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Nelson医生问:近两周来,我们地区有3名内科医师在诊所发现,一些8～18月龄婴幼儿的母亲罹患实验室确诊的急性乙型肝炎。与这些母亲密切接触的幼儿应该接受乙型肝炎免疫球蛋白(HBIG)和乙型肝炎疫苗吗?对这些婴儿及其母亲应进行哪些实验室试验? Krugman医生(纽约大学医学中心)答:回答这一问题需要了解实验室确诊的急性乙型肝炎的自然史。急性乙型肝炎病人的传染期为潜伏期后期到急性肝炎或黄疸出现后的两周至3或4个月。血中出现乙型肝炎表面抗原(HBsAg)是潜在传染性的证据。大约90%病人于HBsAg消失后3个月不再具有传染性。在这些情况下,密切的家庭接触者应该接受HBIG,肌肉注射0.06ml/kg,0.5～1.0ml的HBIG可使8～18月龄幼儿被动获得抗-HBs约3个月。
Dr. Nelson asks: In the last two weeks, three physicians in our area found at the clinic that mothers of infants aged 8-18 months had laboratory-confirmed acute hepatitis B. Which infants and their mothers should undergo laboratory tests with young infants in close contact with these mothers? Dr Krugman (New York University Medical Center) Answer: A question needs to know about the natural history of laboratory-confirmed acute hepatitis B. Infectious phase of acute hepatitis B patients from the late incubation period to acute hepatitis or jaundice after two weeks to 3 or 4 months. The presence of hepatitis B surface antigen (HBsAg) in the blood is evidence of potential infectivity. About 90% of patients are no longer contagious 3 months after HBsAg disappears. In these cases, close family contacts should receive HBIG, intramuscularly at 0.06 ml / kg, and 0.5-1.0 ml of HBIG can passively acquire anti-HBs for 8-18 months of age for about 3 months.