OBJECTIVE: To study the relationship between the different replication status of hepatitis B virus (HBV) and mutations in the core promoter (CP) in mother and her child infected by mother-to-infant transmission. METHO...OBJECTIVE: To study the relationship between the different replication status of hepatitis B virus (HBV) and mutations in the core promoter (CP) in mother and her child infected by mother-to-infant transmission. METHODS: The core promoter was amplified by PCR and cloned into pGEM-T vector with the T-A choning technique. The recombinant plasmid pGEM-CP was confirmed by digestion with restriction enzyme Apa I and Sac I. Two clones were selected to be sequenced in each patient. RESULTS: Every pair of mother and child had same serotype and genotype and the homology of nucleotides encoding 'a' determinant was 98%-100%. The number of mutations in the core promoter of patients with a high replication status was less than that in those with a low replication status. Mutations were mainly distributed in basia core promoter (BCP) and the inbibitor region of Kunitz-type serine protease. This difference was not associated with mother or child. CONCLUSION: The different replication status of HBV is caused by mutations in the core promoter in mother and child infected hy mother-to-infant transmission and appears to be not associated with the status of development of the infection.展开更多
Objective：To search for risk factors that affect mother-to-infant transmission of hepatitis B virus（HBV）. Methods：To obtain studies eligible for meta-analysis, China biological medicine discs and MEDLINE citations...Objective：To search for risk factors that affect mother-to-infant transmission of hepatitis B virus（HBV）. Methods：To obtain studies eligible for meta-analysis, China biological medicine discs and MEDLINE citations were surveyed. Mother HBV DNA or HBeAg positivity,neonate HBeAg positivity, mode of delivery, threatened abortion and threatened premature labor were processed with meta analysis. Criteria for selection of published studies for meta analysis were based on principle by Abdolmaleky HM. Odds ratio （OR） was calculated and summarized by fixed effect model or random-effects model using RevMan software. The heterogeneity of the group of ORs was assessed using an X^2 test. The significance of the pooled OR was determined by the u-test. The strength of association was assessed using the OR. An OR〉1. 0 indicated a positive association between the risk factor and neonate HBV infection. Results： After meta analysis of factors concerned, a significant association was found between the positivity of HBeAg in mother and neonate, of HBV DNA in mother peripheral serum, and HBV mother-to-infant transmission, with a pooled OR equal to 19.43 （95% CI=8. 77-43. 06）, 36.5 （95% CI= 19.85-67. 11）, and 36.5 （95 % CI= 19.85-67.11 ） respectively. Mode of delivery, threatened abortion and threatened premature labor proved not to be of risk factors on the mother-to-infant transmission of HBV. Conclusion： Mother HBV DNA or HBeAg positivity and neonate HBeAg positivity were proved to be of risk factors affecting the transmission of HBV from mother to fetal.展开更多
AIM： To evaluate the efficacy of interruption of intrauterine infection of HBV with HBIG in pregnant women with positive HBeAg and HBsAg.METHODS： A prospective randomized controlled trial was adopted. Sixty cases wi...AIM： To evaluate the efficacy of interruption of intrauterine infection of HBV with HBIG in pregnant women with positive HBeAg and HBsAg.METHODS： A prospective randomized controlled trial was adopted. Sixty cases with positive HBeAg and HBsAg were coincident with the criteria of inclusion, and 8 cases were excluded. Fifty-two cases were analyzed （28 cases in trial group and 24 in control group）. All cases in trial group received 200 IU HBIG intravenously every 4 wk for 3 times from the 28^th wk. The cases of control group received placebo in the same way. All pregnant women were detected for HBeAg and HBV-DNA at the beginning of the trial and end of the trial （delivery）. The cord blood of all newborns were collected for detecting HBeAg and HBV-DNA simultaneously.RESULTS： For investigation of HBeAg of newborns in trial group, 6 of 28 cases of newborns had positive HBeAg, the HBeAg positive rate being 21.4%, the total rate of 95% CI being 8%-41%. In control group, 19 of 24 cases of newborns had positive HBeAg, HBeAg positive rate was 79.2%, the rate of 95%CI being 5%-93%. By statistical analysis, 2= 17.26, P 〈 0.01, RR = 0.27, 95% CI （6.3 × 10^-6, 8.6 × 10^-5）. For investigation of HBV-DNA of newborns in trial group, 7 of 28 cases of newborns had positive HBV-DNA, HBV-DNA positive rate being 25%, the total rate of 95% CI being 11%-45%. In control group, 20 of 24 cases of newborns had positive HBV-DNA, HBV-DNA positive rate was 83.3%, the total rate of 95% CI being 63%-95%. By statistical analysis, X^2 = 17.62, P 〈 0.01, RR = 0.30, 95% CI （1.5 × 10^-5, 1.7× 10^-4）. The results indicated that there was significant difference in HBeAg positive rate and HBV-DNA positive rate of newborns between the two groups. In trial group, 7 of 28 newborns had HBV-DNA positive, but the HBV-DNA load of newborns was lower than that of their mothers. In control group, 20 of 24 newborns still had HBV-DNA positive, and the HBV-DNA load of newborns was close to those of their mothers. Statistical analysis indicated that there was no significant difference in HBV- DNA load between postnatal women without HBIG intervention and their filial generations （T = 81.5, P 〉 0.1）. CONCLUSION： It is effective and safe to prevent intrauterine infection of HBV with HBIG from the 28^th wk in pregnant women with positive HBeAg and HBsAg. In clinical application, those pregnant women with negative HBeAg and positive HBV-DNA also need to be interrupted by HBIG.展开更多
Mother-to-infant transmission of hepatitis B virus(HBV)is a main cause of chronic HBV infection.Maternal high HBV DNA level or positive hepatitis B e antigen(HBeAg)is the major risk factor for the transmission.With re...Mother-to-infant transmission of hepatitis B virus(HBV)is a main cause of chronic HBV infection.Maternal high HBV DNA level or positive hepatitis B e antigen(HBeAg)is the major risk factor for the transmission.With recommended passive and active immunoprophylaxis,the transmission occurs in nearly 0 and 4-12%of infants born to HBV-infected mothers with negative and positive HBeAg,respectively.Therefore,pregnant women with negative HBeAg appear not requiring antiviral therapy to prevent mother-to-infant transmission of HBV.Recent studies demonstrated that oral antivirals(lamivudine,telbivudine,or tenofovir)in pregnant women with high viral load or positive HBeAg,starting from 28-32 weeks of gestation,together with neonatal immunoprophylaxis,can almost completely prevent the transmission,indicating that it does not require antiviral therapy before 28 weeks of gestation.Accumulated evidence showed that the antivirals may be stopped upon delivery,and the infants may receive breast feeding after birth.However,these issues,as well as HBV DNA threshold for antiviral therapy during pregnancy,optimal timing for start and discontinuation of antivirals,and the drug safety of fetuses/infants,require further investigations to optimize the antiviral therapy during pregnancy.The proof of safety of fetal exposure to antivirais needs more evidence,which can be achieved from the real-world data analysis.展开更多
Objective To study the interruptive effect of hepatitis B virus (HBV) specific immunolobulin (HBIG) before delivery in attempt to prevent intrauterine transmission of HBV.Methods Nine hundred and eighty HBsAg carri...Objective To study the interruptive effect of hepatitis B virus (HBV) specific immunolobulin (HBIG) before delivery in attempt to prevent intrauterine transmission of HBV.Methods Nine hundred and eighty HBsAg carrier pregnant women were randomly divided into HBIG group and control group. Each subject in the HBIG group received 200 IU or 400 IU of HBIG intramuscularly at 3, 2 and 1 month before delivery. The subjects in the control group did not receive any specific treatment. All newborn infants received 100 IU of HBIG intramascularly after venous blood samples were taken at birth and 2 weeks after birth, followed by 30 μg plasma-derived HB vaccine or 5 μg recombinant yeast-derived hepatitis B vaccine at 1, 2 and 7 months of age. Blood tests were performed for all the lying-in women and their neonates. Blood specimens were tested for HBsAg and HBeAg by enzyme immunoassay. All infants were followed up for 1 year.Results In the HBIG group, 491 neonates were born to 487 HBV carrier mothers; and in the control group, 496 neonates were born to 493 HBV carrier mothers. The rates of intrauterine transmission in the two groups were 14.3% and 5.7% respectively (χ2=20.280, P<0.001), and the rates of chronic hepatitis B in the two groups were 2.2% and 7.3% respectively (χ2=13.696, P<0.001). The high risk factors of intrauterine HBV infection included HBsAg HBeAg double positive and HBV DNA positive in the peripheral blood of pregnant women.Conclusion HBV infection in the uterus may be interrupted by injecting multiple intramuscular HBIG injections before delivery without causing any side-effects.展开更多
Background:Schistosomiasis remains a major public health concern in China.Since 2004,an integrated strategy was developed to control the transmission of Schistosoma japonicum in China.However,the long-term effectivene...Background:Schistosomiasis remains a major public health concern in China.Since 2004,an integrated strategy was developed to control the transmission of Schistosoma japonicum in China.However,the long-term effectiveness of this integrated strategy for the interruption of schistosomiasis transmission remains unknown in the mountainous and hilly regions of China until now.This longitudinal study aims to evaluate the effectiveness of the integrated strategy on transmission interruption of schistosomiasis in Sichuan Province from 2005 through 2014.Methods:The data regarding replacement of bovines with machines,improved sanitation,access to clean water,construction of public toilets and household latrines,snail control,chemotherapy,and health education were captured from the annual report of the schistosomiasis control programmes in Sichuan Province from 2005 to 2014,and S.japonicum infection in humans,bovines and snails were estimated to evaluate the effectiveness of the integrated strategy.Results:During the 10-year period from 2005 through 2014,a total of 536568 machines were used to replace bovines,and 3284333 household lavatories and 15523 public latrines were built.Tap water was supplied to 19116344 residents living in the endemic villages.A total of 230098 hm2 snail habitats were given molluscicide treatment,and 357233 hm2 snail habitats received environmental improvements.There were 7268138 humans and 840845 bovines given praziquantel chemotherapy.During the 10-year study period,information,education and communication(IEC)materials were provided to village officers,teachers and schoolchildren.The 10-year implementation of the integrated strategy resulted in a great reduction in S.japonicum infection in humans,bovines and snails.Since 2007,no acute infection was detected,and no schistosomiasis cases or infected bovines were identified since 2012.In addition,the snail habitats reduced by 62.39%in 2014 as compared to that in 2005,and no S.japonicum infection was identified in snails since 2007.By 2014,88.9%of the endemic counties achieved the transmission interruption of schistosomiasis and transmission control of schistosmiasis was achieved in the whole province in 2008.Conclusion:The government-directed and multi-department integrated strategy is effective for interrupting the transmission of schistosomiasis in the mountainous and hilly regions of China.展开更多
Background:The development of agenda for global schistosomiasis elimination as a public health problem generates enthusiasms among global health communities,motivating great interests in both research and practice.Rec...Background:The development of agenda for global schistosomiasis elimination as a public health problem generates enthusiasms among global health communities,motivating great interests in both research and practice.Recent China-Africa schistosomiasis control initiatives,aiming to enhance collaboration on disease control in African countries,reflect in part that momentum.Yet there is a pressing need to know whether the Chinese experiences can be translated and applied in African settings.Main body:China’s remarkable achievements in schistosomiasis control programme,associated experiences and lessons,have much to offer to those combating the disease.Central to the success of China’s control programmes is a strategy termed“integrated control”-integrating environmental approaches(e.g.improved sanitation,agricultural and hydrological development and management),which target different phases of the parasite transmission system,to chemical-based drug treatment and mollusciciding.Yet,despite significant measurable public health benefits,such integration is usually based on field experience and remains largely uncharacterized in an ecological context.This has limited our knowledge on relative contributions of varying components of the integrated control programme to the suppression of disease transmission,making it challenging to generalize the strategy elsewhere.In this opinion article,we have described and discussed these challenges,along with opportunities and research needs to move forward.Conclusions:There is an urgent need to formalize an ecological framework for the integrated control programme that would allow research towards improved mechanistic understanding,quantification,and prediction of the control efforts.展开更多
Recombinant DNA Yeast-Derived Hepatitis B Vaccine (RYHB vaccine) is comparable to and can replace Plasma-Derived Hepatitis B Vaccine (PHB vaccine) for the prevention of mother-nfant transmission of hepatitis B virus (...Recombinant DNA Yeast-Derived Hepatitis B Vaccine (RYHB vaccine) is comparable to and can replace Plasma-Derived Hepatitis B Vaccine (PHB vaccine) for the prevention of mother-nfant transmission of hepatitis B virus (HBV), but the duration of immune efficacy of RYHB vaccine is not clear. This study indicates the long-term efficacy for the prevention of mother-infant transmission of HBV. One hundred and six neonates born to HBsAg-arrier mothers with HBeAg positive were randomly divided into two groups, one receiving 20 μg per dose of RYHB vaccine and the another receiving 20 μg per dose of PHB vaccine on the day of birth, at 1 month and at 6 months (three times). Physical examination and blood tests were performed for all infants at 6, 12, 24, 36, 48 and 60 months of age. The results showed that the protective efficacies at 6, 12, 24, 36, 48 and 60 months were 67%, 75%, 63%, 62%, 57% and 56%, respectively for the RYHB vaccine group and 58%, 76%, 51%, 41%, 24% and 18%, respectively for the PHB vaccine group. The protective efficacy was notably significant in the last two years. The study indicates that the duration of protective efficacy is over 5 years with RYHB vaccine, being longer than that of PHB vaccine. These recipients of RYHB vaccine showed no side effects, and the vaccine is regarded as safe and effective.展开更多
基金This study was supported by a grant from the National Natural Science Foundation of China (No. 39630280).
文摘OBJECTIVE: To study the relationship between the different replication status of hepatitis B virus (HBV) and mutations in the core promoter (CP) in mother and her child infected by mother-to-infant transmission. METHODS: The core promoter was amplified by PCR and cloned into pGEM-T vector with the T-A choning technique. The recombinant plasmid pGEM-CP was confirmed by digestion with restriction enzyme Apa I and Sac I. Two clones were selected to be sequenced in each patient. RESULTS: Every pair of mother and child had same serotype and genotype and the homology of nucleotides encoding 'a' determinant was 98%-100%. The number of mutations in the core promoter of patients with a high replication status was less than that in those with a low replication status. Mutations were mainly distributed in basia core promoter (BCP) and the inbibitor region of Kunitz-type serine protease. This difference was not associated with mother or child. CONCLUSION: The different replication status of HBV is caused by mutations in the core promoter in mother and child infected hy mother-to-infant transmission and appears to be not associated with the status of development of the infection.
文摘Objective：To search for risk factors that affect mother-to-infant transmission of hepatitis B virus（HBV）. Methods：To obtain studies eligible for meta-analysis, China biological medicine discs and MEDLINE citations were surveyed. Mother HBV DNA or HBeAg positivity,neonate HBeAg positivity, mode of delivery, threatened abortion and threatened premature labor were processed with meta analysis. Criteria for selection of published studies for meta analysis were based on principle by Abdolmaleky HM. Odds ratio （OR） was calculated and summarized by fixed effect model or random-effects model using RevMan software. The heterogeneity of the group of ORs was assessed using an X^2 test. The significance of the pooled OR was determined by the u-test. The strength of association was assessed using the OR. An OR〉1. 0 indicated a positive association between the risk factor and neonate HBV infection. Results： After meta analysis of factors concerned, a significant association was found between the positivity of HBeAg in mother and neonate, of HBV DNA in mother peripheral serum, and HBV mother-to-infant transmission, with a pooled OR equal to 19.43 （95% CI=8. 77-43. 06）, 36.5 （95% CI= 19.85-67. 11）, and 36.5 （95 % CI= 19.85-67.11 ） respectively. Mode of delivery, threatened abortion and threatened premature labor proved not to be of risk factors on the mother-to-infant transmission of HBV. Conclusion： Mother HBV DNA or HBeAg positivity and neonate HBeAg positivity were proved to be of risk factors affecting the transmission of HBV from mother to fetal.
基金Supported by the office of Science and Technology of Xinjiang,No.960505003
文摘AIM： To evaluate the efficacy of interruption of intrauterine infection of HBV with HBIG in pregnant women with positive HBeAg and HBsAg.METHODS： A prospective randomized controlled trial was adopted. Sixty cases with positive HBeAg and HBsAg were coincident with the criteria of inclusion, and 8 cases were excluded. Fifty-two cases were analyzed （28 cases in trial group and 24 in control group）. All cases in trial group received 200 IU HBIG intravenously every 4 wk for 3 times from the 28^th wk. The cases of control group received placebo in the same way. All pregnant women were detected for HBeAg and HBV-DNA at the beginning of the trial and end of the trial （delivery）. The cord blood of all newborns were collected for detecting HBeAg and HBV-DNA simultaneously.RESULTS： For investigation of HBeAg of newborns in trial group, 6 of 28 cases of newborns had positive HBeAg, the HBeAg positive rate being 21.4%, the total rate of 95% CI being 8%-41%. In control group, 19 of 24 cases of newborns had positive HBeAg, HBeAg positive rate was 79.2%, the rate of 95%CI being 5%-93%. By statistical analysis, 2= 17.26, P 〈 0.01, RR = 0.27, 95% CI （6.3 × 10^-6, 8.6 × 10^-5）. For investigation of HBV-DNA of newborns in trial group, 7 of 28 cases of newborns had positive HBV-DNA, HBV-DNA positive rate being 25%, the total rate of 95% CI being 11%-45%. In control group, 20 of 24 cases of newborns had positive HBV-DNA, HBV-DNA positive rate was 83.3%, the total rate of 95% CI being 63%-95%. By statistical analysis, X^2 = 17.62, P 〈 0.01, RR = 0.30, 95% CI （1.5 × 10^-5, 1.7× 10^-4）. The results indicated that there was significant difference in HBeAg positive rate and HBV-DNA positive rate of newborns between the two groups. In trial group, 7 of 28 newborns had HBV-DNA positive, but the HBV-DNA load of newborns was lower than that of their mothers. In control group, 20 of 24 newborns still had HBV-DNA positive, and the HBV-DNA load of newborns was close to those of their mothers. Statistical analysis indicated that there was no significant difference in HBV- DNA load between postnatal women without HBIG intervention and their filial generations （T = 81.5, P 〉 0.1）. CONCLUSION： It is effective and safe to prevent intrauterine infection of HBV with HBIG from the 28^th wk in pregnant women with positive HBeAg and HBsAg. In clinical application, those pregnant women with negative HBeAg and positive HBV-DNA also need to be interrupted by HBIG.
基金This work was supported by the Science and Technology Department of Jiangsu Province(BK20161105)the National Natural Science Foundation of China(81672002),China.
文摘Mother-to-infant transmission of hepatitis B virus(HBV)is a main cause of chronic HBV infection.Maternal high HBV DNA level or positive hepatitis B e antigen(HBeAg)is the major risk factor for the transmission.With recommended passive and active immunoprophylaxis,the transmission occurs in nearly 0 and 4-12%of infants born to HBV-infected mothers with negative and positive HBeAg,respectively.Therefore,pregnant women with negative HBeAg appear not requiring antiviral therapy to prevent mother-to-infant transmission of HBV.Recent studies demonstrated that oral antivirals(lamivudine,telbivudine,or tenofovir)in pregnant women with high viral load or positive HBeAg,starting from 28-32 weeks of gestation,together with neonatal immunoprophylaxis,can almost completely prevent the transmission,indicating that it does not require antiviral therapy before 28 weeks of gestation.Accumulated evidence showed that the antivirals may be stopped upon delivery,and the infants may receive breast feeding after birth.However,these issues,as well as HBV DNA threshold for antiviral therapy during pregnancy,optimal timing for start and discontinuation of antivirals,and the drug safety of fetuses/infants,require further investigations to optimize the antiviral therapy during pregnancy.The proof of safety of fetal exposure to antivirais needs more evidence,which can be achieved from the real-world data analysis.
基金TheresearchwassupportedbyagrantfromtheMinistryofPublicHealth ,China (No 970 30 2 2 3) .
文摘Objective To study the interruptive effect of hepatitis B virus (HBV) specific immunolobulin (HBIG) before delivery in attempt to prevent intrauterine transmission of HBV.Methods Nine hundred and eighty HBsAg carrier pregnant women were randomly divided into HBIG group and control group. Each subject in the HBIG group received 200 IU or 400 IU of HBIG intramuscularly at 3, 2 and 1 month before delivery. The subjects in the control group did not receive any specific treatment. All newborn infants received 100 IU of HBIG intramascularly after venous blood samples were taken at birth and 2 weeks after birth, followed by 30 μg plasma-derived HB vaccine or 5 μg recombinant yeast-derived hepatitis B vaccine at 1, 2 and 7 months of age. Blood tests were performed for all the lying-in women and their neonates. Blood specimens were tested for HBsAg and HBeAg by enzyme immunoassay. All infants were followed up for 1 year.Results In the HBIG group, 491 neonates were born to 487 HBV carrier mothers; and in the control group, 496 neonates were born to 493 HBV carrier mothers. The rates of intrauterine transmission in the two groups were 14.3% and 5.7% respectively (χ2=20.280, P<0.001), and the rates of chronic hepatitis B in the two groups were 2.2% and 7.3% respectively (χ2=13.696, P<0.001). The high risk factors of intrauterine HBV infection included HBsAg HBeAg double positive and HBV DNA positive in the peripheral blood of pregnant women.Conclusion HBV infection in the uterus may be interrupted by injecting multiple intramuscular HBIG injections before delivery without causing any side-effects.
基金This study was supported by the grant from the China UK Global Health Support Programme(grant no.GHSPOP101).
文摘Background:Schistosomiasis remains a major public health concern in China.Since 2004,an integrated strategy was developed to control the transmission of Schistosoma japonicum in China.However,the long-term effectiveness of this integrated strategy for the interruption of schistosomiasis transmission remains unknown in the mountainous and hilly regions of China until now.This longitudinal study aims to evaluate the effectiveness of the integrated strategy on transmission interruption of schistosomiasis in Sichuan Province from 2005 through 2014.Methods:The data regarding replacement of bovines with machines,improved sanitation,access to clean water,construction of public toilets and household latrines,snail control,chemotherapy,and health education were captured from the annual report of the schistosomiasis control programmes in Sichuan Province from 2005 to 2014,and S.japonicum infection in humans,bovines and snails were estimated to evaluate the effectiveness of the integrated strategy.Results:During the 10-year period from 2005 through 2014,a total of 536568 machines were used to replace bovines,and 3284333 household lavatories and 15523 public latrines were built.Tap water was supplied to 19116344 residents living in the endemic villages.A total of 230098 hm2 snail habitats were given molluscicide treatment,and 357233 hm2 snail habitats received environmental improvements.There were 7268138 humans and 840845 bovines given praziquantel chemotherapy.During the 10-year study period,information,education and communication(IEC)materials were provided to village officers,teachers and schoolchildren.The 10-year implementation of the integrated strategy resulted in a great reduction in S.japonicum infection in humans,bovines and snails.Since 2007,no acute infection was detected,and no schistosomiasis cases or infected bovines were identified since 2012.In addition,the snail habitats reduced by 62.39%in 2014 as compared to that in 2005,and no S.japonicum infection was identified in snails since 2007.By 2014,88.9%of the endemic counties achieved the transmission interruption of schistosomiasis and transmission control of schistosmiasis was achieved in the whole province in 2008.Conclusion:The government-directed and multi-department integrated strategy is effective for interrupting the transmission of schistosomiasis in the mountainous and hilly regions of China.
基金This work was supported by the National Key Research and Development Program of China(No.2016YFC1202001)the International Development Research Center(IDRC)+2 种基金Canada(grant No.108100–001)as well as by the China-UK Global Health Support Programme funded by UK DFID(fund code:GHSP-CS-OP4-D02)Song Liang is supported in part by the National Institutes of Health grant R01AI125842Eniola Michael Abe and Xiao-Nong Zhou were financially supported by the Fourth Round of Three-Year Public Health Action Plan(2015–2017)in Shanghai(grant No.GWTD2015S06).
文摘Background:The development of agenda for global schistosomiasis elimination as a public health problem generates enthusiasms among global health communities,motivating great interests in both research and practice.Recent China-Africa schistosomiasis control initiatives,aiming to enhance collaboration on disease control in African countries,reflect in part that momentum.Yet there is a pressing need to know whether the Chinese experiences can be translated and applied in African settings.Main body:China’s remarkable achievements in schistosomiasis control programme,associated experiences and lessons,have much to offer to those combating the disease.Central to the success of China’s control programmes is a strategy termed“integrated control”-integrating environmental approaches(e.g.improved sanitation,agricultural and hydrological development and management),which target different phases of the parasite transmission system,to chemical-based drug treatment and mollusciciding.Yet,despite significant measurable public health benefits,such integration is usually based on field experience and remains largely uncharacterized in an ecological context.This has limited our knowledge on relative contributions of varying components of the integrated control programme to the suppression of disease transmission,making it challenging to generalize the strategy elsewhere.In this opinion article,we have described and discussed these challenges,along with opportunities and research needs to move forward.Conclusions:There is an urgent need to formalize an ecological framework for the integrated control programme that would allow research towards improved mechanistic understanding,quantification,and prediction of the control efforts.
文摘Recombinant DNA Yeast-Derived Hepatitis B Vaccine (RYHB vaccine) is comparable to and can replace Plasma-Derived Hepatitis B Vaccine (PHB vaccine) for the prevention of mother-nfant transmission of hepatitis B virus (HBV), but the duration of immune efficacy of RYHB vaccine is not clear. This study indicates the long-term efficacy for the prevention of mother-infant transmission of HBV. One hundred and six neonates born to HBsAg-arrier mothers with HBeAg positive were randomly divided into two groups, one receiving 20 μg per dose of RYHB vaccine and the another receiving 20 μg per dose of PHB vaccine on the day of birth, at 1 month and at 6 months (three times). Physical examination and blood tests were performed for all infants at 6, 12, 24, 36, 48 and 60 months of age. The results showed that the protective efficacies at 6, 12, 24, 36, 48 and 60 months were 67%, 75%, 63%, 62%, 57% and 56%, respectively for the RYHB vaccine group and 58%, 76%, 51%, 41%, 24% and 18%, respectively for the PHB vaccine group. The protective efficacy was notably significant in the last two years. The study indicates that the duration of protective efficacy is over 5 years with RYHB vaccine, being longer than that of PHB vaccine. These recipients of RYHB vaccine showed no side effects, and the vaccine is regarded as safe and effective.
