肝炎病毒-病毒-医学微生物学-26.pptVIP

Hepatitis A virus，HAV甲型肝炎病毒 Biological Properties picornavirus, +ssRNA genome小RNA病毒科 27 nm in diameter ,non-enveloped icosahedral particle 27nm, 球形， 20面立体对称，无包膜 one serotype一个血清型 Pathogenesis致病性 spread via the fecal-oral route粪－口途径传播 Source of infection: patient, inapparent infection传染源: 病人、隐性感染者 Viral shedding in the stool precedes the onset of symptoms by 14d but stops before the cessation of symptoms Symptoms Initial symptoms: fever, fatigue, nausea, loss of appetite, abdominal pain Jaundice HAV的致病性 Asymptomatic infections are very common. As already noted, disease in children is generally milder than that in adults and is usually asymptomatic隐性感染多 No a chronic infection and carrier,not associated with hepatic cancer.无慢性病例和病毒携带者，不与肝癌有关 Complete recovery:99% 预后好 Fulminant hepatitis暴发性肝炎: 1~3 / 1000, 80% mortality rate死亡率 Pregnant women may develop more severe disease. 孕妇感染严重 Mechanisim of pathogenisis致病机理： Laboratory Diagnosis微生物学检查 anti-HAV IgM 抗－HAV IgM by an ELISA or radioimmunoassay Treatment and Prevention防治原则 Control the source of infection控制传染源 Cut down the route of transmission切断传播途径 Passive immunization - Normal immunoglobulin 丙种球蛋白 Active immunizations A killed HAV vaccine a live attenuated HAV vaccine hepatitis B virus, HBV乙型肝炎病毒 There are 3 particles in patient’s blood Dane particle Dane颗粒（大球形颗粒） small spherical particle小球形颗粒 tubulose particle管形颗粒 Dane particle HBV的小球形颗粒 HBV的管形颗粒 Genome of HBV Antigen of HBV抗原组成 hepatitis B surface antigenHBsAg表面抗原 indicates that virus replication is occurring in the liver 说明病毒在肝中复制（机体受感染标志） four phenotypes：adr,adw,ayr,ayw anti－HBs:neutralization antibody中和抗体 hepatitis B core antigen HBcAg核心抗原 not found in blood一般不能检出 anti－HBc non－neutralization antibody非中和抗体 Core IgM indicates recent infection. 抗－HBc IgM说明HBV复制 Core IgG indicates exposure to HBV hepatitis B e antigen e抗原HBeAg the best correlate to the presence of infec