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1、25肝炎病毒总结Jaundice黄疸2021/4/4星期日HepatitisAvirus，HAV甲型肝炎病毒ForexampleAnepidemicofHAVthatoccurredinShanghai,China,in1988inwhich300,000peoplewereinfectedwiththevirusresultedfromeatingAnadarasubcrenataobtainedfromapollutedriver.1988年上海发生甲肝流行,三十万人因食用污染甲肝病毒的毛蚶后引起2021/4
2、/4星期日2021/4/4星期日HAV的致病性粪－口途径传播小肠淋巴结中大量增殖入血并形成病毒血症肝脏为最终靶器官（病毒直接损伤或免疫病理作用）通过胆汁随粪便排出体外Asymptomaticinfectionsareverycommon.Asalreadynoted,diseaseinchildrenisgenerallymilderthanthatinadultsandisusuallyasymptomatic隐性感染多,儿童的症状一般比成人轻,常为隐性感染Noachronicinfectionandcarri
3、er,notassociatedwithhepaticcancer.无慢性病例和病毒携带者，不与肝癌有关Completerecovery:99%预后好Fulminanthepatitis暴发性肝炎:1~3/1000,80%mortalityrate死亡率Pregnantwomenmaydevelopmoreseveredisease.孕妇感染严重Mechanisimofpathogenisis致病机理：Directlyinjurybyvirus病毒直接损伤immunopathogenesis免疫病理作用immun
4、ity免疫性无论显性感染还是隐性感染均能产生抗-HAV的IgM和IgG抗体抗-HAV的IgM在急性期和恢复早期出现阳性可作为甲肝的确诊依据抗-HAV的IgG在恢复后期出现有保护作用，维持终身LaboratoryDiagnosis微生物学检查anti-HAVIgM抗－HAVIgMbyanELISA(enzyme—linkedimmunosorbentassay)orradioimmunoassay用酶联免疫吸附试验或放射免疫检定法TreatmentandPrevention防治原则Controlthesourceo
5、finfection控制传染源Cutdowntherouteoftransmission切断传播途径Passiveimmunization-Normalimmunoglobulin被动免疫--丙种球蛋白Activeimmunizations(主动免疫)AkilledHAVvaccine灭活疫苗aliveattenuatedHAVvaccine减毒的活疫苗hepatitisBvirus,HBV乙型肝炎病毒Introductionapproximately350millionpeopleareinfectedglob
6、allywithHBV.全球约有3.5亿人感染2021/4/4星期日SHAPEANDSTRUCTURE一、形态结构Thereare3particlesinpatient’sbloodDaneparticleDane颗粒（大球形颗粒）smallsphericalparticle小球形颗粒tubuloseparticle管形颗粒DaneparticleCompleteparticle,infectiveHBVspherical，doublecapsid球形,双层衣壳。outercapsid=envelope外衣壳=包
7、膜(脂质双层+蛋白质)HBsAg等innercapsid内衣壳：HBcAg、HBeAginternal内部：DNA---circular,double-stranded环状双链DNApolymerase多聚酶乙肝病毒的结构HBV结构核心：双股未闭合环状DNADNA多聚酶内衣壳：蛋白质外衣壳(包膜)HBeAg:e抗原HBcAg:核心抗原HBsAg(表面抗原)前S2Ag前S1Ag抗原组成：外衣壳抗原：小分子量蛋白:含226个Aa,称S蛋白.即HBsAg中分子量蛋白:含281个Aa,：SPr+前S2抗原.大分子量蛋白:
8、含389个Aa,：SPr+前S2抗原+前S1Ag内衣壳抗原：HBeAgHBcAgHBV的小球形颗粒HBsAg-containingparticles过剩的衣壳蛋白装配而成HBV的管形颗粒小球形颗粒串联而成GenomeofHBVacircular,double-strandedDNAcontainingsingle-strandbreaks不完全双链环状DNAfourope
