????????? ??

???????????	D ICD - 10 : B16 , ; B18.0 ? B18.1 ; ICD - 9-CM : 070.2 ? 070.3 ; OMIM : 610424 ; MeSH : D006509 ; DiseasesDB : 5765 ; SNOMED CT : 66071002 ;
??????????????	MedlinePlus : 000279 ; eMedicine : med/992 ped/978 ; Patient UK : ????????? ?? ;

????????? ?? ; (Hepatitis B)
	?????? ???????????????????????? ???????????????? ????????????????
????????	Infectious disease , gastroenterology
?????	None, yellowish skin , tiredness , dark urine, abdominal pain
????????????	Cirrhosis , liver cancer
??????????	Symptoms may take up to 6 months to appear
?????????????	Short or long term
??????	Hepatitis B virus spread by some body fluids
????????????	Intravenous drug use , sexual intercourse , dialysis , living with an infected person
????????????	Blood tests
??????????	Hepatitis B vaccine
????????	Antiviral medication ( tenofovir , interferon ), liver transplantation
???????	356 million (2015)
????????????	65,400 direct (2015), >750,000 (total)

????????? ?? ( ?????? : hepatitis B ) ???? ?????? ??????????????????? ??????????? ???????????????? ^[1] ???????????????????????????????????????????????????????????? ^[1] ???????????????????????????????????????????? ^[1] ??????????????? ???????? ??????? ????????? ????????? ??????????? ??? ??????? ??? ^[1] ????????????????????????????????????? 2-3 ??????? ?????????????????????????????????????????????????????????????????????????????????? ^[1]^[6] ????????????????????????? 30-180 ??? ^[1] ????????????????????????????????????????? ????????????????? ?????? 90% ????????????????????????????????????????????????? 5 ?? ???????????????????????????? 10% ^[4] ?????????????????????????????????????????????????????????????????????????????? ????????????? ? ??????? ??????? ???? ????????? ??????? ^[2] ????????????????????????????????????????????????? 15-25% ????????????????????????????????????? ^[1]

??????????????????????????????????????????????????? ????? ???? ??????????? ^[1] ???????????? ???????????? ???????????????????????????????????????? ?????????????? ????????? ????????????????????????????????????????? ^[1] ???????????????????????????? ???????????????????????????????????? ???????????????????? ????????????? ??????????????????????????? ^[1] ???????????????? ? ?????? ????????????????????????????? (???? ????????????????) ??????????? ??????????? ????????????????????????????? ?????????????????????????????????????????? ????????????????????????????? ^[1]^[4] ????????????????? 1980 ???????????????????????????????? ?????? ??? ?????????? ????????????????????????? ????????? ??????????????????????????????????????????????????????????? ^[7] ???????????????????????????????????????????????????? ?????????????????????????????? ?????? ?????? ????? ??? ???????????????? ^[4] ???????????????????????????????????????????? 30-60 ?????????????????? ^[1] ????????????????????????????????????????????????????????? ( ???????? ) ??????????????????????????????????????????????????????????????????? ( ????????? ) ^[1] ???????????? ?????????????? ??????????????????? 5 ???? ??????????? ??????????? ?? ?? ?? ??? ??

??????? ?.?. 1982 ????????? ???????????????????????????????????????? ?????????? ^[1]^[8] ???????????????? ??????????????????????????????????????????????????????????????? ^[1] ?????????????????????????????????? 2-3 ????? ????????????????????????????????? ^[1] ?????????????????????????????????????????????????????? 95% ^[1] ?????????????????????????????????????????????????????????????????????????????????????????????? 180 ?????? ^[9] ??????????????????????????????????????????????????????????????????????????????? ??? ?????? ??????????????????????????? ?????? ???????????? ??????? ???????????????????????? ^[1] ??????????????????????? ?????????????????????????????????????? ????????????????? (???? ??????? ????????????????) ^[1] ??????????????????????????????????????????? ??????????? ???? ???????????? ???? ??????????????? ????????????????????????? ^[1] ??????????????????????????????????????????????????????? (???? ???????) ???????????????????????????? ???????????????????? ^[1]

????????????????????????????????????????????????????????????????????????????????? ????????????????????????????????????????? 343 ?????? ^[3]^[1]^[10] ?? ?.?. 2013 ???????????????????????????????????? 129 ?????? ^[11] ?????????? ????????????????????????????? ?????? 750,000 ?? ^[1] ?????????? 300,000 ??????????????????????? ^[12] ??????????????????????????????????????????????????????????????? ???????????????????????????????? 5-10% ?????????????????????????? ^[1] ??????????????????????????????????????????? 1% ^[1] ????????????????????????????? serum hepatitis (??????????????????) ^[13] ???????????????????????????????????????????????????????????????????????????????? ^[14] ??????????????????????????????????????????????????????? ??????????? ?????????? ^[15]

????????? [ ??? ]

??????????????????? ?? ??????????????? ????? ???????? ???????????????????? ???? ????????? ????????????????????????????

?????????????????????????????????????????????? ?????????????????????????????????? ??????????????????? ???????????????????????????????????????????? ???????????? ??????????????????? ?????? ?????????? ??????????????????????????????????????????? ?????????????????????????????????? 90% ?????????????? ???????????????????? ?????????????????????????????? ??????????????? ????? ???????? ??????????? ???????????????????? ???????????????????????????????? ????? ??????????? ???????? ?????????

????? [ ??? ]

???????????????????????????????????????????????????????? ?????????????? ????????? ???????????????????????????????????????????? ??????????????? ???????? ??????? ????????????? ??????? ? ???????????????? ???????????????????????? ????????? ?????????????? ???????? ????????????????????????????????????????????????????????????????? ?????????????????????????????????????????????????????????????????????? ???????????????????????????????????????????????????????????? ????????????????????????????????????????????????????? ^[16]

???????????????????????????????????????????????????????? ??????????????????????????????????????? (?????????????????) ??????? ?????????? ???????????? ??????????????????????????????????? ?????????????? (?????????) ???????? ????????????? ??????????????????????????????????????????????????????????????? 50% ?????????? ^[17]^[18] ?????????????????????????????????????????????????????? ????????? ??????????????????????????????????????????????????????? ?????????????????????????????????????????????????? membranous glomerulonephritis (MGN) ^[19]

?????????????????????????????????? 1-10% ???????????????????????????? ?????? ??? serum-sickness?like ??????????????????? ?????? (??????) ????????????????????????????? (membranous glomerulonephritis) ??? ???????????????????????? ^[20]^[21] ??? serum-sickness?like ????????????????????????????????????????????? ^[22] ???????????????? ????????????? ?????????????????????? ?????? ^[23] ?????? 30?50% ?????????????????????????????????? ??????????????????????????????? ^[24] ???????????????????????????????????????????????? ???????????????????????? ^[25]^[26]

??????????? [ ??? ]

???????? [ ??? ]

????????????????????????????????????????????????????????? ???????????????????????????????????????????????????? ???????? 1% ???????????????????????????????????????????????? ????????????????????????????? (?????????????????) ???????????????????????? ?????????????????????????????????????????????????????????????????????????????? ?????????????????????????????????????? ??????????????????????????????????????????????? ???? ???????????????????????????????????? ALT ??????? ???????????????????????????????????? ??????? ????????????????????? 6 ????? ??? 1 ?? ???????????????????????????????????

??????????????????????

?????????? [ ??? ]

??????? [ ??? ]

↑ ^1.00 ^1.01 ^1.02 ^1.03 ^1.04 ^1.05 ^1.06 ^1.07 ^1.08 ^1.09 ^1.10 ^1.11 ^1.12 ^1.13 ^1.14 ^1.15 ^1.16 ^1.17 ^1.18 ^1.19 ^1.20 ^1.21 ^1.22 ^1.23 ^1.24 ^1.25 ^1.26 ^1.27 ^1.28 ^1.29 ^1.30 ^1.31 ^1.32 "Hepatitis B Fact sheet N°204" . who.int . ??????? 2014. ???? ????????????????? 9 ????????? 2014 . ??????????? 4 ????????? 2014 .
↑ ^2.0 ^2.1 Chang MH (June 2007). "Hepatitis B virus infection". Semin Fetal Neonatal Med . 12 (3): 160?167. doi : 10.1016/j.siny.2007.01.013 . PMID 17336170 .
↑ ^3.0 ^3.1 ^3.2 GBD 2015 Disease and Injury Incidence and Prevalence, Collaborators. (8 October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015" . Lancet . 388 (10053): 1545?1602. doi : 10.1016/S0140-6736(16)31678-6 . PMC 5055577 . PMID 27733282 . {{ cite journal }}: |first1= ????????????????? ( help )
↑ ^4.0 ^4.1 ^4.2 ^4.3 "Hepatitis B FAQs for the Public ? Transmission" . U.S. Centers for Disease Control and Prevention (CDC). ???? ????????????????? 11 ??????? 2011 . ??????????? 29 ????????? 2011 .
↑ GBD 2015 Mortality and Causes of Death, Collaborators. (8 October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet . 388 (10053): 1459?1544. doi : 10.1016/S0140-6736(16)31012-1 . PMID 27733281 . {{ cite journal }}: |first1= ????????????????? ( help )
↑ Raphael Rubin; David S. Strayer (2008). Rubin's Pathology : clinicopathologic foundations of medicine ; [includes access to online text, cases, images, and audio review questions!] (5. ed.). Philadelphia [u.a.]: Wolters Kluwer/Lippincott Williams & Wilkins. p. 638. ISBN 9780781795166 . ???? ????????????????? 28 ??????? 2015.
↑ Thomas HC (2013). Viral Hepatitis (4th ed.). Hoboken: Wiley. p. 83. ISBN 9781118637302 . ????????????????????? ????????? ????? 28 ??????? 2015.
↑ Pungpapong S, Kim WR, Poterucha JJ (2007). "Natural History of Hepatitis B Virus Infection: an Update for Clinicians". Mayo Clinic Proceedings . 82 (8): 967?975. doi : 10.4065/82.8.967 . PMID 17673066 .
↑ Williams R (2006). "Global challenges in liver disease". Hepatology . 44 (3): 521?526. doi : 10.1002/hep.21347 . PMID 16941687 .
↑ Schilsky ML (2013). "Hepatitis B "360" ". Transplantation Proceedings . 45 (3): 982?985. doi : 10.1016/j.transproceed.2013.02.099 . PMID 23622604 .
↑ Global Burden of Disease Study 2013, Collaborators (22 August 2015). "Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013" . Lancet . 386 (9995): 743?800. doi : 10.1016/S0140-6736(15)60692-4 . PMC 4561509 . PMID 26063472 . {{ cite journal }}: |first1= ????????????????? ( help )
↑ GBD 2013 Mortality and Causes of Death, Collaborators (17 December 2014). "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990?2013: a systematic analysis for the Global Burden of Disease Study 2013" . Lancet . 385 (9963): 117?71. doi : 10.1016/S0140-6736(14)61682-2 . PMC 4340604 . PMID 25530442 . {{ cite journal }}: |first1= ????????????????? ( help )
↑ Barker LF, Shulman NR, Murray R, Hirschman RJ, Ratner F, Diefenbach WC, Geller HM (1996). "Transmission of serum hepatitis. 1970". Journal of the American Medical Association . 276 (10): 841?844. doi : 10.1001/jama.276.10.841 . PMID 8769597 .
↑ Thomas, Bruce (2002). Production of Therapeutic Proteins in Plants . p. 4. ISBN 9781601072542 . ???? ????????????????? 28 ??????? 2015 . ??????????? 25 ????????? 2014 .
↑ Plotkin, Stanley A.; Orenstein, Walter A.; Offit, Paul A., ?.?. (2013). Vaccines (6th ed.). [Edinburgh]: Elsevier/Saunders. p. 208. ISBN 9781455700905 . ???? ????????????????? 3 ?????? 2015.
↑ Terrault N, Roche B, Samuel D (July 2005). "Management of the hepatitis B virus in the liver transplantation setting: a European and an American perspective". Liver Transpl . 11 (7): 716?32. doi : 10.1002/lt.20492 . PMID 15973718 . {{ cite journal }}: CS1 maint: uses authors parameter ( ????? )
↑ El-Serag HB, Rudolph KL (June 2007). "Hepatocellular carcinoma: epidemiology and molecular carcinogenesis". Gastroenterology . 132 (7): 2557?76. doi : 10.1053/j.gastro.2007.04.061 . PMID 17570226 . {{ cite journal }}: CS1 maint: uses authors parameter ( ????? )
↑ El-Serag HB (22 September 2011). "Hepatocellular carcinoma". New England Journal of Medicine . 365 (12): 1118?27. doi : 10.1056/NEJMra1001683 . PMID 21992124 .
↑ Gan SI, Devlin SM, Scott-Douglas NW, Burak KW (October 2005). "Lamivudine for the treatment of membranous glomerulopathy secondary to chronic hepatitis B infection". Canadian journal of gastroenterology = Journal canadien de gastroenterologie . 19 (10): 625?9. PMID 16247526 .
↑ Dienstag JL (February 1981). "Hepatitis B as an immune complex disease". Seminars in Liver Disease . 1 (1): 45?57. doi : 10.1055/s-2008-1063929 . PMID 6126007 .
↑ Trepo C, Guillevin L (May 2001). "Polyarteritis nodosa and extrahepatic manifestations of HBV infection: the case against autoimmune intervention in pathogenesis". Journal of Autoimmunity . 16 (3): 269?74. doi : 10.1006/jaut.2000.0502 . PMID 11334492 .
↑ Alpert E, Isselbacher KJ, Schur PH (July 1971). "The pathogenesis of arthritis associated with viral hepatitis. Complement-component studies". The New England Journal of Medicine . 285 (4): 185?9. doi : 10.1056/NEJM197107222850401 . PMID 4996611 .
↑ Liang TJ (May 2009). "Hepatitis B: the virus and disease" . Hepatology (Baltimore, Md.) . 49 (5 Suppl): S13?21. doi : 10.1002/hep.22881 . PMC 2809016 . PMID 19399811 .
↑ Gocke DJ, Hsu K, Morgan C, Bombardieri S, Lockshin M, Christian CL (December 1970). "Association between polyarteritis and Australia antigen". Lancet . 2 (7684): 1149?53. doi : 10.1016/S0140-6736(70)90339-9 . PMID 4098431 .
↑ Lai KN, Li PK, Lui SF, Au TC, Tam JS, Tong KL, Lai FM (May 1991). "Membranous nephropathy related to hepatitis B virus in adults". The New England Journal of Medicine . 324 (21): 1457?63. doi : 10.1056/NEJM199105233242103 . PMID 2023605 .
↑ Takekoshi Y, Tanaka M, Shida N, Satake Y, Saheki Y, Matsumoto S (November 1978). "Strong association between membranous nephropathy and hepatitis-B surface antigenaemia in Japanese children". Lancet . 2 (8099): 1065?8. doi : 10.1016/S0140-6736(78)91801-9 . PMID 82085 .

??????????????? [ ??? ]

?????? ?????????? ?????????? ???? ???????????????????????????????? ???????????????

[WHO2014-1] 1.00 ^1.01 ^1.02 ^1.03 ^1.04 ^1.05 ^1.06 ^1.07 ^1.08 ^1.09 ^1.10 ^1.11 ^1.12 ^1.13 ^1.14 ^1.15 ^1.16 ^1.17 ^1.18 ^1.19 ^1.20 ^1.21 ^1.22 ^1.23 ^1.24 ^1.25 ^1.26 ^1.27 ^1.28 ^1.29 ^1.30 ^1.31 ^1.32 "Hepatitis B Fact sheet N°204" . who.int . ??????? 2014. ???? ????????????????? 9 ????????? 2014 . ??????????? 4 ????????? 2014 .

[pmid17336170-2] 2.0 ^2.1 Chang MH (June 2007). "Hepatitis B virus infection". Semin Fetal Neonatal Med . 12 (3): 160?167. doi : 10.1016/j.siny.2007.01.013 . PMID 17336170 .

[GBD2015Pre-3] 3.0 ^3.1 ^3.2 GBD 2015 Disease and Injury Incidence and Prevalence, Collaborators. (8 October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015" . Lancet . 388 (10053): 1545?1602. doi : 10.1016/S0140-6736(16)31678-6 . PMC 5055577 . PMID 27733282 . {{ cite journal }}: |first1= ????????????????? ( help )

[CDC2014T-4] 4.0 ^4.1 ^4.2 ^4.3 "Hepatitis B FAQs for the Public ? Transmission" . U.S. Centers for Disease Control and Prevention (CDC). ???? ????????????????? 11 ??????? 2011 . ??????????? 29 ????????? 2011 .

[GBD2015De-5] GBD 2015 Mortality and Causes of Death, Collaborators. (8 October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet . 388 (10053): 1459?1544. doi : 10.1016/S0140-6736(16)31012-1 . PMID 27733281 . {{ cite journal }}: |first1= ????????????????? ( help )

[6] Raphael Rubin; David S. Strayer (2008). Rubin's Pathology : clinicopathologic foundations of medicine ; [includes access to online text, cases, images, and audio review questions!] (5. ed.). Philadelphia [u.a.]: Wolters Kluwer/Lippincott Williams & Wilkins. p. 638. ISBN 9780781795166 . ???? ????????????????? 28 ??????? 2015.

[7] Thomas HC (2013). Viral Hepatitis (4th ed.). Hoboken: Wiley. p. 83. ISBN 9781118637302 . ????????????????????? ????????? ????? 28 ??????? 2015.

[pmid17673066-8] Pungpapong S, Kim WR, Poterucha JJ (2007). "Natural History of Hepatitis B Virus Infection: an Update for Clinicians". Mayo Clinic Proceedings . 82 (8): 967?975. doi : 10.4065/82.8.967 . PMID 17673066 .

[Will2006-9] Williams R (2006). "Global challenges in liver disease". Hepatology . 44 (3): 521?526. doi : 10.1002/hep.21347 . PMID 16941687 .

[10] Schilsky ML (2013). "Hepatitis B "360" ". Transplantation Proceedings . 45 (3): 982?985. doi : 10.1016/j.transproceed.2013.02.099 . PMID 23622604 .

[11] Global Burden of Disease Study 2013, Collaborators (22 August 2015). "Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013" . Lancet . 386 (9995): 743?800. doi : 10.1016/S0140-6736(15)60692-4 . PMC 4561509 . PMID 26063472 . {{ cite journal }}: |first1= ????????????????? ( help )

[GBD204-12] GBD 2013 Mortality and Causes of Death, Collaborators (17 December 2014). "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990?2013: a systematic analysis for the Global Burden of Disease Study 2013" . Lancet . 385 (9963): 117?71. doi : 10.1016/S0140-6736(14)61682-2 . PMC 4340604 . PMID 25530442 . {{ cite journal }}: |first1= ????????????????? ( help )

[Barker1996-13] Barker LF, Shulman NR, Murray R, Hirschman RJ, Ratner F, Diefenbach WC, Geller HM (1996). "Transmission of serum hepatitis. 1970". Journal of the American Medical Association . 276 (10): 841?844. doi : 10.1001/jama.276.10.841 . PMID 8769597 .

[14] Thomas, Bruce (2002). Production of Therapeutic Proteins in Plants . p. 4. ISBN 9781601072542 . ???? ????????????????? 28 ??????? 2015 . ??????????? 25 ????????? 2014 .

[15] Plotkin, Stanley A.; Orenstein, Walter A.; Offit, Paul A., ?.?. (2013). Vaccines (6th ed.). [Edinburgh]: Elsevier/Saunders. p. 208. ISBN 9781455700905 . ???? ????????????????? 3 ?????? 2015.

[16] Terrault N, Roche B, Samuel D (July 2005). "Management of the hepatitis B virus in the liver transplantation setting: a European and an American perspective". Liver Transpl . 11 (7): 716?32. doi : 10.1002/lt.20492 . PMID 15973718 . {{ cite journal }}: CS1 maint: uses authors parameter ( ????? )

[pmid17570226-17] El-Serag HB, Rudolph KL (June 2007). "Hepatocellular carcinoma: epidemiology and molecular carcinogenesis". Gastroenterology . 132 (7): 2557?76. doi : 10.1053/j.gastro.2007.04.061 . PMID 17570226 . {{ cite journal }}: CS1 maint: uses authors parameter ( ????? )

[pmid21992124-18] El-Serag HB (22 September 2011). "Hepatocellular carcinoma". New England Journal of Medicine . 365 (12): 1118?27. doi : 10.1056/NEJMra1001683 . PMID 21992124 .

[19] Gan SI, Devlin SM, Scott-Douglas NW, Burak KW (October 2005). "Lamivudine for the treatment of membranous glomerulopathy secondary to chronic hepatitis B infection". Canadian journal of gastroenterology = Journal canadien de gastroenterologie . 19 (10): 625?9. PMID 16247526 .

[pmid6126007-20] Dienstag JL (February 1981). "Hepatitis B as an immune complex disease". Seminars in Liver Disease . 1 (1): 45?57. doi : 10.1055/s-2008-1063929 . PMID 6126007 .

[pmid11334492-21] Trepo C, Guillevin L (May 2001). "Polyarteritis nodosa and extrahepatic manifestations of HBV infection: the case against autoimmune intervention in pathogenesis". Journal of Autoimmunity . 16 (3): 269?74. doi : 10.1006/jaut.2000.0502 . PMID 11334492 .

[pmid4996611-22] Alpert E, Isselbacher KJ, Schur PH (July 1971). "The pathogenesis of arthritis associated with viral hepatitis. Complement-component studies". The New England Journal of Medicine . 285 (4): 185?9. doi : 10.1056/NEJM197107222850401 . PMID 4996611 .

[pmid19399811-23] Liang TJ (May 2009). "Hepatitis B: the virus and disease" . Hepatology (Baltimore, Md.) . 49 (5 Suppl): S13?21. doi : 10.1002/hep.22881 . PMC 2809016 . PMID 19399811 .

[pmid4098431-24] Gocke DJ, Hsu K, Morgan C, Bombardieri S, Lockshin M, Christian CL (December 1970). "Association between polyarteritis and Australia antigen". Lancet . 2 (7684): 1149?53. doi : 10.1016/S0140-6736(70)90339-9 . PMID 4098431 .

[pmid2023605-25] Lai KN, Li PK, Lui SF, Au TC, Tam JS, Tong KL, Lai FM (May 1991). "Membranous nephropathy related to hepatitis B virus in adults". The New England Journal of Medicine . 324 (21): 1457?63. doi : 10.1056/NEJM199105233242103 . PMID 2023605 .

[pmid82085-26] Takekoshi Y, Tanaka M, Shida N, Satake Y, Saheki Y, Matsumoto S (November 1978). "Strong association between membranous nephropathy and hepatitis-B surface antigenaemia in Japanese children". Lancet . 2 (8099): 1065?8. doi : 10.1016/S0140-6736(78)91801-9 . PMID 82085 .

[1]

[2]

[3]

[4]

[5]

[6]

[7]

[8]

[9]

[10]

[11]

[12]

[13]

[14]

[15]

[16]

[17]

[18]

[19]

[20]

[21]

[22]

[23]

[24]

[25]

[26]