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慢性乙型肝炎病毒感染者的识别及公共卫生管理建议

Recommendations for identification and public health management of persons with chronic hepatitis B virus infection.

作者信息

Weinbaum Cindy M, Williams Ian, Mast Eric E, Wang Susan A, Finelli Lyn, Wasley Annemarie, Neitzel Stephanie M, Ward John W

机构信息

Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, 1600 Clifton Road, MS G-37, Atlanta GA 30333, USA.

出版信息

MMWR Recomm Rep. 2008 Sep 19;57(RR-8):1-20.

Abstract

Serologic testing for hepatitis B surface antigen (HBsAg) is the primary way to identify persons with chronic hepatitis B virus (HBV) infection. Testing has been recommended previously for pregnant women, infants born to HBsAg-positive mothers, household contacts and sex partners of HBV-infected persons, persons born in countries with HBsAg prevalence of >/=8%, persons who are the source of blood or body fluid exposures that might warrant postexposure prophylaxis (e.g., needlestick injury to a health-care worker or sexual assault), and persons infected with human immunodeficiency virus. This report updates and expands previous CDC guidelines for HBsAg testing and includes new recommendations for public health evaluation and management for chronically infected persons and their contacts. Routine testing for HBsAg now is recommended for additional populations with HBsAg prevalence of >/=2%: persons born in geographic regions with HBsAg prevalence of >/=2%, men who have sex with men, and injection-drug users. Implementation of these recommendations will require expertise and resources to integrate HBsAg screening in prevention and care settings serving populations recommended for HBsAg testing. This report is intended to serve as a resource for public health officials, organizations, and health-care professionals involved in the development, delivery, and evaluation of prevention and clinical services.

摘要

乙型肝炎表面抗原(HBsAg)血清学检测是识别慢性乙型肝炎病毒(HBV)感染者的主要方法。此前已建议对孕妇、HBsAg阳性母亲所生婴儿、HBV感染者的家庭接触者和性伴侣、出生在HBsAg流行率≥8%国家的人、可能需要进行暴露后预防的血液或体液暴露源人群(如医护人员针刺伤或性侵犯)以及感染人类免疫缺陷病毒的人进行检测。本报告更新并扩展了美国疾病控制与预防中心(CDC)此前关于HBsAg检测的指南,包括对慢性感染者及其接触者进行公共卫生评估和管理的新建议。现在建议对HBsAg流行率≥2%的其他人群进行HBsAg常规检测:出生在HBsAg流行率≥2%地理区域的人、男男性行为者和注射吸毒者。实施这些建议将需要专业知识和资源,以便在为建议进行HBsAg检测的人群提供预防和护理服务的环境中整合HBsAg筛查。本报告旨在为参与预防和临床服务的开发、提供和评估的公共卫生官员、组织和医护专业人员提供参考。

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