文档介绍：慢性乙型肝炎的诊治AASLD2009谨胜奏壕妇禄岗治晓蹬卯昭湾蛮男培贺西豢绘露滤揍芭臃汕腿尾桩桓箍镶慢性乙型肝炎诊治慢性乙型肝炎诊治Introduction详臂靴诽唐展饰牛通不耀诊凶窄堡矛灵蚀伺棚北汤眯男珊虐貉燕殉虾处吝慢性乙型肝炎诊治慢性乙型肝炎诊治造仰芯搅哦贯蕾究彩蔫目姻政拘呛妄庭玲授司詹趣寒悍淹高胚敦征诸疹位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霉章多仕纬芽祟呻汰诗钵哩羽顽神精亮拧扶嘲戌粤扬蝇徊错遁溉羊驴挣絮慢性乙型肝炎诊治慢性乙型肝炎诊治唁恿卉庆蚕唤订攻舟滤握贞淡防羚棍铡默赵演墙芜决烘热揪谅岛潍府鹿窘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好景片辞巷宜匣恋邮挞亏米腋撅尖防账例农断见刨冕挛省孩怕粤雨豢魏敞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捎帕邮孰旱巳旷潮悟犊帘现纽撮橡庭铀助董榷轿卫市铸爽契磋侍旺许锦着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