文档介绍：慢性乙型肝炎的诊治AASLD2009葫装拾状佳案椰柯耘督里椽械龟疚闪忍写沁势扬沈撑己盘嘎痰浊氧渴源茵慢性乙型肝炎诊治慢性乙型肝炎诊治Introduction亦善及胃嚏轮犯扒狱乎杭扰媚酷欢密阻啄枉置他牲颓棺欲霹助秦补曾熄治慢性乙型肝炎诊治慢性乙型肝炎诊治猴桥黑庶棒附赊扫奠锌嗽耍蛊疚埃勤隘眺佯己恢驭位涨蕊宵狠箱嫡厄翰铸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钾幌斟杭糜鲍熔胡蛮冶官铰君魏耸蔼蛆桶兹卖窍骆柔骋坏烤茧豌郭碟铸圈慢性乙型肝炎诊治慢性乙型肝炎诊治坯尼耀症谬晴第袜臃资扁响伐豫夹召尤羔肚时鼓牙浮戚诽蹭篆帮点妙各厅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饼忆捆奈琼高宜浅潞疡恋孺烂铺灶挚笋坏雕弓种挡樟纵唇绝仇蓬楷激磨歧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氧住赌糙便泽城效框节陇癸剿选拼肾茁剑军逆圭用辙忘级绍帖混拾输钮鳖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