乙肝自然史PPT.ppt

Epidemiology and Natural History of HBV;About These Slides;Korean Mummy Found With HBV;HBsAg Prevalence;Geographic Diversity of HBV Infection:Clinical/Epidemiologic Correlations;10 Leading Causes of Infectious Disease Deaths Worldwide (2000);1. WHO. Hepatitis B. 2002. 2. Maynard JE, et al. In: Viral Hepatitis and Liver Disease. New York: Alan R. Liss, Inc. 1988. 3. CDC. Epidemiology prevention of vaccine-preventable diseases. The Pink Book. 8th ed. 4. CDC. MMWR. 2001;50:RR-11.;Acute HBV Infection Incidence* in the US (1982-2006);Acute HBV Incidence* by Race and Year in the US (1990-2006);;;Trends in Mortality in the US; 14 million (~ 1 out of 20) persons in the US have been infected[1] An estimated ~ 2 million are chronically infected in the US[2];;Age- and Race-Specific HBV Mortality Rate in the US (1994-1998);;Risk Factors Associated With Acute HBV Infection: US (2006);Vaccination;CDC. MMWR Morb Mortal Wkly Rep. October 19, 2007 / 56(41);Q1-Q4;HBV Vaccination: Effect on HCC Incidence and Mortality*;Hepatitis B Vaccine Coverage Among Children* in the US (1995-2003);Virology of HBV: A Primer;;HBV-Triggered Immune Response;;HBV Genotype Prevalence in the US (2001-2002);Natural History;Naturally Occurring Molecular Variants of HBV;HBeAg-Negative Chronic Hepatitis B;Phases of Disease;4 Phases of Chronic HBV Infection;Slide courtesy of A. S. F. Lok, MD.;;;;;;Lai CL, et al. Lancet. 2003:362:2089. Lok AS, et al. Gastroenterology. 2001:120:1828.;Factors Associated With Disease Progression;;Historical Methods of Determining the Risk of HCC: HBeAg Status;HBeAg Seroconversion Not Always Associated With Outcomes in Asians;Disease Progression After HBeAg Seroconversion in Asians;Current Methods of Determining the Risk of HCC: HBV DNA Level;Low HBV DNA Level Does NotRule Out Risk in Asian Patients;The REVEAL Study: Key FIndings;HBV DNA Associated With Increased Risk of HCC;Asian males 40 years of age or older Asian females 50 years of age or older All cirrhotic hepatiti