C易感者
像美国肝病研究学会（America Society for the Study of Liver
Diseases）发布的指针等均认为，低流行国家的国民去中高流行国家旅行的话，
就是易感群体，要注射疫苗。
因此住在像中国这样的高流行国家的国民，日常生活、工作和学习中面临着
一个数量庞大和比例高的慢性携带者群体，每一个尚未感染乙肝病毒的人原则上
都是易感者。
证据一： 【实验结果：唾液HBV DNA水平比血液HBV DNA水平低一个数量级】
J Clin Virol. 2004 Feb;29(2):92-4.
Paired measurements of quantitative hepatitis B virus DNA in
saliva and serum of chronic hepatitis B patients: implications for
saliva as infectious agent.
van der Eijk AA, Niesters HG, G?tz HM, Janssen HL, Schalm SW,
Osterhaus AD, de Man RA.
Department of Hepatology and Gastroenterology, Erasmus MC,
University Medical Centre, Room Ca 326, Dr. Molewaterplein 40, 3015 GD
Rotterdam, Netherlands.
BACKGROUND: After intensive source and contact tracing 20 % of
acute Hepatitis B virus (HBV) infections remain unexplained. Saliva
may be an unexpected vehicle of HBV DNA transmission. OBJECTIVE: To
further explore this hypothesis we evaluated the quantitative levels
of HBV DNA in saliva and compared these with the HBV DNA levels
measured in serum. STUDY DESIGN: Serum and saliva were collected from
27 chronic HBV patients attending our outpatient clinic. RESULTS:
There were 16 men and 11 women; 15 patients were HBeAg positive,
anti-HBe negative and 11 patients were HBeAg negative, anti-HBe
positive. One patient was HBeAg and anti-HBe negative. Samples of
serum and saliva were collected on the same day. All saliva specimens
were clear on inspection. HBV DNA in serum was measured by the Digene
Hybrid Capture II microplate assay (Digene Diagnostics), the HBV
Monitor assay (Roche Diagnostics) as well as an in-house developed HBV
DNA TaqMan assay. The HBV DNA TaqMan assay was used for the
quantitative measurement of HBV DNA in saliva. Median HBV DNA levels
in serum were 2.10 x 10(5) geq/ml and ranged from 373 genome
equivalents per ml (geq/ml) to 4.13 x 10(9) geq/ml; median HBV DNA
levels in saliva were 2.27 x 10(4) geq/ml and ranged from 373 geq/ml
to 9.25 x 10(6) geq/ml. A clear correlation was shown between HBV DNA
in serum and saliva; log HBV DNA in saliva=1.01 + 0.56 x (log HBV DNA
in serum). CONCLUSIONS: this is the first report of precise
quantitative measurements of HBV DNA levels in saliva and the
relationship with HBV DNA levels in serum. Our findings show that
saliva is a source of HBV DNA.This finding may have implications in
selected patients for the infectivity of saliva and offer further
insight in the routes of transmission of HBV infection.
临床病毒学学报（2004年）
荷兰伊拉斯莫斯大学医学中心肝脏学和胃肠学系
题目：慢性乙肝患者唾液和血清中的定量配对测度：唾液作为传染媒介的含
意
摘要：我们采集了就诊的27为慢性乙肝患者的血清和唾沫。这27人中，16男，
11女。15个病人e抗原阳性、e抗体阴性，11个病人e抗原阴性、e抗体阳性，1个
病人e抗原、e抗体均为阴性。血清和唾液的样本于同一天采集。
测得的结果：血清中HBV DNA水平的中位数为 2.10 x 10^5 geq/ml（最低
373geq/ml，最高4.13 x 10^9 geq/ml）；
唾液中HBV DNA水平的中位数为 2.27 x 10^4 geq/ml（最低373 geq/ml，最
高 9.25 x 10^6 geq/ml)。
血清HBV DNA水平与唾液HBV DNA水平相关性非常明显。
结论：这是第一个唾液HBV DNA水平的精确定量测度报告，也是第一个唾液
HBV DNA水平与血清HBV DNA水平相关性的报告。我们的发现现实唾液是HBV DNA
的一个来源。这个发现在所选患者中会有唾液传染性的含意，并提供了乙肝病毒
感染传播路径的更进一步的洞见。
作者: 小小刘 时间: 2009-9-27 23:18
证据二：【实验结果：唾液HBV DNA水平比血液HBV DNA水平低两个数量级、
尿液HBV DNA水平比血液HBV DNA水平低三个数量级】
Eur J Gastroenterol Hepatol. 2005 Nov;17(11):1173-9.
Paired, quantitative measurements of hepatitis B virus DNA in
saliva, urine and serum of chronic hepatitis B patients.
van der Eijk AA, Niesters HG, Hansen BE, Pas SD, Richardus JH,
Mostert M, Janssen HL, Schalm SW, de Man RA.
Department of Gastroenterology & Hepatology, Erasmus MC,
University Medical Centre Rotterdam, The Netherlands.
OBJECTIVES: Despite an abundance of epidemiological evidence for
horizontal transmission of hepatitis B virus (HBV), the transmission
route remains to be fully elucidated. In a new approach, we evaluated
quantitative HBV DNA content in serum, saliva and urine as a first
step in exploring possible modes of horizontal transmission. METHODS:
In an outpatient setting of an academic hospital, paired serum, saliva
and urine samples were collected from 150 chronically infected HBV
patients. A validated HBV DNA TaqMan assay was used to quantitatively
measure HBV DNA. RESULTS: Mean log HBV DNA in serum was 5.8 (range,
undetectable to 10.0 log HBV DNA) copies/ml, 50% of the patients had
an HBV DNA above 10 copies/ml in serum. Mean log HBV DNA level in
saliva was 3.2 (range, undetectable to 7.5) copies/ml, 15% had an HBV
DNA above 10 copies/ml in saliva. Mean log HBV DNA level in urine was
2.6 (range, undetectable to 5.4) copies/ml and 1% had an HBV DNA above
10 copies/ml in urine. A high, non-linear correlation was shown
between HBV DNA in serum and saliva (Spearman's rho 0.82) and between
serum and urine (Spearman's rho 0.74). CONCLUSIONS: The significant
amounts of HBV DNA found in saliva and urine in chronic HBV patients
with high viraemia in serum may have implications for the
understanding of hepatitis B epidemiology. The potential infectivity
of these body fluids may provide an explanation for the 20% of cases
of infection obtained through horizontal transmission for which the
origin of infection is yet unknown.
证据二：【实验结果：唾液HBV DNA水平比血液HBV DNA水平低两个数量级、
尿液HBV DNA水平比血液HBV DNA水平低三个数量级】
Eur J Gastroenterol Hepatol. 2005 Nov;17(11):1173-9.
Paired, quantitative measurements of hepatitis B virus DNA in
saliva, urine and serum of chronic hepatitis B patients.
van der Eijk AA, Niesters HG, Hansen BE, Pas SD, Richardus JH,
Mostert M, Janssen HL, Schalm SW, de Man RA.
Department of Gastroenterology & Hepatology, Erasmus MC,
University Medical Centre Rotterdam, The Netherlands.
OBJECTIVES: Despite an abundance of epidemiological evidence for
horizontal transmission of hepatitis B virus (HBV), the transmission
route remains to be fully elucidated. In a new approach, we evaluated
quantitative HBV DNA content in serum, saliva and urine as a first
step in exploring possible modes of horizontal transmission. METHODS:
In an outpatient setting of an academic hospital, paired serum, saliva
and urine samples were collected from 150 chronically infected HBV
patients. A validated HBV DNA TaqMan assay was used to quantitatively
measure HBV DNA. RESULTS: Mean log HBV DNA in serum was 5.8 (range,
undetectable to 10.0 log HBV DNA) copies/ml, 50% of the patients had
an HBV DNA above 10 copies/ml in serum. Mean log HBV DNA level in
saliva was 3.2 (range, undetectable to 7.5) copies/ml, 15% had an HBV
DNA above 10 copies/ml in saliva. Mean log HBV DNA level in urine was
2.6 (range, undetectable to 5.4) copies/ml and 1% had an HBV DNA above
10 copies/ml in urine. A high, non-linear correlation was shown
between HBV DNA in serum and saliva (Spearman's rho 0.82) and between
serum and urine (Spearman's rho 0.74). CONCLUSIONS: The significant
amounts of HBV DNA found in saliva and urine in chronic HBV patients
with high viraemia in serum may have implications for the
understanding of hepatitis B epidemiology. The potential infectivity
of these body fluids may provide an explanation for the 20% of cases
of infection obtained through horizontal transmission for which the
origin of infection is yet unknown.
