- 다른 사람의 피를 자주 수혈받는 사람들이나
- 습관성 약물 사용자들이나 마약 중독자들
- 신장부전증 등으로 체외투석 치료를 받는 사람들
- 동성 연애자들
- 피나 혈청을 취급하는 의료 종사자들
- 피로 만든 약품을 취급하는 사람들
- 혈우병 환자들
- 감옥에서 일하는 사람들
- 매매춘부들은
- 다수의 성교 대상자와 성교하는 사람들
- 약 1/3의 B형 간염 환자들이 어떤 B형 간염 바이러스에 감염 경로로 감염되었는지 확실히 알 수 없다고 한다.
| 특성 | A형 간염 | B형 간염 | C형 간염 |
| 간염 바이러스형 | picornavirus(RNA) | hepadnavirus(DNA) | flavivirus(RNA) |
| 전염 방법 | 대변-경구를 통해(드물게는 피하, 근육, 정맥주사 등을 통한 비경구적으로) | 피하, 근육, 정맥주사 등을 통한 비경구적으로) | 피하, 근육, 정맥주사 등을 통한 비경구적으로) |
| 전염 경로 | 사람-사람 접촉, 성교, 음식물을 통해서 | 성교, 습관성 약물 주사, B형 간염 바이러스를 보균한 모체나 B형 간염을 앓는 모체로부터 출생하는 동안 | 습관성 약물 주사, 1990년 전 수혈이나 피로 만든 약물 사용, 성교(?), C형 간염 바이러스를 보균한 모체나 C형 간염을 앓는 모체로부터 출생하는 동안 |
| 황달이 나타나는 빈도 | 성인에서는 흔하지만 소아에서는 흔치 않다 | 성인에서는 흔하지만 소아에서는 흔치 않다. | 흔치 않다. |
| 급성간염이 만성간염으로 되는 빈도 | 없다. | 성인에서는 10% 이하이고 영유아에서 흔하다. | 70% 이상 |
| 매년 급성감염 발생 예상 수(미국내) | 179,000 | 185,000 | 38,000 |
| 미국 내 만성간염 발생 예상 수 | – | 1,250,000 | 2.700,000 |
| 세계적으로 만성간염 발생 예상 수 | – | 350,000,000 | 170,000,000 |
| 치료 약 | 없음 | Interferon alfa, Lamivudine | Interferon alfa와 ribavirin |
| 예방접종 및 면역글로불린 | A형 간염 예방접종 및, 또는 면역글로불린 | B형 간염 예방접종 및, 또는 면역 글로불린 | 없음 |
참고서 New England J Med, Vol 345, No 1 July 5, 2001
더 자세한 정보를 알기 위해서는 www.nejm.org”을 방문하세요.
A형 간염, B형 간염, C형 간염, D형 간염 등 여러 종류의 바이러스성 간염이 있다. 그 중 A형 간염과 B형 간염을 예방할 수 있는 간염 예방접종 백신이 있다.
B형 간염 예방접종백신이 개발된지 오래 됐고 A형 간염 예방접종백신은 최근에 개발되었다. 건강한 모든 아이들에게 B형 간염 예방접종을 통상적으로 해 주라고 권장하지만 A형 간염 예방접종을 건강한 아이들에게 통상적으로 해 주라고 아직 권장하지 않는다.
B형 간염 바이러스에서 인공으로 배양한 항원을 채취해서 B형 간염 예방접종백신을 만든다. B형 간염 예방접종백신의 종류와 접종받는 아이의 나이에 따라 예방접종백신의 용량이 다르다.
접종 연령
갓 태어나서 사춘기가 되기까지 건강한 모든 소아들은 B형 간염 예방접종을 받아야 한다. 태어난 날부터 생후 1주일 이내에 1차 접종을 받고, 생후 1, 2개월에 2차 접종을 받고, 1차 접종을 받은 날로부터 6개월이 될 때에 3차 접종을 받아서 총 3회 접종 받는다.
Pediarix 5-in-1 예방접종약은 디프테리아, 파상풍, 백일해, B형 간염과 불활성 소아마비 예방접종약을 혼합해서 만든 혼합접종약이다.
이 혼합접종약으로 생후 2, 4, 6 개월에 예방접종할 수 있다. 전에는 디피티, B형 간염과 불활성 소아마비 예방접종할 때 세 번 주사를 맞았던 것을 이제 한번 주사로 이 5 가지의 예방접종약이 든 Pediarix 5-in-1 예방접종약으로 접종할 수 있게 되었다. 이것은 또 하나의 소아들의 승리이다.더 자세한 정보는www.aapnews.org”,
접종 방법
건강 진단을 받고 열이 있나 체온을 재고 열이 없고 발열성 질환이 없고 B형 간염 예방접종백신에 알레르기가 없고 접종에 금기가 없으면 근육주사로 접종 받는다.
3차 접종을 받은 후 2~3개월 후에 B형 간염 바이러스 면역체 검사를 해서 B형 간염 바이러스에 대한 면역체가 생겨 있는지 알아볼 수 있으나 여러 가지 이유로 그 검사를 하지 않는다.
| B형 간염바이러스를 보균한 임산부에게서 태어난 신생아에게 다음과 같이 예방접종하면
갓 태어난 아기에게 B형 간염 바이러스성 간염 면역글로불린 주사와 B형 간염 예방접종으로 B형 간염을 예방하면 97%의 예방효과가 나타났다고 한다. 참고: Infectious News 11/01, Pediatric News 11/01 만성 간염 치료(B형 간염) 만성 B형 바이러스 간염을 앓는 소아들을 인터페론(Interferon)이나 라미부딘(lamivudine)으로 3~4년간 치료했을 때 간경화증의 발병이나 간암 발병률은 이 치료를 받지 않은 군에 비해 별 차이가 없다는 연구결과가 나왔다. 참고: Pediatric News 11/01 |
부작용
부작용은 아주 드문 편이다. 예방접종 주사를 맞은 부위가 조금 붓고 아플 수 있다.
B형 간염 예방접종백신을 만드는 과정에서 쓴 효모균이나 그 외의 다른 성분에 알레르기가 있는 아이들은 접종 받아서는 안 된다.
B형 간염 바이러스 면역체가 없는 아이가 B형 간염 바이러스를 보균한 사람이 B형 간염을 앓고 있는 사람과 접촉 됐을 때 B형 간염 예방접종을 받는 방법
| B형 간염 면역 글로불린(HBIG) | B형 간염 면역 글로불린(HBIG) | B형 간염 예방접종 | |
| 접촉된 상태 | 용량 | B형 간염 면역 글로불린 주사를 맞아야 할 때와 맞는 방법 | B형 간염 예방접종을 받아야 할 때와 받는 방법 |
| B형 간염 바이러스를 보균하거나 B형 간염을 앓고 있는 엄마로부터 태어난 신생아 | HBIG 0.5cc를 근육주사로 맞는다. | 생후 12시간 이내에 근육주사로 맞는다. | 1차 B형 간염 예방접종을 하고 HBIG를 근육주사로 맞는다. 1차 B형 간염 예방접종을 받은 후 1~2개월이 될 때 2차, 6개월이 될 때 3차 B형 간염 예방접종을 받는다. |
| B형 간염 바이러스 면역체가 없는 소아나 성인이 B형 간염 바이러스 보균자나 B형 간염을 앓는 사람의 피나 그 사람의 몸에서 나온 분비물에 접촉됐을 때 | 체중 매 kg당 HBIG 0.06cc를 근육주사로 맞는다. | 피나 분비물에 접촉된 후 24시간 이내에 근육주사로 맞는다. | 피부나 점막에 생긴 열상이나 자상 등의 상처에 접촉된 후 7일 이내에 1차 B형 간염 예방접종을 받고, 그 후 1개월이 될 때 2차, 6개월이 될 때 3차 B형 간염 예방접종을 받는다. |
| B형 간염 바이러스 면역체가 없는 소아나 성인이 B형 간염 바이러스 보균자나 B형 간염을 앓는 사람의 피나 몸에서 나온 분비물에 접촉됐을 때 | 체중 매 kg당 HBIG 0.06cc를 근육주사로 맞는다. | B형 간염 예방접종을 받기 싫어하면 피나 분비물에 접촉된 후 24시간 이내에 HBIG 주사를 맞는다. 한달 후에 HBIG를 근육주사로 한 번 더 맞는다. | – |
| B형 간염 바이러스 보균자나 B형 간염을 앓는 사람과 성교했을 때 | 체중 매 kg당 HBIG 0.06cc(최대 용량 5cc)를 근육주사로 맞는다. |
Copyright ⓒ 2014 John Sangwon Lee, MD., FAAP
Hepatitis B during pregnancy 임신 중 B형 간염
Cause
Hepatitis B caused by infection of the liver by the hepatitis B virus is called hepatitis B or serum hepatitis.
People are more susceptible to hepatitis B
if: Transfusion of blood from a person who has hepatitis B virus
or a person with hepatitis B Contact with blood like that Hepatitis B virus is treated with medicines made from the blood of infected people,
or When treated with medicines made with serum containing the hepatitis B virus
It can be transmitted to the hepatitis B virus.
Hepatitis B virus infection may occur if needles or medical devices used for a person suffering from hepatitis B or a person carrying the hepatitis B virus are not disinfected and used again.
Alternatively, the hepatitis B virus may be infected through blood, mucus, body fluids, semen, vaginal fluid, saliva, etc. of a person who has hepatitis B virus or a person suffering from hepatitis B.
Intercourse with someone who has hepatitis B or who has the hepatitis B virus Kissing can spread the hepatitis B virus.
Hepatitis B virus can be transmitted when a person with hepatitis B or a person with the hepatitis B virus does not completely disinfect needles or dental instruments and then re-writes the device to other people. The hepatitis B virus can be transmitted when the skin or mucous membranes of healthy people come into contact with blood pus, semen, vaginal discharge, saliva, body fluids, and body fluids from wounds of a person with hepatitis B or a person carrying the hepatitis B virus. have.
It can also be transmitted by contact with medical devices used for hepatitis B patients or those carrying the hepatitis B virus.
It is not contagious through air or water, and the patient’s feces is not transmitted through the oral route, but in rare cases, a child who has the hepatitis B virus does not have the virus and is close to a child who is not immune to the virus infection.
The virus can be transmitted when in contact with the body, and can also be transmitted through clothes, razors, and toothbrushes.
70% to 90% of newborns born to pregnant women with acute hepatitis B or chronic hepatitis B
or to pregnant women carrying the hepatitis B virus can be infected with the hepatitis B virus.
However, intrauterine transmission is very rare.
Hepatitis B virus can be infected through blood, mucus, or genital secretions from a person with hepatitis B or a person carrying the hepatitis B virus.
When handling other people’s blood, you must wear rubber gloves to avoid contagious diseases such as hepatitis.
- People who frequently receive blood from others
- Addictive drug users or drug addicts
- People who receive extracorporeal dialysis treatment for kidney failure, etc.
- Homosexuals
- Healthcare workers handling blood or serum
- People who handle blood-made drugs
- Hemophilia patients
- People working in prison
- Prostitutes
- People who have sex with a large number of people
- About one-third of hepatitis B patients do not know for sure which hepatitis B virus was infected by the route of infection.
- etc
Most people with the hepatitis B virus do not show any symptoms, but they can pass the hepatitis B virus to others.
Symptom
When you get hepatitis B, there are many different symptoms.
Even if the hepatitis B virus invades the liver, there are also asymptomatic hepatitis B infections that do not show any symptoms of hepatitis, leaving only the hepatitis B virus immune system and recovering naturally.
In particular, infants and toddlers are more susceptible to asymptomatic type B infections.
90% of hepatitis B infections in infants caused by hepatitis B virus infection from the mother during birth become chronic hepatitis. 25-50% of hepatitis B infections in infants 1-5 years old become chronic hepatitis B, and 6-10% of hepatitis B infections in children and adults after 5 years of age. Infants and younger children develop hepatitis B infection, and 25% of adults with chronic hepatitis develop liver cancer or cirrhosis. There are also hepatitis B infections, where symptoms can be subacute. At this time, the initial symptoms are similar to those of hepatitis A, and there may be symptoms such as no taste, weight loss, vomiting, and fatigue.
Symptoms of hepatitis B appear acute and may be severely ill and severe jaundice.
If you get hepatitis B, symptoms such as fever, vomiting, jaundice, abdominal pain, digestive disorders, loss of appetite, and tiredness may appear mildly or severely, and even death may occur in severe cases. There may be no jaundice, and there are many cases where hepatitis B is mildly ill and heals spontaneously. Rarely, hepatitis B virus infection can lead to arthritis and skin rashes. And hepatitis B is not cured and can lead to chronic hepatitis. Chronic hepatitis B is a major cause of liver cirrhosis or liver cancer. The incubation period is about 60 to 180 days.
Diagnosis and treatment
Comprehensive medical history, symptoms, and medical findings.
If this disease is suspected, fertilization, liver function tests, hepatitis B virus antigens-HBsAg and HBeAg and hepatitis B virus antibodies-anti-HBc, IgM anti-HBc and anti-HBeAg You can diagnose it by examining it.
You can also do other tests to diagnose. A blood test can tell if you are carrying the hepatitis B virus, if you have acute hepatitis B, or if you have had hepatitis B in the past. The symptoms of hepatitis B have many similarities to those of hepatitis A, but the prognosis of the two hepatitis is very different and the transmission route is also different. If jaundice is suspected to be caused by hepatitis, various types of hepatitis should be diagnosed as soon as possible with hepatitis blood tests. Hepatitis B is an infectious disease caused by a virus and has no effect on antibiotic treatment.
Chronic hepatitis B can be treated with Interferon-alfa or Lamivudine, but its effectiveness is not clear. Just like when treating hepatitis A, be mentally and physically stable and get enough nutrition.
Hepatitis B patients and ε antigen
A recent study found that if hepatitis B ε antigen is positive in hepatitis B patients, they are more likely to develop liver cancer (Reference; New England Medicine Journal of Medicine, July 18, 2002).
Isolation
When jaundice occurs due to hepatitis, a hepatitis blood test is not performed, and whether hepatitis is caused by hepatitis A, hepatitis B, or other types of causes cannot be determined based on clinical findings.
Therefore, when jaundice occurs, at least hepatitis A, hepatitis B, hepatitis C, etc. must be treated and prevented according to hepatitis until a distinct diagnosis is made.
Since it is not possible to know for sure what type of hepatitis virus he/she is infected with or what type of hepatitis without blood testing, the patient should be isolated from spreading to others until the type of hepatitis is known.
If you are diagnosed with hepatitis B by performing liver function tests, hepatitis A virus, hepatitis B virus, and hepatitis C virus antigens and antibodies, avoid contact with the patient’s blood, saliva, semen, vaginal fluids, and body fluids. Be careful.
Newborns born to pregnant women with hepatitis B or pregnant women with the hepatitis B virus can contract hepatitis B, and the newborn can transmit the hepatitis B virus to others.
Hepatitis B vaccination and intramuscular injection of hepatitis B immune globulin should be used to prevent hepatitis B in newborns born to pregnant women who have hepatitis B or carry the hepatitis B virus.
Vaccination
It is recommended that all healthy children are given the hepatitis B vaccine routine these days.
All newborns are routinely given the first hepatitis B vaccine within one week after birth.
| Characteristics | Hepatitis A | Hepatitis B | Hepatitis C |
| Hepatitis virus type | picornavirus(RNA) | hepadnavirus(DNA) | flavivirus(RNA) |
| Method of transmission | Feces-orally (rarely parenterally through subcutaneous, intramuscular, intravenous injection, etc.) | Parenterally through subcutaneous, intramuscular, intravenous injection, etc. | Parenterally through subcutaneous, intramuscular, intravenous injection, etc. |
| Transmission route | Transmission Routes Human-to-human contact, sexual intercourse, through food, | sexual intercourse,
injections of habitual drugs, birth from mothers carrying the hepatitis B virus or from mothers with hepatitis B, |
Injection of habitual drugs, blood transfusions or blood-based drugs before 1990, sexual intercourse (?), during birth from a mother carrying the hepatitis C virus or from a mother with hepatitis C infection |
| How often jaundice appears | Common in adults but less common in children | Common in adults but less common in children | less common |
| How often acute hepatitis becomes chronic hepatitis | none | It is less than 10% in adults and is common in infants and toddlers. | 70% and more이상 |
| Estimated number of cases of acute infection each year(USA) | 179,000 | 185,000 | 38,000 |
| Estimated number of chronic hepatitis outbreaks in the U.S. | – | 1,250,000 | 2.700,000 |
| Estimated number of chronic hepatitis outbreaks worldwide | – | 350,000,000 | 170,000,000 |
| Drugs for treatment | none | Interferon alfa, Lamivudine | Interferon alfa and ribavirin |
| Vaccination and Immunoglobulin | Hepatitis A vaccination and/or immunoglobulins | Hepatitis B vaccination and/or immunoglobulins | none |
References New England J Med, Vol 345, No 1 July 5, 2001
For more information, please visit “www.nejm.org”.
There are several types of viral hepatitis, including hepatitis A, hepatitis B, hepatitis C, and hepatitis D. Among them, there is a hepatitis vaccination vaccine that can prevent hepatitis A and hepatitis B.
The hepatitis B vaccine has been developed for a long time, and the hepatitis A vaccine has been developed recently.
It is recommended that all healthy children be vaccinated against hepatitis B routinely, but it is not yet recommended that the hepatitis A vaccine be given to healthy children as usual.
Artificially cultured antigens from the hepatitis B virus are collected to make a hepatitis B vaccination vaccine.
The dose of the vaccine depends on the type of hepatitis B vaccine and the age of the child being vaccinated.
Vaccination age
All healthy children from newborn to puberty should be vaccinated against hepatitis B.
The first vaccination is given within 1 week of birth from the date of birth, the second vaccination is received at 1 or 2 months of age, and the 3rd vaccination is received at 6 months from the date of the first vaccination.
Pediarix 5-in-1 vaccination is a combination of diphtheria, tetanus, pertussis, hepatitis B and inactive polio vaccination.
This combination vaccine can be vaccinated at 2, 4, and 6 months of age. Previously, three shots were given when vaccinated against D.P.T, hepatitis B, and inactive polio, and now one shot can be given with the Pediarix 5-in-1 vaccination containing these five vaccinations.
This is another children’s victory.
For more information, visit www.aapnews.org”,
How to vaccinate
- If you have a fever after undergoing a medical examination,
- check your body temperature, do not have a fever,
- are not allergic to the hepatitis B vaccination
- and there is no contraindication to vaccination,
- you will be inoculated by intramuscular injection.
- Two to three months after receiving the 3rd vaccination, a hepatitis B virus immunity test can be performed to see if immunity against the hepatitis B virus has been established,
- but the test is not performed for various reasons.
If a newborn baby born to a pregnant woman carrying the hepatitis B virus is vaccinated as follows:
- It is reported that 97% of newborn babies were prevented from hepatitis B with hepatitis B viral hepatitis immunoglobulin injection and hepatitis B vaccination. Reference: Infectious News 11/01, Pediatric News 11/01
Treatment of chronic hepatitis (hepatitis B)
When children with chronic hepatitis B virus were treated with interferon or lamivudine for 3 to 4 years, the incidence of cirrhosis or liver cancer was not significantly different compared to those who did not receive this treatment, a study found. Ref: Pediatric News 11/01
Side Effect
Side effects are very rare. The area where the vaccination was given may be slightly swollen and sore. Children who are allergic to yeast or other ingredients used in the process of making the hepatitis B vaccination vaccine should not be vaccinated.
How to get hepatitis B vaccination when a child without hepatitis B virus immunity comes into contact with a person who has hepatitis B virus.
B형 간염 바이러스 면역체가 없는 아이가 B형 간염 바이러스를 보균한 사람이 B형 간염을 앓고 있는 사람과 접촉 됐을 때 B형 간염 예방접종을 받는 방법
| Hepatitis B Immunoglobulin(HBIG) | Hepatitis B Immunoglobulin (HBIG) | Hepatitis B vaccination | |
| Contacted state | dose | When to get a hepatitis B immune globulin injection and how to do it | When and how to get the hepatitis B vaccine |
| Newborns born to mothers who carry hepatitis B virus or have hepatitis B infection | HBIG 0.5cc is received by intramuscular injection. | It is given by intramuscular injection within 12 hours of birth. | The first hepatitis B vaccination is given and HBIG is administered intramuscularly. After receiving the first hepatitis B vaccination, you will receive the second hepatitis B vaccination at 1 to 2 months, and the third hepatitis B vaccination at 6 months |
| When a child or adult who does not have a hepatitis B virus immune system comes into contact with the blood of a person who has hepatitis B virus or a person with hepatitis B, or secretions from the person’s body. | HBIG 0.06cc per kg of body weight is given by intramuscular injection. | It is given by intramuscular injection within 24 hours after contact with blood or secretions. | Get the first hepatitis B vaccination within 7 days of contact with cuts or cuts on the skin or mucous membrane, the second hepatitis B vaccination at 1 month thereafter, and the third hepatitis B vaccination at 6 months |
| When a child or adult who does not have the hepatitis B virus immune system comes into contact with the blood or body discharge of a person who has hepatitis B virus or a person with hepatitis B infection. | HBIG 0.06cc per kg of body weight is given by intramuscular injection. | If you do not want to be vaccinated against hepatitis B, you will get an HBIG injection within 24 hours after contact with blood or secretions. After a month, I get another HBIG intramuscular injection | – |
| Having sex with someone who has hepatitis B virus or who has hepatitis B | HBIG 0.06cc (maximum capacity 5cc) per kg of body weight is administered by intramuscular injection. |
Copyright ⓒ 2014 John Sangwon Lee, MD., FAAP.
“부모도 반의사가 되어야 한다”-본 사이트의 내용은 여러분들의 의사로부터 얻은 정보와 진료를 대신할 수 없습니다.
“The information contained in this publication should not be used as a substitute for the medical care and advice of your doctor. There may be variations in treatment that your doctor may recommend based on individual facts and circumstances.
“Parental education is the best medicine.“