NATURAL HISTORY PREVENTION OF VIRAL HEPATITIS IN ALASKA NATIVE PEOPLE

甲型肝炎病毒（HAV）和B肝炎病毒（HBV）感染是中国的重要问题。 阿拉斯加土著甲型和B型肝炎疫苗已成为阿拉斯加原住民的常规免疫接种 分别自1984年和1994年以来。所有1岁以上的儿童都接种甲型肝炎疫苗。 甲型肝炎病毒（HAV）疫苗是一种常见的病毒性肝炎疫苗。 几个国家的所有儿童。所有新生儿都接种了B型肝炎疫苗， 在过去的十年里，美国的儿童和高危人群。 此外，慢性B和C型肝炎感染是发病率和死亡率的重要原因 在美国的高风险人群中，肝细胞癌（HCC）和肝硬化。阿拉斯加 在美国，本地人是所有种族中慢性HBV感染率最高的人群之一 以及丙型肝炎感染的高发病率和死亡率。并非所有慢性病患者 B或C型肝炎会发展为肝硬化或HCC，而进展的风险因素不是 完全阐明。需要进行人群研究，以研究疾病进展的风险因素。 慢性HBV和HCV。 阿拉斯加土著部落健康联盟的肝病和肝炎计划（LDHP） （ANTHC）与北极研究中心的北极研究计划（AIP）合作， 疾病控制和预防中心（CDC）有接受甲型和B型肝炎的人群 婴儿、儿童和成人可接种疫苗以确定长期保护作用。此外，本发明还提供了一种方法， LDHP招募了大量患有慢性B或C型肝炎感染的阿拉斯加土著人。 相关性 甲型肝炎和B型肝炎疫苗接种计划的策略和成本效益取决于 假设这些疫苗将提供针对甲型和B型肝炎的长期保护 感染同样令人关注的是，慢性B或C型肝炎感染者有可能 肝硬化和其他严重肝病。使用几个阿拉斯加土著队列，研究 建议（a）确定保护甲型肝炎和B型肝炎感染的持续时间， 15-30年前免疫的人和（B）更好地了解治疗和自然史 慢性B或C型肝炎感染。

Infections from hepatitis A virus (HAV) and hepatitis B virus (HBV) are significant problems in Alaska Natives. Hepatitis A and B vaccines have been routine immunizations in Alaska Natives since 1984 and 1994, respectively. Hepatitis A vaccine is administered to all children over 1 year of age in the US and catch-up hepatitis A virus (HAV) vaccine programs are employed in several states for all children. Hepatitis B vaccine has been administered to all neonates and children in the US for the past decade and to high risk individuals. In addition, chronic hepatitis B and C infections are significant causes of morbidity and mortality from hepatocellular carcinoma (HCC) and cirrhosis in high risk populations in the US. Alaska Natives have one of the highest rates of chronic HBV infection of any ethnic group in the US and a high rate of morbidity and mortality from hepatitis C infection. Not all persons with chronic hepatitis B or C will develop cirrhosis or HCC and the risk factors for progression are not completely elucidated. Population studies are needed to study risk factors for progression of chronic HBV and HCV. The Liver Disease and Hepatitis Program (LDHP) of the Alaska Native Tribal Health Consortium (ANTHC) working collaboratively with the Arctic Investigations Program (AIP) of the Centers for Disease Control and Prevention (CDC) has cohorts of persons who received hepatitis A and B vaccine as infants, children and adults available to determine long-term protection. In addition, the LDHP has recruited large cohorts of Alaska Natives with chronic hepatitis B or C infection. Relevance The strategy and cost effectiveness of hepatitis A and B vaccination programs depends on the supposition that these vaccines will provide long-term protection against hepatitis A and B infection. Also of concern is that persons with chronic hepatitis B or C infection are at-risk to cirrhosis and other serious liver disease. Using several Alaska Native cohorts, studies are proposed to (a) determine the duration of protection against hepatitis A and B infection in persons immunized 15-30 years ago and (b) better understand the treatment and natural history of chronic hepatitis B or C infection.