the titer was 1:1024 ormore.The humoral immune response was similarinduced by either intramuscular or intradermalinjection.CTL activities were much stronger(45.26%)in NV-HB/s DNA immunized mice as compared with those(only 6%)in plasma-derived HBsAg vaccine immunized mice.Twomonths after inoculation,all muscle sampleswere positive by Southern-blot hybridization forNV.HB/s DNA detection,but decreased to 25%and all were undetectable by in situhybridization after 6 months.No oncogene C-myc activation was found in the muscle ofinoculation site.CONCLUSION NV-HB/s could generatehumoral and cellular immunological responsesagainst HBsAg that had been safely expressed insitu by NV-HB/s vaccination.展开更多
目的调查上海市浦东新区高东社区儿童青少年乙肝病毒感染现状及乙肝疫苗接种状况,为该社区的乙肝防控工作提供依据。方法 2016年3-4月,随机抽取高东社区幼儿园、小学及初级中学各1所,对每所学校每个年级抽取的1个班级中所有学生开展乙...目的调查上海市浦东新区高东社区儿童青少年乙肝病毒感染现状及乙肝疫苗接种状况,为该社区的乙肝防控工作提供依据。方法 2016年3-4月,随机抽取高东社区幼儿园、小学及初级中学各1所,对每所学校每个年级抽取的1个班级中所有学生开展乙肝病毒感染及乙肝疫苗接种相关问卷调查,同时采集静脉血进行乙肝血清指标及HBV DNA定量检测,分析该社区儿童青少年乙肝疫苗接种情况、乙肝病毒感染血清标志物分布情况及其影响因素。结果高东社区儿童青少年乙肝疫苗接种率95.50%(276/289),年龄组越小的儿童青少年乙肝疫苗接种率越高(P<0.01);10岁以下学生接种率高于≥10岁学生(P<0.01);HBsAg、HBcAb和HBsAb阳性率分别为1.04%(3/289)、1.38%(4/289)和32.18%(93/289);未接种乙肝疫苗及未全程接种者HBsAg和HBcAb阳性率均高于接种乙肝疫苗及全程接种者(P<0.05);女性HBcAb阳性率高于男性(P<0.05);≥10岁学生HBcAb阳性率高于3~<10岁学生(P<0.05);年龄组越大的儿童青少年HBsAb阳性率越低(P<0.01);HBsAb阳性学生抗体滴度水平分布以低水平(10 m IU/ml≤HBsAb<100 m IU/ml)为主(占81.33%,61/75),无年龄分布差异(P>0.05)。结论 2016年该社区儿童青少年的乙肝疫苗接种率高于95%,HBsAg、HBcAb阳性率较2012年上海市的调查结果下降明显。展开更多
基金This study was supported by the grants from the Principal Fellow from Jiangsu Province Department of Health, China （No. RC2007005, to Zhou YH）, the National Natural Science Foundation of China （No. 30570063, to Zhuang H）, the 863 National High Technology Research and Development Program of China （No. 2006A A02Z453, to Zhuang H） and the Natural Science Foundation of Guangxi Province （No. 0728008, to Zhuang H）.
文摘Objective To review the implementation of mass vaccination of hepatitis B vaccine and its critical role in prevention of hepatitis B virus infection in China.Data sources The data were mainly from PubMed, China Hospital Knowledge Database, and other popular Chinese journals published from 1980 to 2008. The search term was ＂hepatitis B vaccine＂.Study selection Original studies conducted in China and critical reviews authored by principal investigators in the field of hepatology in China were selected.Results Chinese investigators started to develop hepatitis B vaccine in late 1970s. The first home-made plasma-derived vaccine became available in 1986, which has been completely replaced by the domestically produced recombinant （yeast or Chinese hamster ovary cell） vaccine since 2001. China health authority recommended vaccinating all infants in 1992. From then on, China has put tremendous efforts in implementation of mass vaccination. The overall coverage of hepatitis B vaccine in infants has increased steadily and reached more than 95.0% in urban and 83.0%-97.0% in rural areas. The chronic HBV carrier rate in children 〈10 years of age decreased from 10.0% before the mass vaccination to 1.0%-2.0% in 2006, and that in general population decreased from 10.0% to 7.2%; overall, the nationwide mass hepatitis B vaccination has reduced more than 30 million of chronic HBV infections and HBV related severe sequlae.Conclusion The Chinese successful experience in control of hepatitis B by mass vaccination offers an example for any unindustrialized country whoever is committed to control this disease.
文摘目的评价免疫预防措施在实际应用中阻断乙型肝炎病毒（hepatitis B virus，HBV）母婴感染的效果，阐明孕妇孕晚期使用乙肝免疫球蛋白（hepatitis B immunoglobulin，HBIG）能否减少HBV母婴感染。方法将2002年7月至2004年8月江苏省14个县市的419例乙型肝炎表面抗原（hepatitis Bsurfaceantigen，HBsAg）阳性孕妇所分娩子女作为研究组，同地区同期的453例HBsAg孕妇分娩的子女作为对照组，于2009年10月至2010年3月期间对2组研究对象进行随访，调查母亲孕期HBIG使用情况以及子女出生后HBIG和乙型肝炎疫苗接种情况，检测儿童HBV血清标志物。率的比较采用7。分析或者Fisher精确概率法，均数的比较采用t检验。结果研究组实际随访298例（71．12％），其中11例（3．69％）HBsAg＋；而随访的328例（72．41％）对照组中，HBsAg阳性率为0．00（x2=12．32，P〈0．01）。共11例儿童HBsAg＋，其母亲均为HBsAg和HBeAg同时阳性，除1例具体情况不详外，9例儿童在出生时明确没有使用HBIG或延迟接种疫苗，仅1例同时规范使用了HBIG和乙型肝炎疫苗。2组儿童抗HBs阳性率分别为69．46％和69．21％（x2=0．01，P=0．95）。孕晚期注射HBIG的92例孕妇中，2例（2．17％）儿童HBsAg＋；未使用HBIG的197例孕妇中，9例（4．57％）儿童HBsAg＋（x2=0．98，P=0．51）。结论江苏省常规免疫预防措施在阻断母婴HBV感染方面取得了良好的效果，但对HBV携带孕妇（特别是HBeAg＋者）的新生儿仍需强调及时注射HBIG。孕妇孕晚期使用HBIG不能减少母婴HBV感染。
文摘There are no standard guidelines to follow when a patient with chronic hepatitis B infection becomes pregnant or desires pregnancy. Topics to consider include which patients to treat, when to start treatment, what treatment to use and when to stop treatment. Without any prophylaxis or antiviral therapy, a hepatitis B surface antigen and E antigen positive mother has up to a 90% likelihood of vertical transmission of hepatitis B virus(HBV) to child. Standard of care in the United States to prevent perinatal transmission consists of administration of hepatitis B immune globulin and HBV vaccination to the infant. The two strongest risk factors of mother to child transmission(MTCT) of HBV infection despite immunoprophylaxis are high maternal HBV viral load and high activity of viral replication. The goal is to prevent transmission of HBV at birth by decreasing viral load and/or decreasing activity of the virus. Although it is still somewhat controversial, most evidence shows that starting antivirals in the third trimester is effective in decreasing MTCT without affecting fetal development. There is a growing body of literature supporting the safety and efficacy of antiviral therapies to reduce MTCT of hepatitis B. There are no formal recommendations regarding which agent to choose. Tenofovir, lamivudine and telbivudine have all been proven efficacious in decreasing viral load at birth without known birth defects, but final decision of which antiviral medication to use will have to be determined by physician and patient. The antivirals may be discontinued immediately if patient is breastfeeding, or within first four weeks if infant is being formula fed.
文摘目的了解我国华北、东北、华东、中南、西南和西北地区,2006年1～59岁人群乙型肝炎(乙肝)病毒(Hepatitis B Virus,HBV)感染现状及乙肝疫苗(Hepatitis B Vaccine,HepB)接种情况。方法系统分析2006年全国乙肝血清流行病学调查资料。结果华北、东北、华东、中南、西南和西北地区,2006年1～59岁人群HepB接种率分别为50.81%、53.78%、50.02%、47.93%、31.21%和47.60%;乙肝病毒表面抗原(HBV Surface Antigen,HBsAg)流行率分别3.83%、5.56%、7.76%、9.12%、7.92%、4.87%;抗乙肝病毒表面抗原抗体(Antibody to HBsAg,Anti-HBs)流行率分别42.79%、46.44%、48.76%、57.36%、49.74%、46.42%。结论我国六个区域2006年1～59岁人群HBsAg流行率均有不同程度下降,Anti-HBs流行率有所上升,我国自1992年HepB纳入儿童计划免疫管理效果显著。
文摘目的了解云南省1～59岁人群乙型肝炎(乙肝)病毒(Hepatitis B Virus,HBV)感染状况和乙肝疫苗(Hepatitis B Vaccine,HepB)预防接种效果。方法 2006年9月,在云南省采用多阶段分层抽样方法,分别调查6个县(区)1～4岁、5～14岁、15～59岁492人、764人、1287人的HBV感染和HepB接种状况。结果云南省1～59岁人群HBV感染率为17.15%,乙肝病毒表面抗原(HBV Surface Antigen,HBsAg)阳性率为3.11%,抗乙肝病毒表面抗原抗体(Antibody to HBsAg,Anti-HBs)阳性率为35.71%,5项指标[HBsAg、Anti-HBs、抗乙肝病毒核心抗原抗体(Antibody to HBV CoreAntigen,Anti-HBc)、乙肝病毒e抗原(HBVe Antigen,HBeAg)、抗乙肝病毒e抗原抗体(Antibody to HBeAg,Anti-HBe,下同)]全阴性率为46.72%;HepB接种率为41.01%;农村HBV感染率高于城市;HBV感染率、HBsAg阳性率、5项指标全阴性率均为15～59岁高于5～14岁人群,5～14岁高于1～4岁人群;HepB接种率高的地方Anti-HBs阳性率也高,且HBV感染率和HBsAg阳性率呈下降趋势。结论云南省1～59岁人群HBV感染率呈下降趋势,尤其是≤14岁儿童,应加强农村与边远贫困及少数民族地区乙肝预防控制工作。
基金the National Natural Science Foundation of China,No.39670670
文摘AIM To develop a safe and effective DNAvaccine for inducing humoral and cellularimmunological responses against hepatitis Bvirus surface antigen(HBsAg).METHODS BALB/c mice were inoculated withNV-HB/s,a recombinant plasmid that had beeninserted S gene of hepatitis B virus genome andcould express HBsAg in eukaryotes.HBsAgexpression was measured by ABC immunohis-tochemical assay,generation of anti-HBs byELISA and cytotoxic T lymphocyte(CTL),byMTT method,existence of vaccine DNA bySouthern blot hybridization and activation ofoncogene C-myc by in situ hybridization,RESULTS With NV-HB/s vaccination byintramuscular injection,anti-HBs was initiallypositive 2 weeks after inoculation while all micetested were HBsAg positive in the muscles.Thetiters and seroconversion rate of anti-HBs weresteadily increasing as time went on and weredose-dependent.All the mice inoculated with100 μg NV-HB/s were anti-HBs positive onemonth after inoculation,the titer was 1:1024 ormore.The humoral immune response was similarinduced by either intramuscular or intradermalinjection.CTL activities were much stronger(45.26%)in NV-HB/s DNA immunized mice as compared with those(only 6%)in plasma-derived HBsAg vaccine immunized mice.Twomonths after inoculation,all muscle sampleswere positive by Southern-blot hybridization forNV.HB/s DNA detection,but decreased to 25%and all were undetectable by in situhybridization after 6 months.No oncogene C-myc activation was found in the muscle ofinoculation site.CONCLUSION NV-HB/s could generatehumoral and cellular immunological responsesagainst HBsAg that had been safely expressed insitu by NV-HB/s vaccination.
文摘目的调查上海市浦东新区高东社区儿童青少年乙肝病毒感染现状及乙肝疫苗接种状况,为该社区的乙肝防控工作提供依据。方法 2016年3-4月,随机抽取高东社区幼儿园、小学及初级中学各1所,对每所学校每个年级抽取的1个班级中所有学生开展乙肝病毒感染及乙肝疫苗接种相关问卷调查,同时采集静脉血进行乙肝血清指标及HBV DNA定量检测,分析该社区儿童青少年乙肝疫苗接种情况、乙肝病毒感染血清标志物分布情况及其影响因素。结果高东社区儿童青少年乙肝疫苗接种率95.50%(276/289),年龄组越小的儿童青少年乙肝疫苗接种率越高(P<0.01);10岁以下学生接种率高于≥10岁学生(P<0.01);HBsAg、HBcAb和HBsAb阳性率分别为1.04%(3/289)、1.38%(4/289)和32.18%(93/289);未接种乙肝疫苗及未全程接种者HBsAg和HBcAb阳性率均高于接种乙肝疫苗及全程接种者(P<0.05);女性HBcAb阳性率高于男性(P<0.05);≥10岁学生HBcAb阳性率高于3~<10岁学生(P<0.05);年龄组越大的儿童青少年HBsAb阳性率越低(P<0.01);HBsAb阳性学生抗体滴度水平分布以低水平(10 m IU/ml≤HBsAb<100 m IU/ml)为主(占81.33%,61/75),无年龄分布差异(P>0.05)。结论 2016年该社区儿童青少年的乙肝疫苗接种率高于95%,HBsAg、HBcAb阳性率较2012年上海市的调查结果下降明显。
