儿童乙肝的新认识(英文版）PPT.ppt

IMPORTANT  TRANSMISSION ROUTE IN  HYPERENDEMIC AREAS : MOTHER TO CHILD EFFECTIVE PREVENTION OF HEPATITIS B : VACCINATION IN INFANCY HEPATITIS B VACCINATION AND  CONTROL OF HEPATITIS B  RELATED LIVER DISEASES Acute /Fulminant Hepatitis Chronic Hepatitis Liver Cirrhosis ? Hepatocellular Carcinoma Chang MH * Mei-Hwei Chang , M.D. Department of Pediatrics, National Taiwan University Hospital, Taipei, TAIWAN Replication Cycle of HBV EPIDEMIOLOGY Prevalence of Chronic  Hepatitis B HBsAg Prevalence 8% - High 2-8% - Intermediate 2% - Low Immigration numbers summed by continent from 1996-2002 ~ 2 million Asians ~ 400,000 South Americans ~ 350,000 Africans ~ 930, 000 Europeans Centers for Disease Control. Hepatitis B fact sheet. Available at: /hepatitis. Accessed January 31, 2006. Mahoney FJ. Clin Microbiol Rev. 1999;12:351-366. Hepatitis B Foundation. Hepatitis B statistics. Available at: /hepb/. Accessed January 31, 2006. NATURAL HISTORY OF  HEPATITIS VIRUS INFECTION  - Perinatal Transmission - Childhood Infection - Adolescent/Adult Onset Disease Age of Infection and Outcome HBV GENOTYPE AND HBeAg SEROCONVERSION Kao JH, Chen DS. Current Hepatitis Report 2006 (in press). Kao JH, Chen DS. Current Hepatitis Report 2006 Worldwide Distribution of HBV Genotypes. The Size of the Capitals indicates the Relative Prevalence of the Genotypes No. of Children with Chronic HBV Infection 160 238 62 26 HBV GenotypeFollow-up B B B B C C C C Ni YH, Chang MH, et al. Gastroenterology 2004 ;127:1733-8. Age in Years HBeAg Seropositivity Genotype C Genotype B Ni YH, Chang MH, et al. Gastroenterology 2004 ;127:1733-8. Genotype C Genotype B HBV Genotype and Clinical Course in Children Genotyp