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1、ViralHepatitisDept.ofInfectiousDiseasesSunYat-senUniversityQ.F.XIEIntroductionViralhepatitisareagroupofdiseases,CausedbyA、B、C、DandE5hepatitisvirusHepatitisAandETransmittedbyfecal-oralroute,presentacuteandself-limitedcourseHepatitisB,CandDSpreadparenterallyeas

2、ilyleadtochronichepatitisClinicalcharactersincludingfatigue,intestinalsymptomstenderandenlargedliverabnormalLFTsjaundiceinsomecasesveryvariableinseveritySignificanceHighlyendemicWideclinicalspectrumHighfatalityrateinseverecasesNospecificpathogenictherapyavail

3、ablenowChronichepatitisBandCverycommon,somemaydeveloptocirrhosisevenHCCSuccessfulvaccinationforHBVandHAVEtiology-HAVHeparnavirusAppearedinbileandfeces,spreadedviafecesNochroniccarrierstatusobservedAnti-HAVantibodytoHAVAnti-HAVIgMindicativeofcurrentorrecentinf

4、ectionappearedveryearly,disappearinabout3monthsmostusefulforconfirmthediagnosisAntiHAVIgGcurrentorpreviousinfectionaprotectiveantibody,conferringimmunitypersistforlifelongtimeEtiology-HBVOrthohepadnavirus,Daneparticle4openreadingframe:S,C,P,X8genotypesA-H,Ban

5、dCpredominantlyinChinaStrongabilityagainsttoenvironment3antigenandantibodysystemHBsAgfoundinserumandotherbodyfluidnotinfectiousitselfsuggestingcurrentinfectionandinfectivityAnti-HBsaprotectiveantibodytoHBsAganindicatorofpastinfectionandimmunitytoHBVreinfectio

6、nsuggestingnon-infectiousHBeAgsuggestingHBVreplicationandhighinfectivitynegativewhenpre-Cmutationbutwithhighlevelofreplicationusefulforevaluationofanti-HBVtherapyAnti-HBeantibodytoHBeAgHBeseroconversionHBeAg(+)→(-)andanti-HBe(-)→(+)HBcAgexistinginthecoreofvir

7、ionamarkerofreplicationandinfectivityAnti-HBcIgMamarkerofacuteprimaryHBVinfectionAnti-HBcIgGappearedinalmostallHBVpresentandpastinfectionhostbodyHBVDNAthegenomeofHBVsuggestingactivevirusreplicationandinfectivityusefulfordiagnosisandevaluationofanti-HBVtherapy

8、HepatitisBVirusEtiology-HCVRNAvirus,6genotypes,mainly1binthecountryMolecularheterogeneitydrivenbyhighmutationrateusuallyproceedtochroniccourseAnti-HCVIgMandIgGtypesantibodytoHCVsuggesting