HBV 20 HBV 1/3 HBV 3.5~4 5% 2/3 1/3 15%~25% HBV 60 100 7 WHO and CDC fact sheets, available at www.who.int and www.cdc.gov Van Damme P. Vaccine, 2004, 3:249-267
HBV 7~8 HBV 57.6% 15%~25% HBV HBV 1.2 10% 13 30 WHO and CDC fact sheets, available at www.who.int and www.cdc.gov Van Damme P. Vaccine, 2004
HBV HBV (3.6 ): Margolis HS, et al. Semin Liver Dis, 1991, 11: 84-92 < 2% 2%~7% > 8%
1992~1995 2002 HBsAg Jiangxi Shaxi Chongqing Heilongjian g Jilin Liaoning Inner Mongolia Beijing Tianjin Hebei Shandong Jiangs u Shanghai Zhejia ng Taiwan Fujian Guangdon g Hainan Guaangxi Yunnan Guizhou Sichuan Tibet Xinjiang Qinghai Gansu Ningxi a Shanxi Henan Hubei Hunan Anhui Jiangxi Shaxi Chongqing Heilongjian g Jilin Liaoning Inner Mongolia Beijing Tianjin Hebei Shandong Jiangs u Shanghai Zhejia ng Taiwan Fujian Guangdon g Hainan Guaangxi Yunnan Guizhou Sichuan Tibet Xinjiang Qinghai Gansu Ningxi a Shanxi Henan Hubei Hunan Anhui HBsAg 9% 4~6% 7~8% 1992~1995 2002
HBV / / /
HBV [7] : HBsAg HBV : ( ) HBV ( )
HBV I ( ) 90% ~10%??
[1, 10] ( -2) ( ) : HBV HBV ( ) : ( )
% HBV 22 500 000 ~32 HCV 2 700 000 ~40 HIV 98 000 ~5 Source: CDC and WHO, unpublished data
( ) HBV ( ) 27
4 ( ) ( ) ( ) HBV ( ), 2005, 13:881-891
1990~2004 10 (/10 ) 8 6 4 20 12~19 2 0 12 1990 1992 1994 1996 1998 2000 2002 2004 MMWR, 2005, 54(RR-16)
1990-2001 10~14 (/10 ) 15~19 1990 12.1 16.9 22.1 1992 8.9 19.2 22.7 1994 6.3 15.9 20.2 1996 4.9 16.4 15.7 1998 6.6 19.3 16.4 2000 4.8 15.6 20.1 2001 2.0 10.6 16.5. 2004 25:388-390
HBsAg (%) CDC 1991 WHO 2002 2 2 2 2 2 2 2.8 2.8 ~0.5 0.1-0.2 1 ~0.7 0.62 0.2 2.1 0.9 CDC 1991; WHO World Health Report 2002; BMS Colloqua 2003-4
1992~1995 2002 HBsAg HBsAg (%) 13 12 10 8 6 8.5 10.2 10.5 1992~1995 11.7 12.0 11.2 12.7 11.5 10.5 9.2 9.7 2002 7.1 4 2 0 2.2 2.2 2.4 3.6 4.5 1~ 2~ 3~ 4~ 5~ 6~ 10~ 15~ 20~30 ( ) 4.8
(/10 ) ( ) 1969-1988 1996-2001 ( ) ( ) 10~ 1585 365 91( 5.7) 484 390 2( 0.4) 14.3 20~ 836 197 438( 52.4) 415 159 53(12.8) 4.1 30~ 615 279 807(131.2) 261 755 154(58.8) 2.2 40~ 530 998 758(142.8) 194 943 162(83.1) 1.7 50~ 388 921 469(120.6) 159 779 145(90.8) 1.3 60 456 126 265( 58.1) 190 543 118(61.9) 0.9,. 2004 25:385-387
6~14 1.0 (/10 ) 0.8 0.6 0.4 0.7 /10 0.57 /10 0.36 /10 0.2 0 1981~1986 1986~1990 1990~1996 Chang MH, et al. N Engl J Med 1997
1992.01.01 2002.01.01 2005.06.01 HBV HBV 10 HBV
, 2005, 13:881-891
1967~2000 HBV /10 14 12 10 8 6 4 2 1981 HBsAg 0 1967 1970 Source: NNDSS 1973 1976 1979 1982 1985 1988 1991 1994 1997 2000
HBV / / /
HBsAg HBsAg 24 5µg 10µg (HBIG) ( CHO 12 100 IU) 10µg 20µg (CHO) [10, 26, 27], 2005, 13:881-891
(µg) 5 10 5 10 10 20 CHO 10 20 10 20
5µg 10µg CHO 20µg 20µg CHO, 2005, 13:881-891
Engerix-B (GSK) Dose(mL) 11 10 µg(0.5) 11~19 10 µg(0.5) 20 20 µg(1.0) 40 µg(2.0)** : 0 1 6 HBsAg HBIG * **0 1 2 6 2mL
20µg 10µg HBV ( ) (%) GMT(mIU/mL) 20µg* 10µg 20µg* 10µg Crovari 83 19.9 96.0 93.3 1 098 1 013 Dahl-Hanse 139 21~62 100.0 100.0 2 943 729 Renzulli 241 20~50 98.3 93.1 15 018 1 110 Treadwell 392 39~70 91.0 85.0 840 340 Poovorawan 320 18~22 97.9 97.1 4 774 2 705 Chiaramonte 507 16~40 99.6 99.2 22 601 3 569 * Engerix-B HBV
-HBs (%) -HBs ( 18 ) 100 80 60 40 1000mIU/mL* 20 2 4 6 8 100~999mIU/mL * 10~99mIU/mL* 23.5% 76.5% 35.4% 10 12 14 16 18 20 * 18 - HBs GMT 1000mIU/mL 76.5% 100-999mIU/mL 35.4% 10-99mU/mL 23.5% 1 Are booster immunisations needed for lifelong hepatitis B immunity? European Consensus Group on Hepatitis B Immunity. European consensus group on hepatitis B immunity. Lancet, 2000,12;355:561-565 2 Floreani A, Baldo V, Cristofoletti M, et al. Long-term persistence of anti-hbs after vaccination against HBV: an 18 year experience in health care workers.vaccine,2004, 22(5-6):607-610
(%) 10 8 6 4 2 0 20µg/ 10µg/ 35 45 55 65 25 30 35 40 45 ( ) (BMI) (P<0.05) (P<0.001) Wood RC, et al. JAMA. 1993, 270:2935-9
2000g HBsAg 12 HBIG + 1~2 3 ( 1 ) 9~18 HBsAg -HBs 12 HBIG + HBsAg 1~2 HBsAg ( 1 ) 1 1 MMWR, 2005, 54(RR-16)
HBIG HBV?
1989 226 20% : 30% 50% Iain Chalmers et al. Effective Care in Pregnancy and Childbirth Oxford: Oxford University Press,
,
HBsAg 12 HBIG HBsAg [29] (III) Although HBsAg has been detected in multiple body fluids, only serum, semen, and saliva have been demonstrated to be infectious (51, 52). HBsAg Beasley RP, et al. Lancet, 1975, 2:740-741; WHO MMWR, 2005, 54(RR-16)
HBV 3 HBV 0 1 6 3 HBV 1~2 -HBs
s(%) 100 90 80 90.9% 100% 100% 70 60 -HB 50 40 30 20 10 (20 µg ) (20 µg ) (20 µg ) -HBs 100mIU/mL 39 100mIU/mL 100mIU/mL 39 71 3 20µg Bock et al
100 s(%) 90 80 70 60 83% 83% 76% 99% -HB 50 40 30 20 10 (3 ) (3 ) (4 ) -HBs GMT 709mIU/mL 709mIU/mL 880mIU/mL 3 20µg Ribeiro et al Salassa et al
40 µ g -HBs -HBs(%) 100 80 3 (0 1 6 ) 4 (0 1 2 6 ) 79 75 60 46 46 48 58 55 40 37 20 21 21 0 1 2 3 7 24 el-reshaid K, et al. Vaccine, 1994, 12:223-234
? 12 -HBs -HBs - HBs<10 miu/ml [30] ( ), 2005, 13:881-891
HBV HBV +/No. (%) +/No. (%) 1-2 3-4 5 6 7 8 9-10 11-12 13-14 15 47/2 849(1.7) 23/1 505(1.5) 51/3 306(1.5) 32/1 924(1.7) 35/2 189(1.6) 33/2 156(1.5) 51/3 171(1.6) 22/1 712(1.3) 19/2 335(0.8) 9/ 551(1.6) 111/2 849(3.9) 51/1 505(3.4) 93/3 306(2.9) 47/1 924(2.5) 83/2 189(3.8) 78/2 156(3.6) 101/3 171(3.2) 51/1 712(3.0) 65/2 335(2.8) 18/ 551(3.3). 2002; 16:146~149 % (95% CI) 89.6(86.6-92.6) 90.4(86.4-94.3) 90.3(87.6-93.0) 89.5(85.9-93.2) 89.9(86.6-93.3) 90.4(87.1-93.7) 89.9(87.1-92.7) 91.9(88.6-95.3) 94.9(92.6-97.2) 89.7(83.1-96.4)
-HBs (%) 100 80 50 40 20 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 -HBs (. 2002;16:146~149)
3000 2500 1000 miu/ml 100 miu/ml -HBs (miu /ml) 2000 10 miu/ml 1500 1000 500 0 17 17
-HBs (miu/ml) 3000 1000 miu/ml 2500 100 miu/ml 10 miu/ml 2000 1500 1000 500 0 7 7
HBV HBV -HBs 10mIU /ml HBV HBIG 200~400 IU HBV -HBs 10 miu/ml (20µg) 1 6 -HBs 2 3 ( 20µg)
WPRO 2005 9 2012 5 HBsAg 2% 1%
2005~2010 1. 5 1% 2. 7% 3. 7% 1 2006 2 13