乙型肝炎流行病学及预防2010版解读课件.pptVIP

谢 谢！ * 乙型肝炎是一个严重的卫生问题。全球60亿人口中，约1/2人口生活在HBV高流行区，约20亿人证明有HBV感染，约3.5-4亿人为HBV慢性感染，其中15%～25%最终将死于肝硬化和肝癌。世界卫生组织报告，全球前10位疾病死因中乙肝占第7位，每年约100万人死于HBV感染相关的肝衰竭、肝硬化和肝癌。 * * Global Patterns of Chronic HBV Infection, Geographic Distribution of Chronic HBV infection* Approximately 45% of the global population live in areas with a high prevalence of chronic HBV infection ( 8% of the population is HBsAg?positive); 43% in areas with a moderate prevalence (2%?7% of the population is HBsAg?positive); and 12% in areas with a low prevalence ( 2% of the population is HBsAg?positive). In high prevalence areas, the lifetime risk of HBV infection is 60%, and most infections are acquired at birth or during early childhood when the risk of developing chronic infection is greatest. In these areas, because most infections in children are asymptomatic, very little acute disease related to HBV occurs, but rates of chronic liver disease and liver cancer in adults are very high. In moderate prevalence areas, the lifetime risk of being infected is 20%?60% and infections occur in all age groups. Acute disease related to HBV is common in these areas because many infections occur in adolescents and adults; however, the high rates of chronic infection are maintained mostly by infections occurring in infants and children. In low prevalence areas, the lifetime risk of infection is 20%. Most HBV infections in these areas occur in adults in relatively well defined risk groups. *(Note: The map of HBsAg prevalence generalizes available data and patterns may vary within countries.) * 该示意图显示的是应用乙肝疫苗预防前不同流行地区人群感染HBV的构成情况。乙肝疫苗纳入新生儿计划免疫后，新生儿围产期的传播也大大降低了。 * 强调医源性传播。 * * * * * 为评价1992年我国乙肝疫苗纳入儿童计划免疫管理和2002年乙肝疫苗纳入儿童免疫规划的效果，卫生部于2006年开展了全国人群乙肝血清流行病学调查 * * * * * * * * * * * 2010版慢性乙型肝炎防治指南流行病学及预防 2005版与2010版比较修改要点 我国HBV流行率：2010版采用2006年调查数据。 预防部分 乙肝疫苗接种对象：乙型肝炎疫苗的接种对象主要是新生儿，其次为婴幼儿，15岁以下未免疫人群和高危人群 免疫低下或无应答者的接种程序：应增加疫苗的接种剂量（如60mg）和针次；对3针免疫程序无应答者可再接种3针或1针60mg重组酵母乙肝疫苗，并于第2次接种3针或1针60mg乙肝疫苗后1~2个月检测血清中抗-HBs