南昌市第八人民医院如何总结.ppt

丙肝的预防 经皮和黏膜途径传播的预防 推行安全注射。 对牙科器械、内镜等医疗器具应严格消毒。 医务人员接触患者血液及体液时应戴手套。 对静脉吸毒者进行心理咨询和安全教育,劝其戒毒。 不共用剃须刀及牙具等,理发用具、穿刺和文身等用具应严格消毒。 丙肝的预防 筛选HCV现症感染者 筛选献血员 有输血制品病史 长期血液透析 纹身 转氨酶升高者 治愈现症感染者是预防HCV传播的最有效方法 规范检测、诊断是迈向治愈丙肝的关键第一步 筛查 咨询 检测 评估 治愈 治疗 慢性丙肝是可以治愈的疾病!! 提高丙肝早期诊断率已经成为全球共识 第三届 2006年 丹麦哥本哈根 主题: Get Tested 第四届 2007年 比利时布鲁塞尔 主题: Hepatitis? Get Tested! 呼吁各相关部 门、学会和协会 帮助高危人群 获得及时检测 * Over the past 2 decades, there has been substantial improvement in treatment outcomes for chronic HCV-1 infection. Interferons (IFN) are produced by the innate immune response against viral infections, and when first used as monotherapy in the late 1980s and early 1990s to treat HCV-1, SVR rates were around 7–11%. This poor response is due to the relatively short half-life of the protein following subcutaneous injections (~8 hours). RBV is a nucleoside analog that has antiviral efficacy and appears to work synergistically with IFN, resulting in SVR rates of up to 37% when given in combination with IFN.1 To resolve the problem of the short half-life of conventional IFNs, an inert molecule of polyethylene glycol (PEG) was covalently bonded to the IFN protein to increase its molecular weight.1 This delays its absorption and degradation and thus prolongs its serum half-life. Two pegylated IFNs, pegIFN α-2a (Pegasys?, Hoffmann-La Roche Inc) and pegIFN α-2b (PegIntron?, Merck) are currently licensed and, in combination with RBV, formed the standard of care against HCV-1 until recently, and result in SVR rates of around 40% in these patients. Bocepravir (BOC) is a direct-acting antiviral agent (DAA), which inhibits the NS3/4A serine protease required for RNA replication and virion assembly.2 BOC has demonstrated potent inhibition of HCV-1 replication and has resulted in markedly improved SVR rates of over 60% in treatment-naive and treatment-experienced HCV-1 patients in the past two years. Combining BOC with pegIFN and RBV limits the selection of resistant variants and improves antiviral response. BOC ha