病毒性肝炎应用.pptVIP

29 8 8 8 20 20 20 22 22 22 23 23 23 27 27 27 34 35 1 1 1 15 18 27 25 25 25 15 15 15 31 31 31 Treatment Interferon - may be considered for patients with chronic active hepatitis. The response rate is around 50% but 50% of responders will relapse upon withdrawal of treatment. Ribavirin - there is less experience with ribavirin than interferon. However, recent studies suggest that a combination of interferon and ribavirin is more effective than interferon alone. * Treatmen：hepatitis gravis 出血的防治 肝性脑病的治疗 氨中毒的治疗：低蛋白饮食 乳果糖 诺氟沙星 恢复正常神经递质：左旋多巴 维持氨基酸平衡 补充支链氨基酸 防治脑水肿 、 * hepatitis gravis 感染的防治 急性肾功不全的继发防治 促进肝细胞再生 肝移植 * Endemicity Disease Rate Peak Age of Infection Transmission Patterns High Low to High Early childhood Person to person; outbreaks uncommon Moderate High Late childhood/ young adults Person to person; food and waterborne outbreaks Low Low Young adults Person to person; food and waterborne outbreaks Very low Very low Adults Travelers; outbreaks uncommon Global Patterns of Hepatitis A Virus Transmission * Many cases occur in community-wide outbreaks no risk factor identified for most cases highest attack rates in 5-14 year olds children serve as reservoir of infection Persons at increased risk of infection travelers homosexual men injecting drug users Hepatitis A Vaccination Strategies Epidemiologic Considerations * Pre-exposure travelers to intermediate and high HAV-endemic regions Post-exposure (within 14 days) Routine household and other intimate contacts Selected situations institutions (e.g., day care centers) common source exposure (e.g., food prepared by infected food handler) Hepatitis A Prevention - Immune Globulin * HBV-HDV Coinfection Pre or postexposure prophylaxis to prevent HBV infection. HBV-HDV Superinfection Education to reduce risk behaviors among persons with chronic HBV infection. Hepatitis D - Prevention * Prevention of HBV Vaccination - highly effective recombinant vaccines are now available. Vaccine can be given to those who a