Hepatitis B: Epidemiology and prevention in developing countries
Hepatitis B: Epidemiology and prevention in developing countries
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DOI：
10.4254/wjh.v4.i3.74
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发表时间：
2012-03-27
影响因子：
2.4
通讯作者：
Zaratti, Laura
中科院分区：
文献类型：
--
作者：
Franco, Elisabetta;Bagnato, Barbara;Zaratti, Laura
B型肝炎病毒（HBV）感染是一个严重的全球性公共卫生问题。这种感染可能通过性交、肠胃外接触或在出生时从受感染的母亲传染给婴儿，如果在生命早期感染，可能导致慢性肝病，包括肝硬化和肝细胞癌。根据HBV携带率，世界可分为高、中、低流行率3个地区。主要关切的是高流行率国家，在这些国家，最常见的感染途径仍然是母婴垂直传播。许多发展中国家负担不起对所有孕妇进行筛查和使用人B型肝炎免疫球蛋白进行被动免疫的费用。可以通过改变行为、改善个人教育、对所有献血进行检测、确保临床实践中的无菌操作以及对所有孕妇进行筛查来降低感染率。然而，获得安全有效的疫苗和采取适当的免疫策略是预防HBV感染及其后果的最有效手段。对于目前感染人数众多的最贫穷国家来说，尚未解决的问题是疫苗的成本。今后的一个挑战是克服社会和经济障碍，在全世界维持和改进预防政策，以减轻这一疾病的全球负担。(C)2012年百世登。All rights reserved.
Hepatitis B virus (HBV) infection is a serious global public health problem. The infection may be transmitted through sexual intercourse, parenteral contact or from an infected mother to the baby at birth and, if contracted early in life, may lead to chronic liver disease, including cirrhosis and hepatocellular carcinoma. On the basis of the HBV carrier rate, the world can be divided in 3 regions of high, medium and low endemicity. The major concern is about high endemicity countries, where the most common route of infection remains vertical transmission from mother to child. Screening of all pregnant women and passive immunization with human hepatitis B immunoglobulin are not affordable for many developing countries. The infection rate can be reduced by modifying behavior, improving individual education, testing all blood donations, assuring asepsis in clinical practice and screening all pregnant women. However, availability of a safe and efficacious vaccine and adoption of appropriate immunization strategies are the most effective means to prevent HBV infection and its consequences. The unsolved problem for poorest countries, where the number of people currently infected is high, is the cost of the vaccine. A future challenge is to overcome the social and economic hurdles of maintaining and improving a prevention policy worldwide to reduce the global burden of the disease. (C) 2012 Baishideng. All rights reserved.