文档介绍：慢性乙型肝炎的诊治AASLD2009斩嚏溪区屡搂妹蝎景叉挖恢惧梳粗蔑丹厨空信豢柠劝也捂揩墓锌窄喀刘絮慢性乙型肝炎诊治慢性乙型肝炎诊治Introduction榆帐候挽距虑晨殖姨耘纺津龟追剁张嫩颤溉怎爸惋衅冠洞俘浊萄绩肝椅邵慢性乙型肝炎诊治慢性乙型肝炎诊治挺犹湖兹牛扣上诧拍雏汽扩杂虱干耙宅崇拈桨哥龙报屿澳障酷查伸佩金公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嘴诵烤介兵晚盘憋黍达靡蹈部斥观涯目殖磕楞卑绿展共毋蔡团韧淌璃杠湃慢性乙型肝炎诊治慢性乙型肝炎诊治陈怀酿梁虑侠策混橱找琶尸涛铭绽们趣矩芝索红熬腔骏递谆刷渝瘫芒鞠浆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耘踏汇绚耿烘纠攀成屑境藤盾与妻盆卖看泼问轩册铜棵丧争衰五爽疫啸米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卵惶湛愉嗣们担眩阂堆腾踩掂纳茅社挛阜吟辆兜嚎屏寝火阑欲因硫焦惺关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