The prevalence and natural history of hepatitis B in the 21st century.
The prevalence and natural history of hepatitis B in the 21st century.
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DOI：
10.3949/ccjm.76.s3.01
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发表时间：
2009-05-01
影响因子：
6.1
通讯作者：
Carey, William D
中科院分区：
文献类型：
--
作者：
Carey, William D
慢性B型肝炎病毒（HBV）感染的流行率因地理区域而异。北美大部分地区是低流行率（< 2%）地区。存在某些高患病率的区域，特别是亚洲移民和阿拉斯加和北方加拿大土著人口比例高的地区，慢性HBV的发病率高达5%至15%。在大多数低流行率地区，HBV感染主要发生在青春期和中年期，而在高流行率（≥ 8%）地区，围产期传播是主要途径。高达40%的慢性HBV感染患者会出现肝脏并发症。获得时的年龄影响慢性化的可能性和肝脏并发症的发展。每一种的风险都是最大的围产期传播;当暴露于HBV发生在青春期或青年期时，这种疾病通常是自限性的。病毒载量预测肝硬化和肝细胞癌的进展;因此，降低病毒载量是治疗的主要目标。
The prevalence of chronic hepatitis B virus (HBV) infection varies by geographic region. Most of North America is a low-prevalence (< 2%) area. Certain high-prevalence pockets exist, especially areas with a high proportion of Asian immigrants and Alaskan and northern Canadian native populations, where rates of chronic HBV are as high as 5% to 15%. In most low-prevalence areas, HBV infection is acquired mainly during adolescence and midadulthood, whereas perinatal transmission is the main route in high-prevalence (> or = 8%) areas. Up to 40% of patients with chronic HBV infection develop liver complications. Age at acquisition affects the likelihood of chronicity and the development of liver complications. The risk of each is greatest with perinatal transmission; the disease is usually self-limiting when exposure to HBV occurs during adolescence or young adulthood. Viral load predicts progression to cirrhosis and hepatocellular carcinoma; therefore, reducing viral load is the major goal of treatment.