传染病学英文版课件：Viral Hepatitis.ppt

Viral Hepatitis Short View SummaryAcute HepatitisAcute clinical illness caused by the five hepatitis viruses are similar.Illness ranges from asymptomatic to fulminant.Asympotomatic infection are 10 to 30 times more common than sympotmatic ones. Hepatitis A VirusHAV is an RNA virus that is a member of the Hepatovirus genus.HAV is transmitted via the fecal-oral route.It typically causes an acute , self-limited illness, more often symptomatic in adults than in children.HAV is more severe in patients with preexisting chronic hepatitis B or C.Relapsing and cholestatic hepatitis may occur.Diagnosis is by serology(IgM anti-HAV).Treatment is usually not necessary beyond supportive care.Prevention-highly effective HAV vaccines that have markedly reduced incidence where used are available.Passive immunization with immune globulin intramuscularly is effective in postexposure prophylaxis. Clinical, virologic, and serologic course of acute hepatitis A virus(HAV) infectionHAV viremiaFecal sheddingClinical illnessALTInfectionIgG anti-HAVIgM anti-HAV012345678910111213weeks Hepatitis B VirusVirology/EpidemiologyHBV is double-stranded DNA virus in the Orthohepadnavirus genus and the Hepadnavirus family; 10 genotypes have been identified.Worldwide,350 million people are infected chronically with HBV.One million deaths annually result from complications of chronic infection-cirrhosis, hepatocellular carcinoma(HCC).Prevalence in Asia is estimated at greater than 10%, resulting primarily from perinatal transmission, after which the likelihood of acquiring chronic infection is 90%.In adults, transmission of hepatitis B occurs primarily following high-risk behaviors(injection drug use, sexual activity) or after occupational exposure but resolves in greater than 95% of otherwise healthy person. 0481216202428323652100////Clinical, virologic, and serologic course of acute hepatitis B virus infectionWeeksHBV viremiaHBeAgAnti-HBeClinical illnessALTInfectionHBsAgIgM anti-HBcTotal anti-HBcAnti-H