《慢乙肝儿童抗病毒治疗与临床治愈课件.ppt》由会员分享，可在线阅读，更多相关《慢乙肝儿童抗病毒治疗与临床治愈课件.ppt（48页珍藏版）》请在三一办公上搜索。
1、,慢乙肝儿童抗病毒治疗与临床治愈,内容1.儿童慢性乙肝的流行现状2.儿童慢性乙肝的治疗进展3.有待解决的问题4.展望:如何设计和开展儿童慢性乙肝的新临床试验?,内容1.儿童慢性乙肝的流行现状2.儿童慢性乙肝的治疗进展3.有待解决的问题4.展望:如何设计和开展儿童慢性乙肝的新临床试验?,中国儿童 HBeAg阳性慢性乙肝的流行口 Central96320061-4y5-14yCui F,et al.Emerg Infect Dis.2017,23(5):765-772,不同国家或地区新生儿的乙肝免疫策MaternaInfantMaternal statusscreeningVaccine HBIG
2、ChinaAlaska.USHBsAq+YesYesalyHBSAgSpainHBSAgSaudi ArabiaTaiwan,China HBSAg andHBsAg+,HBeAgYes YesYesHBeAgHBsAg+,HBeAgHBSAgYeThailandIndonesiaNoUnknownGambiaChen s,et al.Clinical Gastroenterology,Springer Science Business Media,2010,新生儿乙肝免疫计划显著降低HBV感812Before immunizationAfter immunization086420Gambi
3、a TaiwaSaudi Indonesia Thailand Alaska,Italy SpainArabiaChen s,et al.Clinical Gastroenterology,Springer Science Business Media,2010,围产期感染儿童慢性乙肝自发的HBeAg血清学转换率及 HBSAg清除率Spontaneous rates of HBeAg seroconversion inchildren infected perinatally are low,occurring infewer than 2%of children younger than t
4、hree years peryear and in 4%0-5%of children older than three yearso Rates of spontaneous annual HBsag clearance areextremely low,between 0.5%and 1.4%,in longitudinalstudies in Asians with vertically transmitted HBVDella C,et al.J Gastroenterol Hepatol.2014,29:912-919Lim THet al.Gut.2015.64:966-972,内
5、容1.儿童慢性乙肝的流行现状2.儿童慢性乙肝的治疗进展3.有待解决的问题4.展望:如何设计和开展儿童慢性乙肝的新临床试验?,AASLD2018关于儿童慢性乙肝治疗的推22 years12 yearsPeglFNa-2aIFNa-2bEntecavirTenofovir disoproxil fumarateTenofovir al afenamideLamivudineAdefovir dipivoxilTelbivudine,AASLD2018关于儿童慢性乙肝治疔的推荐A.The AASLD suggests antiviral therapy in HBeAg-positive child
6、ren(ages 2 to 18 years)with both elevated ALT and measurableHBV DNA levels,with the goal of achieving sustained HBeAgseroconversionQuality/Certainty of Evidence:ModerateStrength of Recommendation ConditionalB.The AASLD recommends against use of antiviral therapy inHBeAg-positive children(ages 2 to 18 years)with persistentlynormal alt,regardless of HBv dna levelQuality/Certainty of Evidence:Very LowStrength of Recommendation Strong,
