某部新战士甲型肝炎特异预防的效果观察

Observation on the Effect of Specific Preventive Treatment on Hepatitis A in the Troop Recruits

为了解部队新战士甲型病毒性肝炎 (甲肝 )易感情况 ,对某部当年入伍的 914名新战士采血 ,用酶联免疫吸附试验检测血清抗 -HAV。对其中抗 -HAV阴性者随机分为疫苗免疫组和对照 (安慰剂 )组 ,观察甲肝减毒活疫苗的免疫效果。调查结果表明 ,新兵甲肝病毒 (HAV)感染率为 77 3 5 % ( 70 7/ 914 ) ,农村籍战士抗 -HAV阳性率 ( 83 99% ) ,极明显地高于城市战士 ( 60 47% ) ( χ2=5 7 18,P <0 0 1)。抗 -HAV阴性者接种甲肝减毒活疫苗后 3、6、12、2 4和 3 6个月 ,疫苗组阳转率均极显著地高于对照组。对照组抗 -HAV阳转者均为自然感染 ,其抗 -HAV滴度在 5个时点均高于疫苗组。部队新战士仍有 2 2 %是HAV易感者。对抗 -HAV阴性者注射甲肝减毒活疫苗是预防集体人群中甲肝局部暴发的有效措施。

In order to understand the infection condition of hepatitis A virus (HAV) in troop recruits, we collected blood samples from 914 recruits at the time of their enlistment in the army. The serum anti-HAV was tested by ELISA. The anti-HAV negative recruits were divided into vaccinated group and the controlled group. The assay revealed that HAV infection rate in recruits was 77.35% (707/914) , of which recruits from rural areas was 83.99% and those from urban areas was 60.47%, showing a significant difference, (χ 2=57.18, P<0.01). The HAV positive seroconversion rate in HAV attenuated vaccine inoculated group after 3, 6, 12, 24, 36 months were all significantly higher than those in the controlled groupled. The positive seroconversion rate occurred in the control group might contribute to natural infection of HA, their anti-HAV titers at the time of 3, 6, 12, 24, 36 months were higher than the vaccinated group. Among the troop recruits, still there were 22% susceptible to HAV. Immunization of anti-HAV negative persons is an effective measure to prevent local HA outbreak in grouped population.