乙肝与乙肝病毒.pptVIP

Third Dose of Hepatitis B Vaccine Minimum of 2 months after second dose, and At least 4 months after first dose, and For infants, at least 6 months of age Very Low Birthweight Infants Infants 2000 grams respond poorly to vaccine  Delay first dose until chronological age 1 month if mother HBsAg negative Birth dose and HBIG if mother HBsAg positive COMVAX Hepatitis B-Hib combination Use when either antigen is indicated Cannot use 6 weeks of age Not licensed for use if mother HBsAg+ Hepatitis B VaccineAdolescent Vaccination Routine vaccination recommended through age 18years Integrate into routine adolescent immunization visit Flexible schedules Dose Primary 1 Primary 2 Primary 3 Minimum Interval --- 1 month 2 months* Usual Interval --- 1 month 5 months Hepatitis B Vaccine Adolescent and Adult Schedule *third dose must be separated from first dose by at least 4 months 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 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 Virus Infection HBsAg HBcAg HBeAg Hepatitis B Virus 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 Fulminant hepatitis Hospitalization Cirrhosis Hepatocellular carcinoma Death Hepatitis B Complications Chronic Hepatitis B Virus Infection Chronic viremia Responsible for most mortality Overall risk 10% Higher risk with early i