第章肝炎病毒精品.ppt

微生物学检查及预防 诊断为检测抗-HD HDV-RNA 丁型肝炎传播途经与乙型肝炎相似。传播途径和防治原则似HBV 戊型肝炎病毒（hepatitis E virus，HEV） Geographic Distribution of Hepatitis E 球形无包膜颗粒，表面为锯齿状和穗状 直径32～34nm 单正链RNA，全长7500bp，内含3个ORF 至少8个基因型 有实心和空心两种颗粒 主要为粪-口途径传播，潜伏期为10-60天，平均为40天 多表现为急性戊型肝炎(包括急性黄疸型和无黄疸型)、重症肝炎以及胆汁淤滞性肝炎 对肝细胞的直接损伤及免疫病理作用 孕妇感染后病情常较严重，常发生流产或死胎，病死率达10%-20% 致病性及免疫性 Hepatitis E Virus Infection Hepatitis E virus is acquired from contaminated food or water. Typical symptoms include acute nausea, vomiting, diarrhea, and jaundice. Most people recover from the disease after a few months. Hepatitis E can be deadly, however, especially for women in their third trimester of pregnancy. Time course of hepatitis E virus infection 戊型肝炎的特点 与甲型肝炎相比，患者黄疸前期症状重，病程持续时间较长，病死率较高，特别是孕妇感染HEV后。青壮年是HEV最喜欢攻击的人群 戊型肝炎分两种：“流行性” 多发生在雨季和洪水后， “散发性” 在秋冬季呈现高峰 传染性强的时间在患者将要出现症状前（潜伏末期）至发病初期，患者的隔离期为起病后3周 尚末发现有2次发病者 微生物学检查及预防 检测HEV：EM或IEM 检测抗-HEV IgM HEV RNA 预防与甲肝类似 一般预防控制传染源、切断传播途径 免疫预防疫苗研制中 治疗措施自限性疾病、休息、恰当的保肝治疗 防治原则 五种肝炎病毒比较 HAV HBV HCV HDV HEV 病毒结构 +ssRNA dsDNA +ssRNA -ssRNA +ssRNA 传播途径 粪-口 血液、性、垂直传播 粪-口 病情 轻 偶尔严重 亚临床,慢性多见 需HBV协助 孕妇重 慢性及携带者 无 有 无 实验室检查 抗HAV IgM HBsAg-Ab HBcAb HBeAg-Ab 抗HCV HCV-RNA 抗HDV IgM 抗HEV IgM 预防 疫苗 疫苗 无 同HBV 预防为主 Question Examples Compare HAV and HBV according to the following criteria: classification, genome, presence of envelope, clinical features, and transmissions. What are the three important antigens in the HBV particle? * The hepatitis A virus (HAV) is transmitted by the fecal-oral route. It usually causes a mild inflammation of the liver and induces life-long immunity. Rarely, fulminate acute hepatitis occurs which often ends in death. An inactive vaccine efficiently prevents the infection and disease. * HAV replicates very slowly in cell culture without causing a cytopathic effect. In this aspect HAV differs significantly from most picornaviruses, yet it is similar to other hepatitis viruses. To understand this particular feature of HAV, we study the following aspects of the viral life cycle app