1. HBV

2. Overview of the Epidemiology of Hepatotropic Viruses

3. Global Prevalence of Hepatitis B Infection

4. F A, B C, D F A D D D D D E A C C Bj Ba F A, B, C, D H Fung et al.: Hepatology 2004 HBV genotypes

5. Routes of HBV Transmission Vary Depending on Prevalence of Infection

6. Hepatitis B immunization 1984 - I programm of common hepatitis B vaccination in Taiwan 2006 - 68% reducing risk of deaths due to HF in children 75% decrease of the rate of HCC 1991 – recommendation of common hepatitis B vaccination 2003 - 155 countries had introduced hepatitis B vaccination 2008 – 177 countries had introduced hepatitis B vaccination szczepień p/wzw B Chien Y.C. i wsp. Epidemiol. Rev. 2006

7. HBV Immunization is Associated With a Reduction in Cases Of Acute Hepatitis B in the United States

8. Benefis of Hepatitis B Vaccination

9. Immunization Strategy to Eliminate Hepatitis B Virus (HBV)

10. Adults Who Should Receive Hepatitis B Vaccination (1)

11. Adults Who Should Receive Hepatitis B Vaccination (2)

12. Adults Who Should Receive Hepatitis B Vaccination (3)

13. Worldwide, HBV is a Major Contributor to Death From Cirrhosis and Hepatocellular Carcinoma

14. In the United States, Hepatitis B is a Less Common Cause of Cirrhosis and Hepatocellular Carcinoma

15. How to Screen for Hepatitis B Infection?

16. Who Should Be Screened for HBV Infection? CDC Screening Recommendations (1)

17. Who Should Be Screened for HBV Infection? CDC Screening Recommendations (2)

18. Who Should Be Screened for HBV Infection? CDC Screening Recommendations (3)

19. Summary

20. Serological Tests for Hepatitis B and Their Interpretation

21. Interpretation of HBV Serological Markers

22. acute hepatitis chronic hepatitis liver cirrhosis death liver failure (ESLD) >30% patients with CHB 2 >90% children <5% adults 23% patients with liver cirrhosis HCC Liver transplantation 1. Fattovich G et al. Hepatology 1995 2. Ikeda K et al. J Hepatol 1998. HBV natural history 5-10% patients with CHB

23. Acute HBV infection

24. Outcomes of Acute HBV Infection Vary by Age of Exposure

25. Risk of HBV Chronic Infection Varies by Age at Time of Infection

26. Five-Year Complication Rate in Chronic HBV Infection

27. Factors Associated With Risk of Cirrhosis in Patients With Chronic HBV

28. HBV DNA Testing

29. High HBV DNA Levels Associated with Risk of Cirrhosis and HCC

30. Summary

31. Algorithm to Identify Treatment Candidates

32. Reactivation of Hepatitis B: Definition

33. HBV Reactivation Occurs in Different Situations

34. Patients on Immunosuppressive Therapy

35. HCV

36. Hepatitis C 170-200 milion infected 3% of world population mortality will increase 2-3 Times during follow 10-20 years Europe 7,3-8,8 mln infected deaths – 86.000 annually the main reason of liver transplantation Uwe Siebert, Nicolai Muhlberger, Stefan Zeuzem 2008 Hepatitis C WHO 2002; HO/CDS/CSR/LYO/2003 Report WHO 2000

37. Global Hepatitis C Burden is Large and Highest in Asia and Africa

38. Hepatitis C Poland 4%? 14 435 examined volunteers 1000 hospitalyzed children 320 diabetics Poland 1,9%? 496/26 057 addmitted to hospital 72% HIV infected c(n=278) 12% hemodialyzed (n=13 680) 7,25% prisoners (n=1860) 0,4% pregnant women (n=1600) Tyczyńska-Hoffmann. Hepatol. Pol., 1996 Muszyńska. Med. Sci. Monitor, 2002 Bielawski i wsp. Arch. Med. Res., 2000 Grąbczewska, HIV&AIDS Rev., 2003 Durlik, 2008

39. Hepatitis C Virus Has Multiple Genotypes Which Affect Treatment Choice and Therapeutic Response

40. Potential Consequences of Hepatitis C

41. Unsafe Injections Are the Major Risks for HCV Transmission

42. Other Exposures Are Associated with Transmission of HCV

43. The Tip of the Iceberg

44. CDC Recommendations for HCV Testing Are Based on Birth Cohort, Risk, and Medical Indications

45. Diagnostic Tests: Anti-HCV

46. Diagnostic Tests: HCV RNA

47. Diagnosis of HCV: Requires Both Anti-HCV (Antibody) and HCV RNA (Viral Load)

48. Acute HCV Infection

49. Acute HCV infection

50. Factors Associated with Higher Rates of Spontaneous Clearance of HCV

51. Extrahepatic Manifestations of HCV

52. Hepatitis C Virus Infection: Natural History

53. Risk Factors Associated with Faster Fibrosis Progression in Chronic HCV

54. Hepatitis C and Alcohol

55. Recommended Baseline Studies in Persons with Chronic HCV Infection

56. Summary

57. All Patients with HCV Should Be Considered for Treatment Based on Individual Risk/Benefit

58. Benefit of HCV Eradication (SVR)