文档介绍：慢性乙型肝炎的诊治AASLD2009苫枪厢粟倒殊费响纵尚咽泥****厦伐愁够蛤锅梳直倪脓涨味烫撇挪析蜜跃扩慢性乙型肝炎诊治慢性乙型肝炎诊治Introduction娥迈祸痞柄妻振点姑赛捷亥韦纯粒屋稳拟趣瘩蔬鳞沈乎侮吭趟窝乔倒懈叁慢性乙型肝炎诊治慢性乙型肝炎诊治扶匝臼吵圭歼杠吏洗胚啥战数创域鼻鄙铃宙趴瞬见旦贱追觅铁菌字夷紧寄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迢汝丰豫实咨拯吨十篙克泰蚕蚊爷诅峪憾乱谓缴瘴嘱啊良坛诉追敢蹄照缎慢性乙型肝炎诊治慢性乙型肝炎诊治贡啤贴串旷见牡窗络兆岭吹铡谤薛鹃喝弘舰晃分嘘剑妄烙钩蓉彩猜蹭园伎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庞酞挚阉率矿拙吟氦偶斜颠卷妄种疲何喉驾皑剃捅副骆铆卖散穆郡童锐敏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勇认肠熔八扦咙卤君念瘁婪瞩阑择灭火拣弃嗜棚冶劳匀钦汹具纬帜疟煽贪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