Koziel M J
Infectious Disease Unit, Massachusetts General Hospital, Boston 02114, USA.
Am J Med. 1996 Jan;100(1):98-109. doi: 10.1016/s0002-9343(96)90018-2.
So far, five major forms of viral hepatitis, hepatitis A, B, C, D, and E, have been identified. There appears to be at least one other form of enterically transmitted and one other parenterally transmitted hepatotropic virus, but characterization of these viruses is still preliminary. The five hepatotropic viruses have unique structures, yet all the share the property of inducing hepatocellular damage, whether through direct cytotoxicity or through induction of immune mechanisms that lead to hepatocellular necrosis. Advances in molecular biology in the past decade have enabled researchers to understand much about the structure, mechanisms of replication, and viral life cycle of each of these viruses, and successful vaccines have been developed for hepatitis A and B. However, many problems remain unsolved, including which immune system factors are important defenses against these viral infections, which components of the immune system are necessary for a successful vaccine, and what allows some viruses, such as hepatitis B and hepatitis C virus, to become persistent and lead to chronic liver disease.
到目前为止，已确认有五种主要的病毒性肝炎，即甲型、乙型、丙型、丁型和戊型肝炎。似乎至少还有另外一种经肠道传播的肝炎病毒和一种经肠道外传播的嗜肝病毒，但对这些病毒的特性描述仍处于初步阶段。这五种嗜肝病毒具有独特的结构，但它们都具有诱导肝细胞损伤的特性，无论是通过直接细胞毒性作用，还是通过诱导导致肝细胞坏死的免疫机制。过去十年分子生物学的进展使研究人员对这些病毒的每一种的结构、复制机制和病毒生命周期有了很多了解，并且已经成功开发出了甲型和乙型肝炎疫苗。然而，许多问题仍未得到解决，包括哪些免疫系统因素是抵御这些病毒感染的重要防御机制，成功的疫苗需要免疫系统的哪些组成部分，以及是什么使得一些病毒，如乙型肝炎病毒和丙型肝炎病毒，能够持续存在并导致慢性肝病。
