Chapter 31 Herpeviruses - 汕头大学医学院

Chapter24(HHV)OutlineClassificationofherpesvirusesCharacteristicsofherpesvirusesQuickdiagnosisofherpesviruses1.Classification(P310Table24-1)α-herpesvirusesHHV-1(HSV-1)HHV-2(HSV-2)HHV-3(VZV)-herpesviruses-herpesvirusesHHV-4(EBV)HHV-8HHV-5(CMV)HHV-6HHV-7ShapeandstructureGlycoproteinspikeLineards-DNACubicnucleocapsidEnvelope120-130nmindiameter162capsomeres2.CharacteristicstegumentCultivation----replicateinintranuclearofhumandiploidcellsandproducecytopathiceffecttypicalCPE:•intranuclearacidophilicinclusionbody•cellfusionformmultinucleargiantcells核内嗜酸性包涵体(exceptEBV)细胞融合形成多核巨细胞Pathogenicity•transmission•infectiousmodeofvirusonhostcellsproliferativelatentinfectioninfectionactivate•commoninfectioustypes(bymanydifferentroutes)*subclinicalinfection*primaryinfectionandlatentinfection*congenitalinfection*integrativeinfection人普遍易感,感染后大多无明显症状FindinginclusionbodyDetectionofviralAgandspecificAbDetectionofviralDNA3.Quickdiagnosis(CMV)(HSV,CMV,EBV)1.Serotype:HSV-1andHSV-22.Pathogenicity•bydirectcontact•bysexualcontact病人和健康带毒者HSV-1:主要是直接密切接触,也有性接触传播HSV-2:性接触传播为主SourceofinfectionRouteoftransmissionHSV-infectionHSV-infection•Primaryinfection•Latentandrecurrentinfection•Congenitalandnewborninfection•Associatedwithcancerprimaryinfection(anew)recurrentinfection(reactivationoflatentvirus)(HSV-1,HSV-2)(siteoflatency)复发性局部疱疹HSV1---唇癌HSV2---宫颈癌大多无明显症状或出现局部疱疹latentinfectionHSV-1---三叉神经节HSV-2---骶神经节Coldsoreorfeverblisters(唇疱疹或热性疱疹)SingleserotypeRouteoftransmissionPrimaryinfectionRecurrentinfection•varicella(chidren)•pneumonia(adults)---zoster(adults)单侧成簇性水疱群沿神经支配的皮肤排列呈带状，伴有神经痛孕妇患水痘易致胎儿畸形、流产或死产通过飞沫和直接接触传播(VZV)1.Species-specific2.Cultivation3.Pathogenicity(slowgrowth,typicalCPE)细胞肿胀、核变大,形成巨大细胞,核内有“猫头鹰眼”的嗜酸性包涵体HCMV只能感染人,只能在人成纤维细胞中增殖Primaryinfection（usuallyasymptomaticinfection）→latentinfection(siteoflatent)Routeoftransmission(transmittedbyavarietyofroute)(CMV)•Verticaltransmission*隐性感染*巨细胞包涵体病(CID)*流产、早产或死胎*先天性畸形/出生后异常*bytransfusion→post-transfusionmono-nucleosisandhepatitis*byclosecontactandsexualcontact*patientswithimpairedimmunefunction→activationoflatentviruscongenitalinfectionperinatalinfection•Horizontaltransmission•Celltransformation&oncogenicpotential致癌潜能(耳聋和智力障碍)肺炎/视网膜炎/食管炎等经产道感染(围生期感染)1.SpecificantigenofEBV(EBNAandLMP)(VCA,EAandMA)ExpressiveantigeninlentantinfectionAntigenassociatedwithproliferativeinfection中和抗原(EBV)2.InfectiousmodeinBcellProliferativeinfectionNon-proliferativeinfectionproliferativeinfection•lentantinfection•malignanttransformation→细胞溶解死亡→恶性肿瘤细胞（嗜B细胞的人疱疹病毒，主要侵犯B细胞）activate3.PathogenicityRouteoftransmissionEBV&humandisease•primaryinfection*asymptomatic*infectiousmononucleosis(puberty)•diseasesassociatedwithEBV-infection*Burkittlymphoma(BL)*nasopharyngealcarcinoma(鼻咽癌)主要通过唾液传播infectiousmononucleosis*positive-heterophilantibody(80%~90%)*positiveEBV-specificantibodyabnormallymphocyte（传染性单核细胞增多症）异嗜性抗体阳性EB病毒的特异性抗体阳性*abnormallymphocytes↑(10%~20%)与CMV感染引起的输血后传染性单核细胞增多症不同(两种抗体均阴性)