47
H Tiêu hóa
Map 3.7 Viêm gan Virus
HEPATITIS A (HAV)
What is HAV?
It is a RNA picornavirus.
Transmission
Faecal–oral transmission, associated with contaminated shellfish. The virus
passes into bile after replication within liver cells. The immune system is
activated by this process and leads to necrosis predominantly in zone 3
of the hepatic lobule.
Incubation period
•
2–3 weeks.
Investigations
•
Anti-HAV IgM in serum.
Treatment
•
Conservative: vaccine for travellers to endemic areas.
•
Medical: supportive since HAV is often self-resolving.
Complications
•
Rarely acute liver failure.
HEPATITIS B (HBV)
What is HBV?
A partially stranded, enveloped DNA virus. It has an e-antigen that
indicates increased infectivity.
Transmission
•
Vertical transmission.
•
Contaminated needles.
•
Infected blood products.
•
Sexual intercourse.
Incubation period
•
1–5 months.
Investigations
HBV DNA in serum, HBsAg, HBeAg, anti-HBc; HBsAg presents on histology
with a ‘ground glass’ appearance.
Treatment
•
Conservative: education and prevention of disease; vaccine
for at-risk groups, e.g. health workers.
•
Medical: antiviral medications, e.g. pegylated alpha-2a interferon,
adefovir, entecavir, lamivudine, tenofovir, telbivudine.
Complications
•
Hepatic cirrhosis, hepatocellular carcinoma (HCC), fulminant hepatitis B.
VIRUS VIÊM GAN C (HCV)
HCV là gì?
Là 1 virus ARN s i đơn có v bao và là thành viên c a
gia đình flavivirus.
Đư ng lây
•
M con (đôi khi).
•
Kim tiêm b nhi m
•
Ch ph m t máu b nhi m.
Th i k b nh
•
Trung bình (6–9 tu n).
C n lâm sàng
•
Kháng th ch ng HCV trong huy t thanh.
Đi u tr
•
B o t n: giáo d c s c kh e và phòng b nh.
•
N i khoa:thu c kháng virus, e.g. pegylated
alpha-2a interferon, ribavirin, taribavirin, telaprevir.
Bi n ch ng
•
Xơ gan, ung thư t bào gan, liver failure.
VIRUS VIÊM GAN D (HDV)
HDV là gì?
Là 1 virus ARN s i đơn không toàn
v n đ ng nhi m v i virus viêm gan B.
S đ ng nhi m v i HDV là tăng kh
năng suy gan
Đư ng lây
•
Kim tiêm b nhi m
•
Ch ph m t máu b nhi m.
•
Quan h tình d c (hi m).
Th i k b nh
•
1–5 tháng.
C n lâm sàng
•
IgM anti-D huy t thanh.
Đi u tr
•
Pegylated alpha-2a interferon.
Bi n ch ng
•
Xơ gan, ung thư t bào gan.
VIRUS VIÊM GAN E (HEV)
HEV là gì?
Là 1 virus ARN s i đơn.
Đư ng lây
•
Đư ng phân-mi ng, liên quan v i nư c
b nhi m b nh.
Th i k b nh
•
2–3 tu n.
C n lâm sàng
•
IgG và IgM anti-HEV.
Đi u tr
•
Thư ng t gi i h n.
Bi n ch ng
•
T vong cao ph n có thai (~20%).
MAP 3.7 Hepatitis Virus
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