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1、 人人 类类 疱疱 疹疹 病病 毒毒Human herpes virusesnContains several of the most important human pathogensnA spectrum of diseasesnLife long persistent infectionnPeriodic reactivationMain propertiesnVirion: spherical, 150-200nm core + capsid + envelope dsDNA, encodes at least 100 proteins 35 proteins structure of
2、 virusnReplication: nIn the nucleusnBud from nuclear membranenEarly replication and late replicationnCPE: apart from EBV, others can cause CPE in cell culturenForm of infectionnReplication infection : primary, reactivatednLatent infectionnCongenital infection ( (先天性感染先天性感染) )nCell transformation 病毒病
3、毒 infected cells diseasesHSV1粘膜上皮细胞感觉神经节细胞粘膜上皮细胞感觉神经节细胞多种疾病及潜伏感染多种疾病及潜伏感染HSV2粘膜上皮细胞感觉神经节细胞粘膜上皮细胞感觉神经节细胞生殖器疱疹及潜伏感染生殖器疱疹及潜伏感染VZV皮肤细胞脊髓后根神经节，颅神皮肤细胞脊髓后根神经节，颅神经的感觉神经节经的感觉神经节水痘带状疱疹水痘带状疱疹EBVB细胞，上皮细胞细胞，上皮细胞B细胞细胞传染性单核细胞增多症传染性单核细胞增多症Burkitt瘤，鼻咽癌瘤，鼻咽癌CMV上皮细胞，白细胞，精子细胞上皮细胞，白细胞，精子细胞分泌腺体分泌腺体多种疾病多种疾病HHV6CD4+T细胞细胞婴儿
4、丘疹（唾液传播）婴儿丘疹（唾液传播）免疫低下：持续急性感染免疫低下：持续急性感染HHV7CD4+T细胞细胞幼儿皮疹（唾液传播）幼儿皮疹（唾液传播）与其他疾病关系不清与其他疾病关系不清HHV8不清不清Kaposi肉瘤有关肉瘤有关 Herpes simplex virus (HSV)nPropertiesnTwo serotypes : HSV1 and HSV2nHSV genome: encodes at least 70 proteins some associated with viral replication some envelope proteins associated with
5、 immune reaction viral penetration Herpes simplex virus （ HSV HSV ） PathogenicitynSource of infection patients and carriersnRoutes of transmissionq HSV1： contactq HSV2： sexually / maternal genital infectionqPathology :cytolytic infection nPrimary infection most are inapparent , but result in antibod
6、y production and latent infectionnHSV1 nGingivitis (齿龈炎齿龈炎): most frequentlynKeratoconjunctivitis ( (角膜结膜炎角膜结膜炎) )nSkin infectionnEncephalitisnLatent infection : in the trigeminal ganglia (三叉神经节三叉神经节)nHSV2nGenital herpes: common seennSkin herps : as HSV1nNeonatal herpes : during birth, is a severe d
7、isease skin, eye, month lesion encephalitis multiple organ disseminated ( (多器官多器官感染感染) )nLatent infection：sacral ganglia (骶神经骶神经节节)nLatent and recurrence infection HSV1,HSV2 neuron virus reactivate , replication axon (神经纤维神经纤维) peripheral sites, skin or mucous membraneHSV1：口唇部疱疹口唇部疱疹 HSV2：genital he
8、rpes Varicella-zoster virus （VZV） 水水 痘痘 带带 状状 疱疱 疹疹 病病 毒毒n similar as HSV VZV nakedVZV nakedVZV VZV envelopedenvelopednPathogenicityn Source of infection：patientsn Routes of infection: respiratory tractn Disease：n 水痘水痘( (VaricellaVaricella/chickenpox)/chickenpox)：n 儿童：斑丘疹，水疱，偶见并发症儿童：斑丘疹，水疱，偶见并发症n 孕妇
9、：症状较重，可致胎儿畸形，流产，死胎孕妇：症状较重，可致胎儿畸形，流产，死胎n 免疫低下：重症水痘免疫低下：重症水痘n Latent infection dorsal root ganglia ( (脊髓后根神经节脊髓后根神经节) )nZoster (带状疱疹带状疱疹)nSeen in adultsnSevere pain and vesicle, often in chest Cytomegalovirus (CMV) 巨巨 细细 胞胞 病病 毒毒nThe largest genetic content of HHVnVery species specific and cell specif
10、ic (种属种属和细胞特异性和细胞特异性)nCharacteristic CPE: multinucleated cells and intranuclear inclusionnIs spread cell to cell PathogenicitynSource of infection: patients / inapparent patientsn Routes of infectionnClose contactnMother to child DiseasesnNormal hostnMost are subclinicalnMononucleosis like syndrome
11、(单核细胞增多症单核细胞增多症) a mild illnessnLatent infectionnImmunosuppressed hostnMuch more severenDisseminated pneumonia nIn AIDS: 胃肠炎，视网膜炎胃肠炎，视网膜炎nCongenital and perinated infection 先天和围产期感染先天和围产期感染nMay be severenFetal and new born nCytomegalic inclusion disease (巨细胞包涵体病巨细胞包涵体病)nDeath of fetusnC.N.S defect :
12、 耳聋，智力发育迟缓耳聋，智力发育迟缓nAn important public problem Epstein-Barr virus EBVnViral antigensnLatent phase AgnEBNA1: latent infectionnEBNA2: transformation of cellsnLMP: latent infection transform cellsnReplication AgnEarly Ag: viral replicationnLate Ag: structure proteins Pathogenecity nSpeared by contact
13、:nPrimary infection: more unapparent nLatent infectionnCell transformationnDiseases nInfectious mononucleosisnTransmitted by infected salivanMore seen in adolescents and young adultsnFever, sore throat, WBC incraesednDistinguish with leukemia heterophil agglutination (异嗜凝集试验异嗜凝集试验)：heterophil Ab can agglutinate sheep RBCnBurkitts lymphomanNasopharyngeal carcinomanImmunodeficient host: 淋巴细胞增殖性疾病淋巴细胞增殖性疾病nMicrobiologic diagnosisMicrobiologic diagnosis 异嗜性抗体的检测异嗜性抗体的检测传染性单核细传染性单核细胞增多症的辅助诊断胞增多症的辅助诊断nEBVEBV感染后非特异活化产生的感染后非特异活化产生的IgMIgM抗体，抗体，能非特异凝集牛、绵羊能非特异凝集牛、绵羊RBCRBC，抗体滴度抗体滴度超过超过1 1：8080有诊断意义有诊断意义
