文档介绍：慢性病毒性肝炎的诊治进展
肝 炎
以肝脏炎症和功能障碍为特征的疾病
非感染性
中毒性：酒精、药物、化学、生物
免疫性：自身免疫性肝病---自身免疫性肝炎
原发性胆汁性肝硬化
硬化性胆管炎
感染性
寄生虫、原虫:血吸虫、肝吸虫、阿米巴病、疟疾
细菌: 伤寒、败血症
病毒: YFV, CMV, EBV, HSV → secondary effect
Hepatitis viruses → Viral Hepatitis
病毒性肝炎
由肝炎病毒所致
以肝脏炎症和肝细胞坏死为特征的
一组感染性疾病
临床特点：
乏力
食欲减退、恶心、呕吐
黄疸
肝脾大
肝功异常 ( ALT , AST )
肝炎病毒
Hepatitis A virus (HAV) 甲型肝炎
Hepatitis B virus (HBV) 乙型肝炎
Hepatitis C virus (HCV) 丙型肝炎
Hepatitis D virus (HDV) 丁型肝炎
Hepatitis E virus (HEV) 戊型肝炎
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Hepatitis G virus /GB virus-C (HGV/GBV)?
Transfusion transmitted virus (TTV)??
病毒性肝炎的类型
HAV
甲肝
HEV
戊肝
HDV
丁肝
HBV
乙肝
急性肝炎
重症肝炎
慢性肝炎
原发性肝细胞癌
肝硬化
肝纤维化
HCV
丙肝
Hepatitis B --- HBV
42nm, enveloped spherical particle
Three forms:
Big spherical(Dane particle): 42nm
Small spherical: 22nm spherical
Filamentary: 22nm/100-1000nm
Hepadnaviridae family
which include HBV, WHV, GSHV, DHBV
Etiology
Etiology
Dane’s particle
HBsAg
HBcAg
HBV DNA
DNAP
Hepatitis B virus (HBV)
10 antigenic subtypes(mainly adw, adr, ayw, ayr)
4 antigen – antibody system
HBsAg – anti-HBs
HBeAg – anti-HBe
HBcAg – anti-HBc(Ig M & Ig G)
HBxAg – anti-HBx
Partially double-stranded DNA (HBV DNA)
Very strong resistance
Inactivation needs 100℃10’ or 65℃10h
Etiology
Etiology
Hepatitis B virus
HBsAg major envelope polypeptide
HBsAg middle envelope polypeptide
HBsAg large envelope polypeptide
HBcAg polypeptide
HBV DNA polymerase
HBV terminal protein
HBV plus strand RNA primer
HBV DNA
RNA
RNA
RNA
RNA
X-ORF
P-ORF
S-ORF
PS1-ORF
C-ORF
PC-ORF
HBV DNA
(