成人乙型肝炎病毒感染筛查、检测及管理专家建议

中华预防医学会感染性疾病防控分会; 中华预防医学会促进消除病毒性肝炎工作委员会

doi:10.12449/JCH240807

成人乙型肝炎病毒感染筛查、检测及管理专家建议

DOI: 10.12449/JCH240807

利益冲突声明：所有作者均声明不存在利益冲突。

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出版历程
- 收稿日期: 2024-07-22
- 录用日期: 2024-08-03
- 出版日期: 2024-08-25

Expert recommendations on screening， testing and management for hepatitis B virus infection in adults

Society of Prevention and Control of Infectious Diseases of Chinese Preventive Medicine Association,
Working Committee of Promoting the Elimination of Viral Hepatitis of Chinese Preventive Medicine Association

摘要

摘要: 乙型肝炎（乙肝）流行是重要的公共卫生问题，其疾病负担重。在我国，乙型肝炎的诊断率和治疗率与世界卫生组织（World Health Organization，WHO）提出的2030年消除病毒性肝炎公共卫生危害的目标仍有较大差距。为实现WHO和“2030健康中国”规划纲要目标，中华预防医学会组织国内临床、公共卫生和检验等领域专家，在全面回顾国内外相关文献的基础上，经过多轮讨论形成本建议，以实现对成人进行普遍筛查，对乙型肝炎病毒感染者进行评估、治疗和长期随访管理，对未感染者进行乙肝疫苗接种，消除乙型肝炎危害的目标。
- 乙型肝炎病毒 /
- 筛查 /
- 检测 /
- 管理
Abstract: The prevalence of hepatitis B represents a significant public health concern with a heavy disease burden. In China， there is still a big gap between the current diagnosis and treatment rates of hepatitis B and the goal of eliminating viral hepatitis as a public health threat by 2030 set by the World Health Organization （WHO）. In order to achieve the WHO goal and the goal of 2030 Healthy China Outline， the Chinese Preventive Medicine Association organized domestic experts in the fields of clinical medicine， public health and clinical laboratory medicine to develop theExpert Recommendations on Screening， Testing and Management for Hepatitis B Virus Infection in Adultsafter several rounds of discussion based on comprehensive review of relevant domestic and international guidelines and literatures， the purpose is to facilitate universal screening of hepatitis B virus （HBV） infection in adults and provide practical guidance on disease assessment， treatment and long-term follow-up management of people infected with HBV and vaccination for people susceptible to HBV infection， thus promoting the elimination of the threat of hepatitis B.
- Hepatitis B Virus /
- Screening /
- Testing /
- Management

HTML全文

图 1 无HBV感染史成人HBV感染筛查流程图

Figure 1. Flow chart for HBV infection screening in adults without the history of HBV infection

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图 2 HBV筛查后管理流程图

Figure 2. Flow chart for management after HBV screening

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图 3 HBsAg阳性者的评估、诊治及随访监测流程

Figure 3. Evaluation， diagnosis， treatment， follow-up， and monitoring processes for HBsAg-positive individuals

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表 1 HBV 3项筛查结果解释和处理意见

Table 1. Result interpretation of three HBV screening items and treatment recommendations

筛查结果			结果解释	处理意见
HBsAg	抗- HBs	抗- HBc	结果解释	处理意见
-	-	-	易感，未感染过	建议接种乙肝疫苗
-	+	-	有免疫（接种过乙肝疫苗）	确认全程接种乙肝疫苗，如未全程，建议补种
+	-	+	急性或慢性感染	联系诊治
-	+	+	感染后康复	评价再活动风险
-	-	+	单项抗-HBc阳性	处理见表2
注：“-”表示筛查结果是阴性；“+”表示筛查结果是阳性。

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表 2 单项抗-HBc阳性结果解释和处理意见

Table 2. Result interpretation of anti-HBc positivity and treatment recommendations

单项抗-HBc阳性结果解释	处理意见
既往感染，但抗-HBs消失	评价再活动风险
隐匿性乙肝	可抗病毒治疗
HBsAg突变株感染，所用试剂检测不到HBsAg	可抗病毒治疗
婴儿可由母亲被动输入抗-HBc	随访
抗-HBc假阳性	随访

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