Epidemiologia e profilassi di hbv hcv hiv 2009
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Epidemiologia e profilassi di hbv hcv hiv 2009
- 1. Le principali Malattie Infettive trasmissibili in ambiente di lavoro Prof. Guglielmo Borgia Dott. Ivan Gentile Università di Napoli “Federico II ” CORSO di Formazione ECM 2010: Malattia infortunio: rapporti tra medico competente e INAIL alla luce del Decreto Legge 106/09 Napoli, 23 febbraio 2010
- 10. HBV
- 13. Reported Incidence of Acute Hepatitis B, United States, 1978-2002 Hepatitis B vaccine licensed Decline among homosexual men Decline among IV drug users CDC. Hepatitis B. In: Atkinson W et al, eds. Epidemiology & Prevention of Vaccine-Preventable Diseases . 8th ed. Washington DC: Public Health Foundation; 2005:191-212. 0 5000 10000 15000 20000 25000 30000 1978 1982 1986 1990 1994 1998 2002 Cases
- 15. The Clinical Outcomes of HBV Infection Adult acute infection Recovery Fulminant hepatitis 95% <1% 30%-90% 5-50 years Transplant or Death Perinatal/childhood acute infection Recovery 10%-70% <5% 1* * per 100 patient years. . Adapted from EASL Consensus Statement. J Hepatol . 2003;39(S1):S3-S25. 0.1* 2-10* 4* 3* 2-8* 25%-30% LIFETIME DEATH RISK Decompensation HCC Cirrhosis Inactive carrier state Mild, moderate or severe chronic hepatitis Chronic infection
- 24. HCV
- 28. Natural History of HCV Infection Stable 80% (68%) HCC Liver failure 25% (4%) Slowly progressive 75% (13%) Resolved 15% Acute HCV Cirrhosis 20% (17%) Chronic HCV 85%
- 34. 2008 Report on the global AIDS epidemic A global view of HIV infection 33 million people [ 30–36 million ] living with HIV, 2007
- 35. HIV prevalence (%) in adults (15–49) in Africa, 2007 2008 Report on the global AIDS epidemic
- 36. Estimated number of adult and child deaths due to AIDS globally, 1990–2007 Year Millions 0 1.5 2.0 2.5 3.0 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 0.5 1.0 This bar indicates the range around the estimate 2008 Report on the global AIDS epidemic
- 47. Gestione delle punture da HIV e profilassi post esposizione (PEP)
- 101. Indicazioni alla profilassi post esposizione ad HIV
- 102. Profilassi in operatori sanitari Ferita o puntura con ago o altro tagliente Raccomandata Contaminazione congiuntivale Raccomandata Contaminazione di cute lesa o altre mucose Considerata Ferita da morso Considerata Contaminazione di cute integra Sconsigliata Sangue, altro materiale biologico visibilmente contenente sangue; liquido cerebrospinale, materiale ad elevata concentrazione virale (p. Es. Colture, sospensioni concentrate di virus) Raccomandata Liquido amniotico, sinoviale, pleurico, pericardico peritoneale; tessuti; materiale di laboratorio; sperma o secrezioni genitali femminili Considerata Urine, vomito, saliva, feci Sconsigliata
Notes de l'éditeur
- HCC, hepatocellular carcinoma; HCV, hepatitis C virus. This slide depicts the natural history of hepatitis C infection, as gleaned from cohorts of posttransfusional patients. These posttransfusional cohorts have been most informative because they are able to pinpoint the exact time of infection and are, therefore, able to estimate fairly precisely the duration of disease. After acute infection, the predilection for chronicity is remarkable: Approximately 85% of patients progress to chronic infection, whereas only an elite 15% to perhaps 25% experience spontaneous resolution. Among those with chronic HCV infection, a stable course is seen in approximately 80% of patients, whereas 20% will develop cirrhosis. Once cirrhosis has supervened, a variable course is still observed; most patients will progress slowly, but about one quarter will experience liver failure, and approximately 1% will develop HCC annually. In other words, among 100 patients with acute infection, approximately 4 will develop a highly undesirable clinical outcome. However, it is possible that investigators may find that this is only a minimum estimate of the number of patients who will experience these outcomes as the cohort now matures.