E5398CF5d01 - HEPATITIS A, B, C, ... Geert Leroux-Roels...

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Unformatted text preview: HEPATITIS A, B, C, ... Geert Leroux-Roels Centrum voor Vaccinologie UZGent-UGent Het Hepatitis Alfabet Virus Discovered Genome Envelope Classification HAV 1975 ss-RNA Picorna HBV 1970 ds-DNA HBsAg HepaDNA HCV 1989 ss-RNA E1-E2 Flaviviridae HDV 1978 ds-RNA HBsAg viroid HEV 1990 ss-RNA Caliciviridae HGV 1995 ss-RNA E1-E2 Flaviviridae TTV 1997 ss-DNA Parvoviridae Hepatitis virussen • Virus • Ziektebeeld • Epidemiologie • Diagnose • Behandeling • Vaccinatie Hepatitis A virus - HAV • Pico rna virus – Hepatovirus • 27-29 nm diameter • 1 enkel serotype • Geen omhulsel • Zeer resistent Stabiliteit van HAV Pathogenese van HAV Inname Replicatie in de orofarynx/GI systeem Transport naar de lever = belangrijkste plaats van replicatie Uitscheiding van het virus via de gal naar de darm Uitscheiding in de faeces Korte viremie en immunologische klaring Incubatieperiode: 10 tot 50 dagen Symptomen van een HAV infectie • koorts • grippaal syndroom • anorexie • nausea en braken • moeheid • buikpijn • geelzucht Verwikkelingen van HAV infectie • Fulminante hepatitis • Cholestatische hepatitis zeldzaam • Relapsing hepatitis • Chronische sekwellen geen Verloop van een HAV infectie 1 2 3 4 5 6 7 8 9 10 11 12 13 Week Response Clinical illness ALT IgM IgG HAV in stool Infection The image cannot be displayed. Your computer may not have enough memory to open the image, or the image Viremia < 6 j - <10% >14j - 70-80% HAV in lichaamsvochten Feces Serum Saliva Urine 10 0 10 2 10 4 10 6 10 8 10 10 Lichaamsvochten Infectieuze doses per mL Bron Viral Hepatitis and Liver Disease 1984;9-22 J Infect Dis 1989;160:887-890 Transmissie van HAV • Fecaal - oraal • Contact tussen personen – Household contact – Sexueel contact, MSM – Kinderdagverblijf • Gecontamineerd voedsel of water – Voedselbereiding • Contaminatie via bloed – transfusie, IV druggebruik Transmissie van HAV Unknown 46% Contact of day- care child/employee 6% Other Contact 8% Child/employee in day-care 2% Food- or waterborne outbreak 4% Injection drug use 6% Sexual or Household Contact 14% Men who have sex with men 10% International travel 5% Anti-HAV seropositiviteit vs leeftijd 20 Years Hepatitis A sero-epidemiology in Belgium « In Belgium the number of unprotected individuals younger than 50 years increased in the past 20 years. This number will still increase in the coming years. Considering the more severe course of the disease as age increases, vaccination may become an important strategy to protect susceptible individuals (i.e. pediatric nurses, catering personnel, travelers). » Vranckx R. J. Clin. Virol. 2003, 28S, , S46 Preventie van HAV infecties • Zuiver water • Preventie van voedselcontaminatie • Goede (hand)hygiëne • Passieve immunisering - immuun Ig • Actieve immunisering - vaccinatie QuickTime™ en een TIFF (ongecomprimeerd)-decompressor zijn vereist om deze afbeelding weer te geve HAV verspreidt zich via de handen Na 4 uren worden 16 tot 30 % van het initieel aantal infectieuze HAV partikels op de handen teruggevonden Preventie van HAV infecties...
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This note was uploaded on 05/28/2010 for the course GE BIOM000000 taught by Professor Geertleroux-roels during the Spring '10 term at Ghent University.

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E5398CF5d01 - HEPATITIS A, B, C, ... Geert Leroux-Roels...

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