Acute hepatitis

急性肝炎
  • 文章类型: Practice Guideline
    乙型肝炎病毒(HBV)感染仍然是一个全球性的公共卫生问题。在墨西哥,估计至少三百万成年人已获得乙型肝炎(总乙型肝炎核心抗体[抗HBc]阳性),其中,300,000个活性携带者(乙型肝炎表面抗原[HBsAg]阳性)可能需要治疗。因为HBV是可以通过疫苗预防的,应强调其普遍应用。HBV感染是发生肝细胞癌的主要危险因素。半年一次的肝脏超声和血清甲胎蛋白检测有利于早期发现癌症,应在所有慢性HBV感染患者中进行,无论是否存在晚期纤维化或肝硬化。目前,核苷/核苷酸类似物具有高的抗性屏障是一线治疗。
    Hepatitis B virus (HBV) infection continues to be a worldwide public health problem. In Mexico, at least three million adults are estimated to have acquired hepatitis B (total hepatitis B core antibody [anti-HBc]-positive), and of those, 300,000 active carriers (hepatitis B surface antigen [HBsAg]-positive) could require treatment. Because HBV is preventable through vaccination, its universal application should be emphasized. HBV infection is a major risk factor for developing hepatocellular carcinoma. Semi-annual liver ultrasound and serum alpha-fetoprotein testing favor early detection of that cancer and should be carried out in all patients with chronic HBV infection, regardless of the presence of advanced fibrosis or cirrhosis. Currently, nucleoside/nucleotide analogues that have a high barrier to resistance are the first-line therapies.
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  • 文章类型: Practice Guideline
    乙型肝炎病毒(HBV)感染仍然是一个全球性的公共卫生问题。在墨西哥,估计至少三百万成年人已获得乙型肝炎(总乙型肝炎核心抗体[抗HBc]阳性),其中,300,000个活性携带者(乙型肝炎表面抗原[HBsAg]阳性)可能需要治疗。因为HBV是可以通过疫苗预防的,应强调其普遍应用。HBV感染是发生肝细胞癌的主要危险因素。半年一次的肝脏超声和血清甲胎蛋白检测有利于早期发现癌症,应在所有慢性HBV感染患者中进行,无论是否存在晚期纤维化或肝硬化。目前,核苷/核苷酸类似物具有高的抗性屏障是一线治疗。
    Hepatitis B virus (HBV) infection continues to be a worldwide public health problem. In Mexico, at least three million adults are estimated to have acquired hepatitis B (total hepatitis B core antibody [anti-HBc]-positive), and of those, 300,000 active carriers (hepatitis B surface antigen [HBsAg]-positive) could require treatment. Because HBV is preventable through vaccination, its universal application should be emphasized. HBV infection is a major risk factor for developing hepatocellular carcinoma. Semi-annual liver ultrasound and serum alpha-fetoprotein testing favor early detection of that cancer and should be carried out in all patients with chronic HBV infection, regardless of the presence of advanced fibrosis or cirrhosis. Currently, nucleoside/nucleotide analogues that have a high barrier to resistance are the first-line therapies.
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  • 文章类型: Journal Article
    戊型肝炎病毒(HEV)感染是发达国家和发展中国家急性肝炎的主要原因之一。这种传染病在欧洲有很高的患病率和发病率。HEV感染对脆弱人群有更大的临床影响,如免疫抑制患者,孕妇和潜在肝病患者。因此,病毒性肝炎研究小组(GrupodeEstudiodeHepatitisVíricas,GEHEP)西班牙传染病和临床微生物学学会(SociedadEspañoladeEnfermedades传染病和微生物,SEIMC)认为准备一份共识文件以帮助做出有关诊断的决策非常重要,临床和治疗管理,和预防HEV感染。
    Hepatitis E virus (HEV) infection is one of the main causes of acute hepatitis in both developed and developing countries. This infectious disease has a high prevalence and incidence in Europe. HEV infection has a greater clinical impact in vulnerable populations, such as immunosuppressed patients, pregnant women and patients with underlying liver disease. Therefore, the Study Group for Viral Hepatitis (Grupo de Estudio de Hepatitis Víricas, GEHEP) of the Spanish Society of Infectious Diseases and Clinical Microbiology (Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica, SEIMC) believed it very important to prepare a consensus document to help in decision-making regarding diagnosis, clinical and therapeutic management, and prevention of HEV infection.
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  • 文章类型: Journal Article
    全球,约有2.4亿人患有慢性乙型肝炎病毒(HBV),非洲和亚洲感染率最高。我们对HBV感染的自然史和由此产生的疾病的治疗潜力的理解正在不断提高。新的数据已经成为自2012年出版的HBV感染的管理APASL指南。本手稿的目的是更新慢性HBV感染的最佳管理建议。2015年指南是由APASL选出的亚洲专家小组制定的。临床实践指南基于现有出版物的证据,或者,如果没有证据,专家们的个人经历和审议后的意见。截至2015年1月出版的重要会议的手稿和摘要已经过评估。本指南涵盖了感染乙型肝炎的患者的全方位护理,包括新的术语,自然史,筛选,疫苗接种,咨询,诊断,评估肝脏疾病的阶段,适应症,定时,单一或联合抗病毒药物的选择和持续时间,肝癌筛查,像童年这样特殊情况下的管理,怀孕,合并感染,肾功能损害和肝移植前后,和政策方针。然而,不确定的领域仍然存在,和临床医生,病人,因此,公共卫生当局必须继续根据不断发展的证据做出选择。最后的临床实践指南和建议在这里提出,以及相关的背景资料。
    Worldwide, some 240 million people have chronic hepatitis B virus (HBV), with the highest rates of infection in Africa and Asia. Our understanding of the natural history of HBV infection and the potential for therapy of the resultant disease is continuously improving. New data have become available since the previous APASL guidelines for management of HBV infection were published in 2012. The objective of this manuscript is to update the recommendations for the optimal management of chronic HBV infection. The 2015 guidelines were developed by a panel of Asian experts chosen by the APASL. The clinical practice guidelines are based on evidence from existing publications or, if evidence was unavailable, on the experts\' personal experience and opinion after deliberations. Manuscripts and abstracts of important meetings published through January 2015 have been evaluated. This guideline covers the full spectrum of care of patients infected with hepatitis B, including new terminology, natural history, screening, vaccination, counseling, diagnosis, assessment of the stage of liver disease, the indications, timing, choice and duration of single or combination of antiviral drugs, screening for HCC, management in special situations like childhood, pregnancy, coinfections, renal impairment and pre- and post-liver transplant, and policy guidelines. However, areas of uncertainty still exist, and clinicians, patients, and public health authorities must therefore continue to make choices on the basis of the evolving evidence. The final clinical practice guidelines and recommendations are presented here, along with the relevant background information.
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