乙肝与乙肝病毒.pptVIP

Hepatitis B and Hepatitis B Vaccine Hepatitis B Epidemic jaundice described by Hippocrates in 5th century BC Jaundice reported among recipients of human serum and yellow fever vaccines in 1930s and 1940s Australian antigen described in 1965 Serologic tests developed in 1970s Hepatitis B Virus Hepadnaviridae family (DNA) Numerous antigenic components Humans are only known host May retain infectivity for at least 1 month at room temperature 200 million carriers worldwide Established cause of chronic hepatitis and cirrhosis Human carcinogen - cause of up to 80% of hepatocellular carcinomas Hepatitis B Clinical Features Incubation period 6 weeks to 6 months (average 120 days) Nonspecific prodrome of fever, malaise, headache, myalgia Illness not specific for hepatitis B At least 50% of infections asymptomatic Hepatitis B Complications Fulminant hepatitis Hospitalization Cirrhosis Hepatocellular carcinoma Death Chronic Hepatitis B Virus Infection Chronic viremia Responsible for most mortality Overall risk 10% Higher risk with early infection Risk of Chronic HBV Carriage by Age of Infection Hepatitis B Epidemiology Reservoir Human. Endemic Transmission Bloodborne Subclinical cases transmit  Communicability 1-2 months before and after onset of symptoms Chronic carriers Hepatitis B Perinatal Transmission* If mother positive for HBsAg and HBeAg 70%-90% of infants infected 90% of infected infants become chronic carriers If positive for HBsAg only 20% of infants infected 90% of infected infants become chronic carriers High (8%): 45% of global population lifetime risk of infection 60% early childhood infections common Intermediate (2%-7%): 43% of global population lifetime risk of infection 20%-60% infections occur in all age groups Low (2%): 12% of global population lifetime risk of infection 20% most infections occur in adult risk groups Hepatitis B – United States, 1978-2000 Total infections 80,000/yr Current c