H Tiêu hóa
46
Map 3.7 Viêm gan virus
VIRUS VIÊM GAN A (HAV)
HAV là gì?
Là m t ARN picornavirus.
Đư ng lây
Đư ng phân-mi ng, g n li n v i đ ng v t nhuy n th b nhi m b nh.
Virus chuy n vào m t sau khi sao chép trong t bào gan, H th ng mi n
d ch đư c kích ho t b i quá trình này và d n đ n ho i t ch y u
vùng trung tâm ti u thùy gan.
Th i k b nh
•
2–3 tu n.
C n lâm sàng
•
Anti-HAV IgM trong huy t thanh.
Đi u tr
•
B o t n: vaccine cho khách du l ch đ n vùng có b nh.
•
N i khoa: đi u tr h tr vì HAV thư ng t kh i
Bi n ch ng
•
Suy gan c p hi m g p
VIRUS VIÊM GAN B (HBV)
HBV là gì?
Là 1 virus ADN có s i không toàn v n có v . Nó có 1 kháng
nguyên e ch đi m s lây nhi m đang gia tăng.
Đư ng lây
•
M con.
•
Kim tiêm b nhi m.
•
Ch ph m t máu b nhi m.
•
Quan h tình d c.
Th i k b nh
•
1–5 tháng.
C n lâm sàng
ADN HBV trong huy t thanh, HBsAg, HBeAg, anti-HBc; HBsAg hi n
di n trong mô v i hình m t kính m .
Đi u tr
•
B o t n: giáo d c s c kh e và phòng b nh; vaccine cho nhóm có
nguy cơ cao, e.g. nhân viên y t .
•
N i khoa:thu c kháng virus, e.g. pegylated alpha-2a interferon,
adefovir, entecavir, lamivudine, tenofovir, telbivudine.
Bi n ch ng
•
Xơ gan, ung thư t bào gan,v
iêm gan B k ch phát.
HEPATITIS C (HCV)
What is HCV?
It is a single stranded, enveloped RNA virus and a member
of the flavivirus family.
Transmission
•
Vertical transmission (occasionally).
•
Contaminated needles.
•
Infected blood products.
Incubation period
•
Intermediate (6–9 weeks).
Investigations
•
Antibody to HCV in the serum.
Treatment
•
Conservative: education and prevention of disease.
•
Medical: antiviral medications, e.g. pegylated alpha-2a
interferon, ribavirin, taribavirin, telaprevir.
Complications
•
Hepatic cirrhosis, HCC, liver failure.
HEPATITIS D (HDV)
What is HDV?
It is a single stranded defective RNA virus
that co-infects with hepatitis B virus.
Co-infectivity with HDV leads to
an increased chance of liver failure.
Transmission
•
Contaminated needles.
•
Infected blood products.
•
Sexual intercourse (rare).
Incubation period
•
1–5 months.
Investigations
•
Serum IgM anti-D.
Treatment
•
Pegylated alpha-2a interferon.
Complications
•
Hepatic cirrhosis, HCC.
Hepatitis E (HEV)
What is HEV?
It is a single stranded RNA virus.
Transmission
•
Faecal–oral transmission, associated with
contaminated water.
Incubation period
•
2–3 weeks.
Investigations
•
IgG and IgM anti-HEV.
Treatment
•
Usually self-limiting.
Complications
•
High mortality of pregnant women (~20%).
MAP 3.7 Virus viêm gan
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