HBV HBV (1964) HDV (1977) HCV (1988)
2009
Yotsuyanagi H et al. J Med Virol 2005 Yotsuyanagi H et al. J Hepatol 2002
Universal vaccination (UV) 45 HB 2009
1/3
Progress Toward the Elimination of Hepatitis B Virus Transmission Among Health Care Workers in the United States Francis J. Mahoney, et al. Arch Intern Med. 1997;157(22):2601-2605. 2532 employees (90%) were eligible to receive hepatitis B vaccine, and 66.5% of them (95% confidence interval, 61.9%- 70.9%) had received 3 doses of hepatitis B vaccine. Studies on long-term protection demonstrate that vaccine induced protection persists at least 11 years even when titers of antibody to hepatitis B surface antigen decline below detectable levels.
10
1992 1988 1994 1.80 7 HBV 6 30 0 0.6HBV HIV 1.7RNA 4.3
2008
HBV+HCV 7.3% ( ) 63% 6.3% HBV 19.6% HCV 66.8% HBV:HBsAg(+) HCV:anti-HCV(+) n=842 K. Koike Univ. of Tokyo
HCV 1-6 months 20-30% 70-80% Rare 50% 15-30% 5-7%/ HCC F1: 0-1%/year y F2: 1-2%/year F3: 3-5%/year
2/3 NS3 protease inhibitors (Telaprevir, etc.) ) NS5B RNA polymerase inhibitors (R1626, R7128, VCH759, etc.) Ursodeoxycholic acid ( ) Glycyrrhizine ( C (iron depletion therapy)
100 (sus stained virologica al respo onse) 80 60 40 20 0 IFN Peg-IFN IFN IFN IFN Peg-IFN RBV RBV RBV RBV 24 48 24 24 48 48 2-5 15 20 + IFN 45 50 24 30
15/19 44/64 99/168 p<0.0001 7/8 135/273 107/262 10/35 12/22 35/67 p<0.0001 73/184 65/242 5/28 Cochran-Armitage test
SVR. non-svr) (2009: analysis of 1598 cases from 29 institutes)