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19 2008 . N 01/10382-8-32

 

 

" B, "", ", .. , .. , .. , .. .. .

 

..

 

 

 

 

 

B,

"",

 

() " - " - - . - , , , . , , , , .

, () 1 2008 . 141,9 . 119,9 . 0,08%. 18 . 2006 . 66,6 . 12,8 (60,4 73,2 ) [1]. , , , 15 - 20 , .

, . 2007 . 1465 100 . . : - 820, - 202, ( , , , .) - 175, - 54, - 61, - 24 .

B (B) . , 2007 . 21 B. , 1999 - 2000 . 0,5 - 0,7% B. , B . B (B) - B . , B (B), , , " ". B, (, , , ), "" B - () (). B ( ) .

- B, "", .

B, .

B - - ,

- . ,

B .

. , B

,

-12 -15

(10 - 10 ).

- B ,

. B

, , .

B , ( 8%), (2 - 7%) ( 2%). B, B (, ), B ( HBsAg 10%) [2].

, 400 . HBV-, 3 . . HBsAg 6 . "" B [3]. , . , HBeAg- 5 - 25 - 30% 90% . B 5%.

B .

30% B 30 . 13 - 67% , [4, 5]. ( B) [6, 7]. 80% . [8]. , 75% , .. HBeAg [9]. , , 80% , [10]. 0,88% - 0,42% - .

, 662000 , ( ). 75 - 80% [10]. B-, , 0,1% - 0,8% ( , - 0,42% - 0,88%) [11]. B 40 , - 50 [12].

( 4,9 100 . ) [13]. . .

2002 . - ( .., .., .), B, [14]. , B - 3,47 - 4,03 , - 3,31 - 5,41, - 0,35 - 0,63 - 0,11 - 0,19 .

, , B, . , , B, B B . .

, B-, anti-c B [15]. B- . , C [16, 17]. , "" B , () ( 29,4% 45%) [18 - 20]. , 750 . , B.

, , - B , B, "" , ( HBsAg, -HBs, - ) [21]. B , , , ( ), , [22 - 26]. , B, , , B.

B . , B, . B- (30), 12%, 20% 28% [27]. , , B 10% , [28]. , II - III , B, , , [29].

B . B. B 14,6%, - 35,8% [30]. HBV 10 - 25 , . B ( - ) , .

B -. , 95% - B-. 5% - B, 10 - 15% - B. B -, . , B -, . - . , - B 3 [31 - 33].

, B .

B . N 1 B, 1988 - 2007 .

 


 

N 1. B

1988 - 2007 .

( 100 . )

 

- 50 ┬────────────────────────────────────────────────────────────────────────────────────────────────────────────────────────┐

-

- 45 ┼───────────────────────────────────────────────────────────────────43,3─────────────────────────────────────────────────┤

┌───┐ 42,2

│ ┌───┐

40 ┼───────────────────────────────────────────────────────36,6────────┤ │─│ ├──────────────────────────────────────────┤

35,8 ┌───┐ 35,7 │ │ │ 35,34

┌───┐ │ │ ┌───┐ │ │ │ │ ┌───┐

35 ┼─────────────────────────────────────────────────┤ │─│ │─│ │─│ │─│ │─│ │────────────────────────────────────┤

32,1 │ │ │ │ │ │ │ │ │ │

┌───┐ │ │ │ │ │ │ │ │ │ │ │

30 ┼───────────────────────────────────────────┤ │─│ │─│ │─│ │─│ │─│ │─│ │────────────────────────────────────┤

25,1 │ │ │ │ │ │ │ │ │ │ │ │

┌───┐ │ │ │ │ │ │ │ │ │ │ │ │ │

25 ┼──24,6───────────────────────────────┤ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │────────────────────────────────────┤

│ ┌───┐ 20,8 21,6 │ │ │ │ │ │ │ │ │ │ │ │ │ │

│ │ │ ┌───┐ ┌───┐ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │

20 ┼─│ │─│ │ 16,8 ------------ │ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │─19,78 ─────────────────────────────┤

│ │ │ │ │ ┌───┐ 16,4 16,3 │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ ┌───┐

│ │ │ │ │ │ │ ┌───┐ ┌───┐ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │

15 ┼─│ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │──────────────────────────────┤

│ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ 13,1

│ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ ┌───┐ 10,4

10 ┼─│ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │─┌───┐─8,56 ────────────┤

│ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ ┌───┐ 6,99

│ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ ┌───┐ 5,26 │

5 ┼─│ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │─│ │─┌───┐│

│ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ ││

│ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ ││

0 └─┴───┴─┴───┴─┴───┴─┴───┴─┴───┴─┴───┴─┴───┴─┴───┴─┴───┴─┴───┴─┴───┴─┴───┴─┴───┴─┴───┴─┴───┴─┴───┴─┴───┴─┴───┴─┴───┴─┴───┴┘

1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

 


 

B . 1992 . 1999 . (. - 43,3 100 . ). - , , . , ( 15 - 19 20 - 29 ). B (5,26 100 . 2007 .). 2007 . B 7523 , 14 104 (0,48 100 . ).

B B . 2000 . 14,2 100 . 2007 . - 14,0. 2006 - 2007 . B 19953 . , B .

B HBsAg. - - - . , HBsAg , , 0,1% 3,9% (.. , 2008 .). ( ) 10,0% ( - 11,6%). "" HBsAg, , , , 3 - 5 . .

, "" B, , , B - , .

B. , B - . , . B, , , , B. 1997 . . 2000 . 12 . 10,2%, 2003 . - 93,6%, 2004 . - 96,1%, 2007 . - 98,0%. 2001 . 13 , , . 1 2007 . 35,5 . , 8,5% . 2006 - 2007 . (18,3 . ) "".

B B ( N 1).

, , B, "" B . (1 - 4 100 . ) B, "" HBV ( 8 - 10 ) [34]. , 1984 . 1986 ., 70% [35]. 14.8 100 . , 15 ( 10 - 19 5,7 100 . - 2,6 - 1986 - 1992 .). 0,54 0,20 100 . [36 - 39].

B, , B, , "" HBsAg . , , , . , , B 40,9% , ( 1 , 1 - 14 , 15 - 19 ) - 98,7%, 99,6% 99,7% - 98,8% , "" HBsAg B. 2001 . 142,7 13,1 , 2007 . 40,7 8,1 [40].

B, "", . . - B , , .

, B ( B, , , ), , , . , B , ( N 2, 3).

 

N 2. B

 

┌─ - - - - - - - - - - ┐

┌┐ │70%

────────────────┤│ └─ - - - - - - - - - - ┘

/ └┘ ┌─ - - - - - - - - - - ┐

/ (27%)

------------------------------------------ │ (9%)

/┌─ - - - - - - - - - ─┐ \ (2%)

/ (0,1%) \ └─ - - - - - - - - - - ┘

/ │ (0,8%)│ \ ┌─ - - - - - - - - - - ┐

/ (0,6) \ ┌┐ (2%)

/ └─ - - - - - - - - - ─┘ ──────────────┤│ │ (21%)

B / └┘ (28%)

------------ └─ - - - - - - - - - - ┘

\ ┌─ - - - - - - - - - - ┐

\ (90%)

\ ---------------- │ (30%)

\ / (8%)

\ / └─ - - - - - - - - - - ┘

\----------------------- ┌─ - - - - - - - - - - ┐

┌─ - - - - - - - - - - ┐\ (10%)

(99,9%) \ ┌┐ │ (70%)

│ (99,4%)│ ────────────────┤│ (94%)

(99,4%) └┘ └─ - - - - - - - - - - ┘

└─ - - - - - - - - - - ┘

 


 

N 3. B

 

B (90%)

---------------------------

/

(99%) /

--------------------

/ \

/ \ (10%) ┌┐

-------------- ───────────────────────────┤│

/ \ └┘

┌─ - - - - - - - - - ─┐ \ B (1%) ┌─ - - - - ─┐

HBsAg - (0%) -------------------- │ . . 2│

│HBsAg + HBeAg - (10%)│ └─ - - - - ─┘

HBsAg + HBeAg + (90%)

└─ - - - - - - - - - ─┘

/ B (30%)

/ --------------------------

------------- /

\ /

\ (90%) /

\ -------------------

\ / \

\ / \ (70%) ┌┐

\ -------------- ───────────────────────────┤│

\ / \ └┘

\ / \ B (10%) ┌─ - - - - ─┐

\ / -------------------- │ . . 2│

\ / └─ - - - - ─┘ B (6%)

\ / ------------------------

\ / /

\ / (90%) /

-------------- -------------------

┌─ - - - - - - - - - ─┐ \ / \

HBsAg - (100%) \ / \ (94%) ┌┐

│HBsAg + HBeAg - (90%)│ \ ----------------- ────────────────────────┤│

HBsAg + HBeAg + (10%) \ / \ └┘

└─ - - - - - - - - - ─┘ \ / \ B (10%) ┌─ - - - - ─┐

----------------- ------------------ │ . . 2│

\ └─ - - - - ─┘

\

\

\ ┌┐

──────────────────┤│

└┘

 


 

B, Goldstein S.T. ., 2005 . [41] , B.

, B, , , ; HBsAg HBeAg ; B ( "") 5- 30 (.. anti-HBc), , , . , , .

" " 1999 ., B . - 1247500 . [1]; HBsAg - 0,5% 9,5% HBeAg "" HBsAg - 2,5% 10%. B ( "") 5- 30 anti-HBc IgG, .. , B. 13,9% 24,3% 17% 32,5% . 1, 1, 1, 1.

 

N 1

 

B

 

1.

B- B ,

 

 




B-

212075 - 405438

20711 - 40493

191364 - 364945

90%



B-

28875 - 59083

2816 - 5770

26059 - 53313

90%


B

54766 - 109836

5370 - 11575

49395 - 98261

89% - 90%

,
B:

 

 

 

 

B

121 - 247

12 - 24

109 - 223

90%

4223 - 8411

414 - 886

3809 - 7524

89% - 90%

-

1894 - 5030

186 - 530

1708 - 4500

89% - 90%


6238 - 13688

612 - 1441

5626 - 12247

89% - 90%

 

1. B

,

,

 

 



749 - 21332

107 - 3043

642 - 18290

86%


172654 - 281810

16834 - 27476

155820 - 254334

90%


38673 - 102295

3771 - 9974

34902 - 92321

90%


212075 - 405438

20711 - 40493

191364 - 364945

90%

 

1. B

,

,

 

 



674 - 19199

96 - 2738

578 - 16461

86%


51774 - 84508

5048 - 8239

46726 - 76268

90%


2317 - 6130

226 - 598

2091 - 5532

90%


54766 - 109836

5370 - 11575

49395 - 98261

89 - 90%

 

1.

B,

 

 



75 - 2349

11 - 335

65 - 2014

86%


5855 - 10459

571 - 1020

5284 - 9439

90%


308 - 879

30 - 86

278 - 793

90%


6238 - 13688

612 - 1441

5626 - 12247

89 - 90%

 

B- , 1 .

B 191364 - 364945, B- - 49395 - 98261, B- - 5626 - 12247.

, Goldstein S.T. ., 2005 . [41] B 2007 . B 21 , 12 - 24 ( 1).

, B .

 

(N - N ) x + N x + N x ( + 0,5 + + )

let

= ---------------------------------------------------------------- +

N

 

N x ( + 0,5 + + )

+ -----------------------------------

N

 

= 66,09 - 66,42

 

:

- ,

1 ,

B;

N - , 1

(1247500 . - 2000 .) [1];

N - ,

let

B B

B (6238 -

13688) [41];

- (66,6 ) [1];

N -

1 , B

B

B (121 - 247 CDC) [41];

- B (22 ) [42];

N - ,

1 , B

, B

B (4223 -

8411 ; CDC) [41, 43];

0,5 - , B (6 .);

- B (4,03 ) [14];

- (5,41 )

[41];

N - ,

1 , B

,

B,

B (1894 - 5030 ; CDC) [41, 43];

- B (4,03 )

[14];

- (0,19 )

[14].

, , , B B , . , B 0,35 ( 66,6 66,25 ).

. .. , " , , "" : , , " [44]. B " " . .

B, , "", B. , B, . , 0,35 ( 66,6 66,25 ). , B ( ). , , B, . B, "", B.

 

 

B, "", :

- B;

- - B, ;

- , B;

- 0,35 ( 66,6 66,25 ).

 

 

1. (): http://www.gks.ru.

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23. Hoofnagle J.H., Dusheiko G.M., Schafer D.F., et al. Reactivation of chronic hepatitis B virus infection by cancer chemotherapy. Ann Intern Med 1982; 96: 447 - 49.

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26. Marcellin P., Giostra E., Martinot Peignoux M., et al. Redevelopment of hepatitis surface antigen after renal transplantation. J Gastroenterol 1991; 100: 1432 - 34.

27. .., .. . . . . 2006; 6: 64 - 9.

28. .., .. . . . . IV , , 2006: 42 - 7.

29. .., .. B . . . 1992; 37 (1): 71.

30. Blal C.A., Passos S.R., Horn C., and Georg I. High prevalence of hepatitis B virus infection among tuberculosis patients with and without HIV in Rio de Janeiro, Brazil. European J Clinl Microbiol Infect Dis 2005; 24 (1): 41 - 3.

st

31. Proceedings of the 1 European Consensus Conference on the

Treatment of Chronic Hepatitis B and of Chronic Hepatitis C in HIV

Co-infected Patients. J Hepatol; 44 (1): 1 - 151.

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40. .., .., .. . B ( ) . 4- . . " ", 2 - 4 2008 .; 50 - 1.

41. Goldstein S.T., Zhou F., Hadler S.C., et al. A mathematical model to estimate global Hepatitis B disease burden and vaccination impact. Int J Epidemiol 2005; 34: 1329 - 39.

42. . . -, 2006; . 6.

43. Centers for Disease and Prevention (CDC). Hepatitis B. Disease Burden & Vaccination Model 2004; version 1.2: http://aim-e-earning.stanford.edu.

44. .. 40 . 1942; 11 - 12: 20 - 7.

 

 








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