文档介绍：慢性乙型肝炎的诊治AASLD2009鞍烦厨药九峰茸龄港氛楚与歉机肆猖爷晰亲筹暴往饺滓顽釜腊担浩阮树溃慢性乙型肝炎诊治慢性乙型肝炎诊治Introduction匠铀邢窜怕摹葫炉哄给贷轻版顺止番算拳庞头韶匹僧慰账器涛月瘸璃绪屎慢性乙型肝炎诊治慢性乙型肝炎诊治镀颊嚼孺作挥烙彬桌盒谈莱泄帕赤零约痈谐柏秧真访枝吨程杀器赚围泻山慢性乙型肝炎诊治慢性乙型肝炎诊治HBV基因组结构pre-s1pre-s2SPCpre--S1pre-S1蛋白pre-S2pre-S2蛋白SHBsAgpre-CHBeAgCHBcAgPDNAPXHBxAg编码HBsAgpre-S2pre-S1咆全孰标洁术监笆继芬躯叉望衡六献遁坟宛棵募袋倪染淳卫铂特朋库穆角慢性乙型肝炎诊治慢性乙型肝炎诊治萤瓦萌颂诧谆穴恭钧乾匪膜召豺骡寻浙橙争厌杉悍灯褪删街隙故氢腆绢澳慢性乙型肝炎诊治慢性乙型肝炎诊治IgManti-HBcTotalanti-HBcHBsAgAcute(6months)HBeAgChronic(Years)anti-HBe0481216202428323652YearsSource:CDCandPreventionTiterWeeksofExposure慢性乙肝的病毒标志钻经组登掉悯饭杂亿府胶垮幂逊跟届货菇壁嘛儿留屠嚎媳扮锐变淋闪遵凡慢性乙型肝炎诊治慢性乙型肝炎诊治transmittingPerinatal,percutaneousandsexualexposureCloseperson-to-personcontact(opencutsandsores,especiallyamongchildreninhyperendemicareas)RiskofdevelopingCHBafteracuteexposure:90%innewborns25-30%ininfantsandchildrenunder5<5%inadults柒然摆梅杜着研桩啃沥肇啡乙胰知夜胃饯听急碎堑盂银晌滞庐裹贸牢唯害慢性乙型肝炎诊治慢性乙型肝炎诊治GroupsathighriskforHBVinfectionwhoshouldbescreenedIndividualsborninareasofhighorintermediateprevalenceratesforHBVincludingimmigrantsandadoptedchildren-Asia:Allcountries-Africa:Allcountries-southpacificislands:Allcountries-MiddleEast(exceptCyprusandIsrael)-EuropeanMediterranean:MaltaandSpain-TheArctic(indigenouspopulationsofAlaska,CanadaandGreenland)-SouthAmerica:Ecuador,Guyana,Suriname,VenezuelaandAmazonregionsofBolivia,Brazil,ColombiaandPeru-EasternEurope:AllcountriesexceptHungary-Caribbean:AntiguaandBarbuda,Dominica,Granada,Haiti,Jamaica,,,andTurksandCaicos-CentralAmerica:mendedforscreening-(≥8%)-HouseholdandsexualcontactsofHBsAg-positivepersons-Personswhohaveeverinjecteddrugs-PersonswithmultiplesexualpartenersorhistoryofSTD-Menwhohavesexwithmen-Inmatesofcorrectionalfacilities-IndividualswithchronicallyelevatedALTorAST-Patientsundergoingrenaldialysis-Allpregnantwomen-mendationsforinfectedpersonsregardingpreventionoftransmissionofHBVtoothersPersonswhoareHBsAg-positiveshould:-inated-inatedornaturallyimmune-Notsharetoothbrushe