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复旦大学:《医学微生物学 Medical Microbiology(MBBS)》课程讲义_理论课_Lecture20-Hepatitis B and D Viruses

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Hepatitis B and D Viruses Zhenghong Yuan Key Lab of Medical Molecular Virology Shanghai Medical College, Fudan Universit 2013.11.28

Hepatitis B and D Viruses Zhenghong Yuan Key Lab of Medical Molecular Virology Shanghai Medical College, Fudan University 2013.11.28

HEPATITIS Hepatitis---INFLAMMATION OF THE LIVER resulting in a clinical illness characterized by fever, gastrointestinal symptoms such as nausea and vomiting, and jaundice CAUSED BY VIRUSES- A,B. C,DEG etc OTHER INFECTIONS (yellow fever virus CMV, HSV, rubella virus, and enteroviruses CHEMICALS ALCOHOL ACETAMINOPHEN

HEPATITIS Hepatitis---“INFLAMMATION OF THE LIVER” resulting in a clinical illness characterized by fever, gastrointestinal symptoms such as nausea and vomiting, and jaundice. CAUSED BY: • VIRUSES - HEPATITIS A, B, C, D, E, G etc. • OTHER INFECTIONS (yellow fever virus, CMV,HSV, rubella virus, and enteroviruses ) • CHEMICALS – ALCOHOL – ACETAMINOPHEN

Definitions for Hepatitis Acute: Acute hepatitis is where the disease develops quickly, has symptoms and lasts less than 6 months short term and/or severe Chronic: Lingering or lasting where the symptoms and disease last longer than 6 months May or may not be severe Fulminant: Developing quickly and lasting a short time, high mortality rate Hepatocellular carcinoma: closely associated with hepatitis B and at least in some regions of the world with hepatitis C virus

Definitions for Hepatitis • Acute: Acute hepatitis is where the disease develops quickly, has symptoms and lasts less than 6 months. Short term and/or severe. • Chronic: Lingering or lasting where the symptoms and disease last longer than 6 months. May or may not be severe • Fulminant: Developing quickly and lasting a short time, high mortality rate. • Hepatocellular carcinoma:closely associated with hepatitis B, and at least in some regions of the world with hepatitis C virus

Viral hepatitis needs detail discussion as aIt is responsible for more than 90% cases of both acute and chronic hepatitis aVery important from public health point of view-as preventable u Types a and E cause only acute hepatitis and spread by feaco-oral route Types B, C, D and G cause both acute chronic hepatitis and are transmitted by blood and blood products and body fluids

Viral hepatitis needs detail discussion as It is responsible for more than 90% cases of both acute and chronic hepatitis Very important from public health point of view – as preventable Types A and E cause only acute hepatitis and spread by feaco-oral route Types B,C,D and G cause both acute & chronic hepatitis and are transmitted by blood and blood products and body fluids

Overview of Hepatitis virus Virus Virus group Nucleic Mode of Severity acid infection (chronicity HAV Enterovirus RNA Fecal-oral +(acute) 72(heptoviru HBV hepadnavirus DNA Percutaneous; ++(chroni Permucosal HCV Flavivirus RNA Blood(transfuse on-associated)(chronic B-dependent RNA blood small virus (chronic) HEV Calicivirus RNA Fecal-oral +(acute) HGV ? RNA Blood

Overview of Hepatitis Virus Virus Virus group Nucleic acid Mode of infection Severity (chronicit y) HAV Enterovirus 72(heptoviru s) RNA Fecal-oral +(acute) HBV hepadnaviru s DNA Percutaneous; Permucosal ++(chroni c) HCV Flavivirus RNA Blood(transfusi on-associated) + (chronic) HDV B-dependent small virus RNA blood + (chronic) HEV Calicivirus RNA Fecal-oral +(acute) HGV ? RNA Blood ?

Hepatitis B Virus Zn mANN

Hepatitis B Virus

Background a Hepatitis B virus(HBV) prevalence 8%0-High ● Infected:2 billion 2-7%0-Intermediater ● Chronically infected < 2%-Low 350-400 million

> 8% - High 2-7% - Intermediate < 2% - Low  Hepatitis B virus (HBV)prevalence Background  Infected: 2 billion  Chronically infected: 350-400 million

Outcome of Hepatitis B and c virus Infection HBV HCV Horizontal transmission vertical transmission Horizontal transmission (adults) 95% 5% 95-100% 85-100% Clearance Chronic infection No protective 70% Antibodies Protective Chronic hepatitis antibodies Liver cirrhosis Hepatocellular carcinoma

Outcome of Hepatitis B and C Virus Infection HBV HCV Horizontal transmission (adults) Vertical transmission Clearance Chronic infection Protective antibodies Chronic hepatitis Liver cirrhosis Hepatocellular carcinoma Horizontal transmission No protective Antibodies 95% 5% 95-100% 85-100% 70%

Hepatitis b In the World 2 billion people have been infected (1 out of 3 people 400 million people are chronically intected 10-30 million will become infected each year An estimated 1 million people die each year from hepatitis B and its complications Approximately 2 people die each minute from hepatitis B

Hepatitis B In the World • 2 billion people have been infected (1 out of 3 people). • 400 million people are chronically infected. • 10-30 million will become infected each year. • An estimated 1 million people die each year from hepatitis B and its complications. • Approximately 2 people die each minute from hepatitis B

Hepatitis B in China °1.3 billion people the world's largest population of hepatitis B patients, with nearly half a million people dieing of the liver disease every year 120 million Chinese have tested positive for hepatitis B, which has become a severe public health problem in the country

Hepatitis B in China • 1.3 billion people • the world's largest population of hepatitis B patients, with nearly half a million people dieing of the liver disease every year • 120 million Chinese have tested positive for hepatitis B, which has become a severe public health problem in the country

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