传染病Viral-hepatitisVIP免费

1ViralhepatitisTianjinMedicalUniversityGeneralHospitalDepartmentofInfectiousDiseases逄崇杰2难点HBV形态、基因组结构和编码蛋白HBV、HCV的发病机制肝炎的临床分类和临床表现（慢肝和重肝）HBV抗原-抗体系统的组成和意义慢性HBV、HCV的治疗HBV的母婴阻断3重点和问题定义：病毒性肝炎，Dane颗粒，慢性肝炎，窗口期，cccDNA，胆酶分离HBV在人体内的复制过程和发病机制HCV感染易转为慢性的原因HBV抗原-抗体系统的组成和意义各型病毒性肝炎的传播途径病毒性肝炎的临床分类重型肝炎的并发症慢性乙肝、丙肝的药物治疗意外暴露HBV后的预防4IntroductionViralhepatitisisagroupsystemiccommunicablediseaseaffectingtheliverpredominantlycausedbysomekindsofvirusesViralhepatitismaybedividedinto5typesaccordingtoetiology,thatishepatitisA,B,C,DandEAlthoughtheagentscanbedistinguishedbyitsantigenicproperties,the5kindsofvirusesmayproduceclinicalsimilarillness5IntroductionClinicalmanifestationsarecharacterizedbyanorexia,nausea,fatigue,enlargedliverandabnormalliverfunction,apartofcasesmayappearjaundice.HepatitisAandEshowsacutehepatitis,fecal-oralroutepredominantlyHepatitisB,CandDpredisposetoachronichepatitisandisrelatedtolivercirrhosisandhepaticcancer,humoraltransmission.6IntroductionRecently,3kindsofvirusesnamedGBV-C,TTVandSENVarediscovered,andnotyetconsideredtorelatetoviralhepatitis7Etiology:HepatitisAvirus(HAV)HAVisonekindofpicornavirus（微小RNA病毒科）andusedtobeclassifiedasenterovirustype72,butrecently,itisconsideredtobeclassifiedasheparnavirus（嗜肝RNA病毒属）HepatitisAvirionisasphericalparticle,diameter27~32nmConsistsofagenomeoflinear,single-strandedRNA,7.5kb8Etiology:HepatitisAvirus(HAV)Sevengenetypes,1,2,3,4typesfromhumanbodyOnlyoneantigen-antibodysystem.Anti-HAVIgMisdiagnosticevidenceofrecentinfection,IgGisprotectiveantibody.Duringacutestageofinfection,HAVcanbefoundinbloodandfecesofinfectedhuman9Etiology:HepatitisBvirus(HBV)Akindofhepadnavirus（嗜肝DNA病毒科）1965~1967,BlumbergandKrugman,hepatitisassociatedantigen,HAA1972,hepatitisBsurfaceantigen,HBsAg1970,Daneparticle1979,genomewidesequencefinished10BaruchS.BlumbergJuly28,1925~April5,2011Afterreceivingtheprize,hewasinvitedtoChina.“Ispokebeforeseveralthousandpeople,”hetoldTheTimesin2002.“Iprovidedthemwithacopyofthepatent,andnowI’mtoldthatithelpedtochangethedirectionofwhattheyweredoingandledtothesavingofalotoflives.”“Savinglives”,hesaid,“isthewholepointofhiscareer”,and“Thisiswhatdrewmetomedicine.Thereis,inJewishthought,thisideathatifyousaveasinglelife,yousavethewholeworld,andthataffectedme.”NobelPrizeinPhysiologyorMedicinein197611Etiology:HepatitisBvirus(HBV)ThreeparticlesinserumSphericalparticleswithadiameterof22nmandtubularparticles,composedofHBsAgLargeparticleswithadiameterof42nm,namedDaneparticle.ItisacompleteinfectiousHBVparticles,consistsofanouterproteinshell(envelope,containHBsAg)andaninnerbody(core,containHBcAg,HBeAg,HBV-DNAandDNAP)12largeparticlessphericalparticlestubularparticles13Etiology:HepatitisBvirus(HBV)HepatitisBviriongenomeisasmallcircular,partiallydoublestrandedDNAwith3.2kb.HBVDNAisasymmetryinlengthoftwostrands:minusstrand(longstrand,L)hasfulllength.1415Etiology:HepatitisBvirus(HBV)Fouropenreadingframes(ORF)Sregion:includepre-s1,pre-s2andSgene,encodedpre-s1protein,pre-s2proteinandSproteinCregion:includedpre-candCgene,encodeHBeAgandHBcAgPregion:encodedDNApolymerase...