课件：德州检验会.pptVIP

* HSV * HSV概述 HSV感染临床症状没有特异性 HSV-1 型感染率很高，主要通过非性接触；也可通过性传播，并且性传播的方式近年有增高的趋势 HSV-2 型主要通过性传播途径，HIV易感 女性感染率往往比男性要高 主要威胁在孕妇，导致胎儿和新生儿感染 孕妇初次感染HSV通过胎盘传给胎儿/新生儿的可能性远高于HSV复发的 Maternal and Neonatal Herpes Simplex Virus Infections N Engl J Med 2009;361:1376-85. * 先天性和新生儿感染HSV的临床特点 先天性HSV (宫内感染） 流产，宫内发育迟缓，畸形 皮肤小囊泡，疤痕 眼部损伤(脉络视网膜炎，小眼畸形，白内障） 神经损伤（颅内钙化，小头畸形等） 新生儿 涉及皮肤，眼口部损伤， 脑炎 多系统功能衰竭 * HSV孕妇血清学检测意义 孕妇的血清学表现 鉴别孕妇是否高风险 亚型辨别：对临床治疗和孕期指导意义有限 “the type-specific test is useful but not essential” Herpes simplex virus infection in pregnancy and in neonate: status of art of epidemiology, diagnosis, therapy and prevention. Virology Journal 2009, 6:40 * Primary infection or non-primary first episode 30-34 WG Acyclovir 200 mg five times daily Acyclovir 400 mg three times daily from 36 weeks to delivery Genital Lesion + Genital Lesion - Caesarean Section Vaginal Delivery Primary infection or non-primary first episode 34 WG Acyclovir 200 mg five times daily Acyclovir 400 mg three times daily from 36 weeks to delivery Caesarean Delivery Accidental Vaginal Delivery Virus isolation in the mother and newborn Follow up Virus isolation in the mother and newborn To consider neonatal therapy Virus isolation in the mother and newborn To consider neonatal therapy 孕期初次HSV 临床方案 WG: weeks’ gestation * Recurrent infection Acyclovir 200 mg five times daily at 36 weeks gestation Positive cultures negative genital lesions at the time of delivery Caesarean Section caesarean section with intact membranes or within 4-6 hours from membranes rupture 孕期HSV复发的临床方案 WG: weeks’ gestation Vaginal Delivery Negative cultures negative genital lesions at the time of delivery Positive genital lesions at the time of delivery Maternal antivital therapy + Neonatl antiviral treatment (if neonate develops signs of infection) Lazzarotto Tiziana, UO di Microbiologia, Policlinico S. Orsola Malpighi, Bologna * HSV的IgG和IgM检测试剂盒 HSV-1/2 IgG HSV-1 IgG HSV-2 IgG HSV-1/2 IgM 我该选择哪个品牌的Torch试剂，它们真