治疗性病毒与治疗性疫苗

Viper

(一) Canada Communicable Disease Report 简称CCDR去年九月份颁布了一则报告. 分析了东南亚和中国乙型肝炎的现状和发展. 为什么呢?



因为加拿大的科学家意识到虽然加拿大的乙肝感染很低 (全世界3亿6千万, 亚洲占78%, 非洲16%,  南美洲3%, 欧洲, 北美洲, 岛屿和加拿大合占3%), 但是无论加拿大还是美国, 法国..., 东南亚和中国的乙肝不治好, 其流行性会影响到加拿大人民(和其他国家人民)的安全和健康. 所以要继续观测和关心这些地区乙肝的流行和治疗. 加拿大的肝病研究也是一流的.



所以什么 "FDA, 外国不注重HBV研究..." 是没有根据的, 不正确的; 或许中国人喜欢"自扫门前雪", 但是别人不一定会, 这也就是常常外国人被中国指责"干涉内政"的因素之一;



(二) FDA 不会介入发明, 发展药的生意, 治学领域去; 这违背了其宗旨(可以参观FDA看看其治家之宗旨~Mission Statement); FDA 也不会 "只注重艾滋病, 癌症, 老人痴呆症的研究不注重乙肝的研究..."; FDA只会对于治疗严重的艾滋病, 癌症, 老人痴呆症的新药批准(比其它药物)快一些而已, 以需减轻病人痛苦, 这一点根据最近批准乳腺癌, 白血病, 艾滋病和今天治疗糖尿病的例子可以证明;





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Hepatitis B and its Control in Southeast Asia and China



CCDR Volume: 27S3 • September 2001

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Zhiyong Hong, Shimian Zou, Antonio Giulivi







Hepatitis B is one of the major infectious diseases of mankind: of 360 million chronic carriers worldwide, 78% are in Asia, 16% in Africa, 3% in South America, and 3% in Europe, North America, and Oceania combined. HBV infection is the most common cause of chronic hepatitis, liver cirrhosis and HCC worldwide(1).



In order to combat HBV infection and subsequent carriage, most East Asian and Southeast Asian countries introduced mass vaccination programs during the late 1980s and mid-1990s, which have resulted in a drastic decline in the HBV carrier rate and the number of patients with HCC.



Although HBV prevalence is low in Canada, changes in the epidemiology of this disease in other parts of the world may have a significant impact on the health of Canadians. Therefore, it is important to closely and continuously monitor the status of the disease in the world, especially in areas where HBV is endemic.



Indonesia

The island of Lombok, east of Bali in Nusa Tenggara Barat Province, was the first to introduce a mass infant hepatitis B immunization project in Indonesia, which ran from November 1987 to October 1991(2). The Lombok Project clearly demonstrated the feasibility of incorporating HBV vaccine into the Expanded Program on Immunization (EPI) in a way that can significantly reduce chronic HBV infection and strengthen the EPI. The success of the Lombok Project was the basis for a national program of universal infant immunization in Indonesia. Four provinces were added to the program in 1991-1992, and the program was further expanded to 10 provinces in 1992-1993, requiring 4.5 million annual vaccine doses. The overall reduction in the prevalence of HBsAg among fully vaccinated children (less than 4 years old) fell from 6.2% to 1.9%, for a reduction of 70%.



Malaysia

From February 1997 to July 1999, a total of 79,103 individuals, including university students, health care workers, and primary and secondary school students, participated in a prospective study of hepatitis B. In all, 92.9% were Chinese, 4.8% were Malays, 2.1% were Indians, and 0.1% were from other ethnic groups(3). The age of the participants ranged from 5 to 60 years old. Demographic data and history of hepatitis B vaccination were obtained from each participant, and testing was carried out for HBsAg and anti-HBs. The overall prevalence of HBsAg was 1.5%. The rate among the Malays, Chinese, and Indians was 1.5%, 1.5%, and 0.3% respectively. Among all participants, 62.4% had been vaccinated with all three doses of HBV. Chinese participants were found to have the highest vaccination rate (64.5%), followed by Indians (37.8%), and Malays (32.7%). The rate of endemic HBV in Malaysia is now low, as its vaccination programs and possibly other intervention measures have successfully reduced the incidence of the infection(4).



The Philippines

The prevalence of chronic HBV infection in the Philippines, as indicated by HBsAg positivity, has been found to range from 2.0% to 16.5%, with an average of 12.0%, in a study of rural villagers(5). In a study assessing the feasibility and effectiveness of incorporating hepatitis B vaccine into the national EPI, HBsAg positivity decreased to 2% during the last 10-year period (1987-1996) in the Philippines(6).



The Republic of Singapore

In Singapore, the HBsAg carrier rate for the general population was 9% to 10% in 1980-1981. A national childhood hepatitis B vaccination program was formulated and implemented in phases, starting with babies born to carrier mothers on October 1, 1985, and finally extending to all newborns on September 1, 1987. During the period from 1994 to 1996, more than 90% of children completed the full schedule of immunization by 1 year of age, and 85% had evidence of vaccination at school entry at age 6. Follow-up of two cohorts of vaccinated children showed that perinatal transmission was reduced by 80% to 100%. Horizontal transmission also declined through other public health measures. The incidence of acute hepatitis B declined from 10.4 per 100,000 in 1985 to 4.8 per 100,000 in 1996(7). The vaccination coverage in newborns reached 100%, and the HBsAg positive rate declined to 2% to 3% in 1997 and 1998 in randomized population groups and in new blood donors. The acute HBV morbidity had fallen continuously from 10.4 per 100,000 in 1985 to 4.5 per 100,000 in 1997, and the incidence of HCC continued to decline(8).



Thailand

In 1992, hepatitis B vaccine was included in the EPI on a nationwide scale in Thailand. Recent data on the immunization program against hepatitis B demonstrate a steady decline in the incidence of HBV carriers among the Thai population during the period from 1981 to 1991. For example, the prevalence of HBV carriers among blood donors and students decreased from 8.2% and 6.6 % in 1987 to 6.5% and 5.2% in 1991 respectively(9). Current data from an epidemiologic survey in Songkhle Province in the south of Thailand demonstrated an overall prevalence of HBV carriers of 0.55% among children less than 15 years of age(10). It has been clearly shown that hepatitis B immunization as part of the EPI is highly efficient in protecting newborns from infection.



Viet Nam

Blood donors from two cities in Viet Nam were tested for markers of HCV and HBV infection. Among 491 donors in Ho Chi Minh City and 499 donors in Hanoi City, HBsAg carrier rates were 3.1% and 3.0% respectively(11). There is no report about the HBsAg carrier rate in the general population.



China (mainland)

HBV infection rates reported for university students ranged from 4.5% to 19.4% during the period from the mid-1980s to the early 1990s(12). The HBsAg carrier rate in China showed a substantial decrease after the implementation of the WHO strategy. Zeng et al carried out a randomized two-stage household sampling survey at 112 disease surveillance points from 25 provinces, autonomous regions, and municipalities of China in 1996(13). The results showed that the hepatitis B vaccination coverage rates among neonates were 96.7% in 1993 and 97.5% in 1994-1996 in urban areas, and 50.8% in 1993 and 73.9% in 1994-1996 in rural areas. Vaccination coverage rates among 7-9 year-old students in 1994 in urban and rural areas were 97.5% and 73.9% respectively. Lu et al conducted a sampled survey on hepatitis A, B, and C in Yunnan province, China, in 1998(14). The prevalence of HBsAg was 2.0% in 452 serum samples collected from pupils aged 6-12 years old in three different counties. Zhang et al(15) determined the persistence of immunity in neonates born to HbsAg positive mothers following HB immunization with different schedules(15). In total, 2

对蛙类无反感

其实,看到有这样的讨论出来,就说明对HBV的研究还是有希望的,至少讨论的双方都是出于学术与社会责任的目的,向他们表示感谢!

lmzen

有关此类的文章我一直在注意看，但我认为要靠我国来研制出治疗乙肝的特效药，希望不大，而且我国是乙肝感染大国，虽然占全世界的78%，但我国用在此项上的经费能有多少，堂堂的一个大国有这么多的乙肝感染者要重视早该重视了！你们看看如今的证券市场情况便就知道了。

lxx00630

静下心等外国的进展吧国内没戏

spama

我是不相信国内的科研水平，国内药厂卖的都是仿制国外药。
我就等有没有可以治疗hiv的药了。
如果那个都出来了，hbv就有望了。

spama

国内?
一个国家十分之一以上的人口有一种病，国家都不拨出专款来研究。
我还敢指望国内

shldol

NIH投入肝炎基金费是AIDS、癌症和痴呆的多少？？？？拉米在美国的费用是中国有多少？？？阿德？？？？
国内肝炎一直是攻关的？？？？
从明天开始，新药的审批程序将发生一些人性化的改变。《药品注册管理办法》规定，新药的门槛将得到进一步提高，同时创制的新药及治疗疑难危重疾病的新药将能在第一时间得到审批。

　　可以实行快速审批的药品包括：1.新的中药材及其制剂，中药或者天然药物中提取的有效成分及其制剂；2.未在国内外获准上市的化学原料药及其制剂、生物制品；3.抗艾滋病病毒及用于诊断、预防艾滋病的新药，治疗恶性肿瘤、罕见病的新药；4.治疗尚无有效治疗手段的疾病的新药-----肝病？？？？？