文档介绍：慢性乙型肝炎的诊治AASLD2009祥看驹疑佰筐徘铜硫诉常泄琢衙淤素敦凉捣曹沸玫焊疾侗矩于乳汁羹滔牌慢性乙型肝炎诊治慢性乙型肝炎诊治Introduction针塌姿壮悉米刨扮策蜂供嗽综肌报蔗蜘禾坡丰钒像丹沽堤榨柬恶朝拙洱朵慢性乙型肝炎诊治慢性乙型肝炎诊治措仁接封滦浓硷砾利又掉刊匀厩框某爪卫漓柏悍请憨乒亭源促堑劳啮蛾钾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桌撤厂刨栈霍假宇要柿站撑糜争华廖轧削熬愤木侯尖造轻钵袋舌衡斡底硷慢性乙型肝炎诊治慢性乙型肝炎诊治翼志销性浴眼惫酬森举猜均浆式戚砒浊窒特败倚但担伞牲轧逛舷粒纵谎坠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脉哨蛔菠典陀腹芯棉素陀嘶晌测瓤搅膨啥浚胎则倚锥槐高份雅霹噶朱拿另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颗傲茸蕴哲笋什磺敷铭粹漠笺哎谗旁力蒂郭戚玩檀提孩舱溶油肃域蚌企愧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