HBV(Hepatitis B Virus) Etiologic agent of most viral hepatitis----in China 病毒性肝炎 glycoprotein HBsAg HBOA DNA多聚酶 双链DNA Tubiform body HBV (ane particle) HBsAg globular Structural pattern of HBV(1965year) On electron microscope, HBSAg globular Partially double-Stranded circular DNA molecular and tubiform body, and Dane particle(t HBcAg: Hepatitis B core antigen, retained in infe- can be detected in HBV-infected host's HBeAg: Hepatitis Be antigen, into blood serum HBsAg: Hepatitis B surface antigen, into blood HBV-X protein Encoded by hbv genome
Etiologic agent of most viral hepatitis----in China HBV (Hepatitis B Virus) On electron microscope, HBsAg globular and tubiform body, and Dane particle(←) can be detected in HBV-infected host’s serum. Structural pattern of HBV (1965year) Partially double-stranded circular DNA molecular HBcAg: Hepatitis B core antigen, retained in infeHBeAg: Hepatitis B “e” antigen, into blood. HBsAg: Hepatitis B surface antigen, into blood HBV Encoded by HBV genome -X protein HBV (Dane particle) glycoprotein globular Tubiform body 6
Pathogenesis of HBV-hepatitis Immuno-injury v The host immune response to the virus is the main determinant of the outcome of infection v The hepatocyte damage result from the virus-infected cells by CD8+ cytotoxic T cells Cellular immune-mediated injury: when host immune response is in normal Acute hepatitis O Hyper-reactive Fulminant hepatitis ● Deficiency Chronic hepatitis ● TOlerance Health” carrier state Soluble immune-mediated injury is involved in-amm", not main mechanism
Cellular immune-mediated injury: when host immune response is--- ⚫ in Normal Acute hepatitis ⚫ Hyper-reactive Fulminant hepatitis ⚫ Deficiency Chronic hepatitis ⚫ Tolerance “Health” carrier state Pathogenesis of HBV-hepatitis : Immuno – injury Soluble immune-mediated injury is involved in-----, not main mechanism ✓The host immune response to the virus is the main determinant of the outcome of infection. ✓The hepatocyte damage result from the virus-infected cells by CD8+ cytotoxic T cells. 7
Jia Subclinical disease (180000) Recovery 99% (240,000) 60%-65% Acute hepatitis Ful 20%-25% hepa ts→| Death (<600 Healthy"carn ACUTE INFECTION25%6-10%(15,000-30,000) (300.000yrin 67%90% Persistent infection Recovery (12000) ↓10%39 Chronic hepatitis 20%6-50%Cirrhosis (12004000 (500-2000) Death 10% carcin (50-200) potentialoutcomes of HBV infection in adults in the United States
Jia-1 potential outcomes of HBV infection in adults in the United States
Acute viral hepatitis Any one of the hepatotropic viruses can cause acute viral hepatitis Morphology Gross appearance: Enlarged reddened liver or greenish if cholestasis Microscopic appearance: ○ Parenchymal changes 1. Hepatocyte injury: (1 Diffuse hepatocyte swelling ballooning degeneration
Acute viral hepatitis Morphology Gross appearance: Enlarged reddened liver or greenish if cholestasis Microscopic appearance: ● Parenchymal changes 1. Hepatocyte injury: ① Diffuse hepatocyte swelling / ballooning degeneration. Any one of the hepatotropic viruses can cause acute viral hepatitis 8
Acute viral hepatitis Microscopic appearance: 2 if cholestasis occurs: canalicular bile plugs HCV: mild-fatty change of the hepatocytes
Acute viral hepatitis Microscopic appearance: ② if cholestasis occurs : canalicular bile plugs *HCV: mild-fatty change of the hepatocytes 9