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SCA SWGVHP SCA SWGVHP 145 5 (852) 2304 6100 (852) 2337 0897 aca@dh.gov.hk
- 1. 2. SCA SWGVHP SCA 1992 Prevention of transmission of HIV in health care settings guidelines and practices SCA SWGVHP 3. HBV HCV HIV SCA SWGVHP 4. (a) 1
(b) (c) 5. 8% 25% HCC 1 2% 40% 2 6. 70% 80% 3 0.035 0.099% 4 3% 10% 2 7. AIDS 0.4% 2 0.1% 8. I 1 Chu CM. Natural history of chronic hepatitis B virus infection in adults with emphasis on the occurrence of cirrhosis and hepatocellular carcinoma. J Gastroenterol Hepatol. 2000;15(Suppl):E25-30. 2 Gerberding JL. Management of occupational exposures to blood-borne viruses. N Engl J Med 1995; 332:444-51. 3 Yatsuhashi H, Yano M. Natural history of chronic hepatitis C. J Gastroenterol Hepatol. 2000;15(Suppl):E111-6. 2
9. 10. 11. 12. HBIg HBIg 92% 54% 5 HBIg 70 75% 6 HBIg 85 95% 7, 8 4 5 Beasley RP, Hwang LY, Lee GC, et al. Efficacy of hepatitis B immune globulin for prevention of perinatal transmission of the hepatitis B virus carrier state: final report of a randomized double-blind, placebo-controlled trial. Hepatology 1983;3:135-41. 6 CDC. Hepatitis B virus: a comprehensive strategy for eliminating transmission in the US through universal childhood vaccination: recommendation of the Immunization Practices Advisory Committee (ACIP). MMWR 1991:40(no. RR-13) 1-25. 7 Beasley RP, Hwang LY, Lee GC, et al. Prevention of perinatally transmitted hepatitis B virus infection with hepatitis B immune globulin and hepatitis B vaccine. Lancet 1983;2:1099-1102. 8 Wong VCW, Ip HMH, Reesink HW, et al. Prevention of the HBsAg carrier state in newborn infants of mothers who are chronic carriers of HBsAg and HBeAg by administration of hepatitis B vaccine and hepatitis immunoglobulin: double-blind randomized placebo-controlled study. Lancet 1984;1:921-6. 3
13. HBIg II HBIg HBsAg 14. 9 15. 10 16. 9 US CDC. Updated US Public health service guidelines for the management of occupational exposures to HBV, HCV, and HIV and recommendations for postexposure prophylaxis. MMWR 2001; 50(RR-11): 1-52. 10 US CDC. Recommendations for prevention and control of hepatitis C virus (HCV) infection and HCV-related chronic disease. MMWR 1998;47(RR19):1-39. 4
17. (a) (b) (c) (d) 11 18. (a) (b) (c) 19. III 1 2 zidovudine 20. AZT/3TC indinavir nelfinavir nevirapine 12 efavirenz 21. 13 11 Cardo DM, Culver DH, Ciesielski CA et al. A case-control study of HIV seroconversion in health-care workers after percutaneous exposure. N Engl J Med 1997; 337: 1485-90 12 US CDC. Serious adverse events attributed to nevirapine regimens for postexposure prophylaxis after HIV exposures Worldwide, 1997-2000. MMWR 2001; 49: 1153-56 13 Parin JM, Murphy M, Anderson J et al. Tolerability and side-effects of post-exposure prophylaxis for HIV infection. 5
22. 23. Lancet 2000; 355: 722-23 6
II III 7
II HBsAg -ve HBsAg +ve anti-hbs -ve anti-hbs +ve I. (a) HBsAg +ve (b) HBsAg ve 24 HBIG HBIG 1 anti-hbs * (c) HBsAg HBsAg HBsAg anti-hbs * HBIG II. I(a) I(a) I(a) 1. 2. 24 7 HBIG 3. a b 10µg B-Hepavac II 20µg Engerix-B 4. * anti-hbs (a) anti-hbs (b) anti-hbs 8
III * Zidovudine 200mg 300mg + lamivudine 150mg + indinavir 800mg 8 nelfinavir 750mg 125mg Zidovudine 200mg 300mg + lamivudine 150mg * 9