Eur J Gastroenterol Hepatol. 2007 Aug;19(8):659-64.
Etiologies of chronic liver diseases in Hong Kong.
Fung KT, Fung J, Lai CL, Yuen MF.
Department of Medicine and Geriatrics, Kwong Wah Hospital, Hong Kong.
BACKGROUND: In Hong Kong, chronic hepatitis B (CHB) is endemic with a prevalence rate of 8.8%. Data, however, on chronic hepatitis C infection and other nonviral causes of chronic liver disease (CLD) are limited. AIM: To investigate the spectrum of CLDs in Hong Kong. METHODS: Records of all patients attending the Hepatology Clinic of Queen Mary Hospital, Hong Kong, in 2004 were reviewed to identify those with CLDs and their underlying causes. RESULTS: A total of 6106 patients were found to have CLD. CHB accounted for 89.4% of the cases, followed by chronic hepatitis C infection (5.1%). Nonviral causes accounted for the remaining 5.5% [alcoholic liver disease (ALD) (1.7%), nonalcoholic fatty liver disease (1.5%), primary biliary cirrhosis (PBC) (1.3%)]. Patients with CHB and Wilson's disease were significantly younger than patients with other causes (P<0.002). More than 90% of patients with autoimmune hepatitis and PBC were women. The prevalence of CHB infection was lower in patients with PBC than the general population. Among patients with ALD, the prevalence rate was higher for chronic hepatitis C but similar for CHB, as compared with the general population. CONCLUSIONS: Despite universal HBV vaccination since 1988, CHB remains the commonest cause of CLD in Hong Kong. PBC and nonalcoholic fatty liver disease were not rare in the Chinese population, being important causes of nonviral liver disease. The prevalence of chronic viral infection among patients with PBC or ALD confirmed the findings of other published literatures.
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TermToSearch=17625435&ordinalpos=37&itool=EntrezSystem2.PEntrez.Pubmed .Pubmed_ResultsPanel.Pubmed_RVDocSum
Cochrane Database Syst Rev. 2011 Mar 16;(3):CD007879.
Hepatitis B vaccination during pregnancy for preventing infant infection.
Sangkomkamhang US, Lumbiganon P, Laopaiboon M.
Source.
Department of Obstetrics and Gynaecology, Khon Kaen Hospital, Srichan Road, Maung, Khon Kaen, Thailand, 40000.
Abstract.
BACKGROUND:
Infant hepatitis B infection increases risk of chronic infection, cirrhosis or liver cancer (hepatocellular carcinoma) in adult. Perinatal transmission is a common route of infection.
OBJECTIVES:
To assess the effectiveness and adverse effects of hepatitis B vaccine administered to pregnant women for preventing hepatitis B virus infection in infants.
SEARCH STRATEGY:
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 December 2010).
SELECTION CRITERIA:
Randomized controlled trials (RCTs) assessing hepatitis B vaccination compared with placebo or no treatment during pregnancy for preventing infant infection. We excluded quasi-RCTs and crossover studies.
DATA COLLECTION AND ANALYSIS:
Two review authors independently assessed trial eligibility.
MAIN RESULTS:
We were not able to include any studies.
AUTHORS' CONCLUSIONS:
We found no RCTs that assessed the effects of hepatitis B vaccine during pregnancy for preventing infant infection. Consequently, this review cannot provide guidance for clinical practice in this area. However, it does identify the need for well-designed randomized clinical trials for the effect of hepatitis B vaccine during pregnancy on the incidence of infant infection and adverse effects.
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Отсутствие научных исследований в области профилактики заражения детей при вакцинации беременных.
Cochrane Database Syst Rev. 2008 Jul 16;(3):CD006481.
Hepatitis B immunisation in persons not previously exposed to hepatitis B or with unknown exposure status.
Mathew JL, El Dib R, Mathew PJ, Boxall EH, Brok J.
Source.
Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medial Education and Research (PGIMER), Chandigarh, India, 160012.
jlmathew@rediffmail.com
Abstract.
BACKGROUND:
The benefits and harms of hepatitis B vaccination in persons not previously exposed to hepatitis B infection or with unknown exposure status have not been established.
OBJECTIVES:
To assess the benefits and harms of hepatitis B vaccination in people not previously exposed to hepatitis B infection or with unknown exposure status.
SEARCH STRATEGY:
Trials were identified from The Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, LILACS,Science Citation Index Expanded (last search, March 2007). Additionally, we contacted experts and vaccine manufacturers, and read through reference lists for eligible trials.
SELECTION CRITERIA:
Randomised clinical trials comparing hepatitis B vaccine versus placebo, no intervention, or another vaccine in persons not previously exposed to hepatitis B (HBsAg negative) or with unknown exposure status.
DATA COLLECTION AND ANALYSIS:
The primary outcome was hepatitis B infection (detecting HBsAg, HBeAg, HBV DNA, or anti-HBc). Secondary outcomes were lack of sero-protection, antibody titre, clinical complications, adverse events, lack of compliance, and cost-effectiveness. Dichotomous outcomes were reported as relative risk (RR) with 95% confidence interval (CI), using intention-to-treat analysis assuming an unfavourable event for missing data. Sensitivity analyses based on methodological quality (risk of bias), available data analysis, intention-to-treat analysis assuming a favourable event for missing data, best-case scenario, and worst-case scenario were conducted.
MAIN RESULTS:
Twelve trials were eligible. All had high risk of bias and reporting was inconsistent. Hepatitis B vaccine did not show a clear effect on the risk of developing HBsAg (RR 0.96, 95% CI 0.89 to 1.03, 4 trials, 1230 participants) and anti-HBc (RR 0.81, 95% CI 0.61 to 1.07; 4 trials, 1230 participants, random-effects) when data were analysed using intention-to-treat analysis assuming an unfavourable event for missing data. Analysis based on data of available participants showed reduced risk of developing HBsAg (RR 0.12, 95% CI 0.03 to 0.44, 4 trials, 576 participants) and anti-HBc (RR 0.36, 95% CI 0.17 to 0.76, 4 trials, 576 participants, random-effects). Intention-to-treat analysis assuming favourable outcome for missing data showed similar reduction in risk. Hepatitis B vaccination had an unclear effect on the risk of lacking protective antibody levels (RR 0.57, 95% CI 0.26 to 1.27, 3 trials, 1210 participants, random-effects). Development of adverse events was sparsely reported.
AUTHORS' CONCLUSIONS:
In people not previously exposed to hepatitis B, vaccination has unclear effect on the risk of developing infection, as compared to no vaccination. The risk of lacking protective antibody levels as well as serious and non-serious adverse events appear comparable among recipients and non-recipients of hepatitis B vaccine.
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