2014病毒性肝炎钟渊斌_ppt课件.ppt

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Slide *. HCV Infection: Worldwide Prevalence “We stand at the precipice of a grave threat to our public health.…It affects people from all walks of life, in every state, in every country.” —C. Everett Koop, Former US Surgeon General.1 HCV infection is rapidly becoming a global epidemic and is one of the greatest public health threats faced by mankind. Although the incidence of HCV infection has declined in recent years, the sizable population of infected individuals continues to serve as a source of transmission to others, perpetuating the global impact of the disease. The demographic prevalence of HCV infection shown in this slide is based on published studies and/or data from 131 countries and regions as of June 1999 and does not necessarily reflect the prevalence of HCV infection today.2 According to information from the World Health Organization (WHO), nations with a prevalence exceeding 10% include Guinea (10.7%), Mongolia (10.7%), Burundi (11.1%), Bolivia (11.2%), Cameroon (12.5%), Rwanda (17.0%), and Egypt (18.1%).3 By World Health Organization (WHO) region, Africa has the highest prevalence of HCV infection (5.3%), compared with Eastern Mediterranean (4.6%), Western Pacific (3.9%), Southeast Asia (2.2%), the Americas (1.7%), and Europe (1.0%).4 ? 1. Koop CE. . 2. WHO. Wkly Epidemiol Rec. 2000;75:18-19. 3. WHO. Wkly Epidemiol Rec. 1999;74:421-428. 4. WHO. Hepatitis C. Fact sheet no. 164. * * * * * * * * * * * * * * * 类流感综合征：通常在注射后2～4h发生； 骨髓抑制：表现为粒细胞及血小板计数减少； 神经精神症状：如焦虑、抑郁、兴奋、易怒、精神病； 失眠、轻度皮疹、脱发； 少见的不良反应：如癫痫、肾病综合征、间质性肺炎和心律失常等时，应停药观察； 诱发自身免疫性疾病：甲状腺炎、血小板减少性紫癜、溶血性贫血、风湿性关节炎、Ⅰ型糖尿病等。 α干扰素抗病毒治疗的不良反应（掌握） * 完全应答（显效）：ALT复常，HBV DNA、 HBeAg均阴转； 部分应答（有效）：介于完全应答和无应答之间。 无应答（无效）： ALT、HBeAg、HBV DNA均无应答。 持续应答：完全应答（显效）或部分应答（有效）者， 停药后6～12个月仍为显效或有效者； 复发：治疗结束时为显效和有效，停药6～12个月内出现 ALT异常及HBV DNA阳转者为复发。 α干扰素治疗慢乙肝的疗效评定标准 * 核苷(酸)类似物抗病毒机制（掌握） 作