Schwab K S, Shaw R D
Department of Veterans' Affairs Medical Center, Northport, NY.
Baillieres Clin Gastroenterol. 1993 Jun;7(2):307-31. doi: 10.1016/0950-3528(93)90044-s.
Increased knowledge has been gained into the aetiology and pathogenesis of viral gastroenteritis during the past two decades. There are now thought to be four major subclassifications of gastroenteritis-causing viruses; these include rotavirus, enteric adenovirus, calicivirus, including Norwalk and Norwalk-like viruses, and astrovirus. The association of these agents with gastroenteritis has been made by their electron microscopic detection in stool and intestinal biopsy specimens from affected patients, the inability to detect the viruses after recovery from disease, and the subsequent development of immunoglobulin responses after infection; in some instances disease transmission was achieved in human volunteers. The association of these viral agents with gastroenteritis has facilitated the study of classification, epidemiology, immunity, diagnostic tests, methods of treatment and, most importantly, disease prevention strategies such as vaccine development for rotavirus. This chapter highlights the major features of these agents, with special attention being given to the pertinent molecular biology as well as current and future prospects for vaccination. Enteric viral infections of the gastrointestinal tract in patients with AIDS are also discussed.
在过去二十年中，人们对病毒性肠胃炎的病因和发病机制有了更多的了解。目前认为，引起肠胃炎的病毒主要有四大亚类；其中包括轮状病毒、肠道腺病毒、杯状病毒（包括诺如病毒和诺如样病毒）以及星状病毒。通过在患病患者的粪便和肠道活检标本中进行电子显微镜检测、疾病康复后无法检测到病毒以及感染后免疫球蛋白反应的后续发展，确定了这些病原体与肠胃炎的关联；在某些情况下，还通过人体志愿者实现了疾病传播。这些病毒病原体与肠胃炎的关联促进了分类、流行病学、免疫、诊断测试、治疗方法的研究，最重要的是促进了疾病预防策略的研究，如轮状病毒疫苗的研发。本章重点介绍了这些病原体的主要特征，特别关注相关分子生物学以及疫苗接种的现状和未来前景。还讨论了艾滋病患者胃肠道的肠道病毒感染。
