Changes of Hepatitis B Markers among Young Adults in a Hepatitis B Virus Endemic Area: A Follow up Study on Medical Students

台灣青少年B型肝炎標記的改變

劉俊鴻(June-Hong Liu) ； 盧勝男(Sheng-Nan Lu) ； 何啟功(Chi-Kung Ho) ； 王景弘(Jing-Houng Wang) ； 莊萬龍(Wan-Long Chuang) ； 張文宇(Wen-Yu Chang)

《The Kaohsiung Journal of Medical Sciences》 13卷5期 (1997/05) Pp. 286-292

https://doi.org/10.6452/KJMS.199705.0286

摘要

台灣是B型肝炎的高盛行區，B型肝炎疫苗從1984年起施打，這一代的年輕人將是最後一代未施打疫苗者。本篇研究是觀察醫學院學生B型肝炎在五至六年間的變化，藉以了目前年輕人B型肝炎的變化與以往有何不同。
經研究發現，這一代年輕人的帶原率（14.4%）與國人相近，但在25歲以前有74%的帶原者已經是e抗原陰轉。只有一位學生在大學生活時代感染B型肝炎（年年發生率：0.47%）而得到抗體。低濃度anti-HBs抗體的學生，在追加一劑疫苗後，大部分都可以得到顯著的抗體濃度上升。
由本次的研究發現，這一代年輕人，其B型肝炎帶原率不變，故對於於肝硬化，肝癌的診治計劃仍而延續。但這一代年輕人有著比已往報告更多且更早的e抗原陰轉率，不過對於B型肝炎高感染群仍需更加建議B型肝炎疫苗的注射。

並列摘要

To elucidate the hepatitis B virus (HBV) infection status of teenagers, to observe changes of the status of these young adults after long-term follow up, to clarify the HBV replication acitivity of young HBsAg carriers, and to understand the anti-HBs titer of those immune to HBV-infection, a comparison between two health examinations at a 5-or 6-year interval was conducted among 132 medical students. Their ages were 19.1±0.9 (mean ± SD). There were 19 (14.4%) HBsAg carriers, 57 (43.2%) immune to HBV infection, and 56 (42.4%) susceptible to HBV. All 19 HBsAg positive carriers were still incarrier status in the second examination. Twelve (63.1%) of the HBV carriers had already HBeAg negative seroconversion before the age of 25. And two carriers might be in the late e seroconversion phase. One susceptible student had a subclinical HBV infection during his university life, with an incidence of HBV infection of 0.47% (1/213) per person-year. Nine (11%) of 82 HBV-immune students had lower anti-HBs concentrations. Six of the 9 students were immunized by natural infection. Anamnestic response developed after booster vaccination. This study shows that these young adults have an HBsAg-carrier rate similar to the general adult population in Taiwna. However, HBeAg seroconversion occurs more ofthen an earlier in this particular population than previous reports have indicated. Moreover, only 24 (40%) susceptible subjects received HBV vaccination after the first recommendation and it is necessary to be more forceful in recommending prompt vaccination.

並列關鍵字

hepatitis B virus (HBV) ； HBsAg carrier ； vaccination