各型肝炎概述、诊断及治疗.pptVIP

VIRAL HEPATITIS Institute for viral hepatitis Second clinical college CQMU Prof. Ren Hong HEPATITIS A VIRUS RNA Picornavirus Single serotype worldwide Acute disease and asymptomatic infection No chronic infection Protective antibodies develop in response to infection - confers lifelong immunity Life circle of HBV GEOGRAPHIC DISTRIBUTION OF HEPATITIS A VIRUS INFECTION Close personal contact(e.g., household contact, sex contact, child day-care centers) Contaminated food, water(e.g., infected food handlers) Blood exposure (rare)(e.g., injection drug use, rarely by transfusion) Transmission of HBV (1) Concentration of HBV in various body fluids High: Blood, serum, wound exudates Medium: saliva, semen, and vaginal secretions Low/not detectable: urine, feces, sweat, tears, breastmilk Perinatal – transplacental transmission, rare (2-5%) Sexual transmission – unprotected sex Transmission of HBV (2) Percutaneous transmission – sharing of injection drug use equipment, needle stick injury, ear-piercing, body piercing, tattooing, inadequate sterilization of medical equipment, scarification Household and interhousehold transmission – less risk but significant - can occur in settings such as shared toothbrushes, razors, combs, washcloths Transmission of HBV (3) More than 1/4 of acute cases have no readily identifiable risk factor Not spread by sneezing or coughing, sharing eating utensils. Risk of Developing Chronic Hepatitis B by Age at Infection Distribution of different genetype of HCV Posttransfusion Hepatitis C Sources of Infection forPersons With Hepatitis C Immunopathology of HBV InfectionHBV感染的免疫病理学 免疫机制影响了HBV感染的慢性化和清除 “The HBV replication is not directly cytotoxic to cells” “In chronic carriers of HBV, such virus-specific T-cell responses are greatly attenuated” “It is now thought that host immune responses to viral antigens displayed on infected hepatocytes are the principal determination of hepatocellular injury” T-cell responses, especially the res