Chuyn ai cng vi sinh

Mc lc
1. LCH S PHT TRIN ........................................................................ 2
2. PHN LOI VIRUS ................................................................................ 4
3. C IM VI SINH VT HOC CU A VIRUS ..................................... 6
4. S XM NHP VO T BO V NHN LN CA VIRUS11
5. HU QUA CU A S NHN LN ........................................................ 14
6. CAC PHNG PHAP CHN OAN NHIM VIRUS .................... 15
7. NG LY CU A VIRUS.................................................................. 17
8. PHONG BNH ...................................................................................... 17
9. IU TRI ...............................................................................................
18

10. MT S BNH VIRUS THNG GP ......................................... 20

TI LIU THAM KHO ......................................................................... 22

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AI CNG VIRUS
Virus l mt trong nhng sinh vt nh nht, cu to n gin nht.
Chng ch l mt i phn t nucleoprotein mang c tnh di truyn c bn
ca sinh vt. Virus khng c cu to t bo, khng c qu trnh trao i cht
v khng t sinh sn c.
Mt virus hon chnh c gi l mt virion. Trong mt loi virus, cc
virion c kch thc v hnh th nh nhau nn c th kt tinh cc ht virion
thnh tinh th.
Virus bi b t hoa t trong mi trng ngoa i bao, chung chi nhn ln trong
cac t bao s ng. Acid nucleic cua virus cha cac thng tin c n thi t l p
trin h cho t bao ky chu bi nhi
m nh m t ng h p cac a i phn t c hi u c n

cho s nhn ln cua virus.

1. LCH S PHT TRIN
- Vo nhng nm 1880, Louis Pasteur khi nghin cu v bnh di
khng th tm ra tc nhn gy ra bnh ny, v d on v mt mm bnh m
qu nh c th pht hin c di knh hin vi. Nm 1884, nh vi sinh
vt hc ngi Php Charles Chamberland pht minh ra mt b lc (c
bit ti ngy nay l b lc Chamberland hay b lc Chamberland-Pasteur)
vi cc l c kch thc cn nh hn c vi khun. Nh th, ng c th cho
mt dung dch cha vi khun chy qua b lc v hon ton loi b chng
khi dung dch. Nm 1892, nh sinh vt hc ngi Nga, Dmitriy Iosifovich
Ivanovskiy s dng b lc ny nghin cu v th m hin nay c
bit vi tn virus khm thuc l. Th nghim ca ng cho thy chit xut t
l cy thuc l nhim bnh c nghin nt vn c th ly nhim sau khi
lc. D. I. Ivanovskiy xut rng s nhim bnh c th l do mt c t t
vi khun gy ra, nhng khng theo ui tng . L do l v vo thi
im , ngi ta ngh rng tt c cc tc nhn truyn nhim u c th b
cc b lc gi li v ch c th pht trin trn mt mi trng dinh dng
y l mt phn ca thuyt mm bnh. Nm 1898, nh vi sinh ngi H Lan
Martinus Beijerinck lp li th nghim v tin rng dung dch lc vn
cn cha mt dng tc nhn truyn nhim mi. ng nhn thy rng tc nhn
ny ch c th nhn ln trong t bo m ang phn chia, nhng th nghim
ca ng khng ch ra l n c lm t cc ht; ng gi tc nhn ny l mt
contagium vivum fluidum (mm sng c th ha tan) v s dng li t virus
gi n. Beijerinck gi quan im rng virus c bn cht l cht lng, tuy
nhin v sau thuyt ny b bc b bi Wendell Stanley, ngi chng
minh c chng c dng ht. Trong cng nm , Friedrich Loeffler v

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Frosch cho chy ln u tin dung dch cha virus ng vt tc nhn

gy bnh l mm long mng (aphthovirus) qua mt b lc tng t.
- Vo u ca th k 20, Frederick Twort - mt nh vi khun hc ngi
Anh - khm ph ra mt nhm nhng virus m xm nhim vo vi khun,
m nay gi l thc khun th (bacteriophage hay phage), v nh vi sinh hc
ngi Canada gc Php Flix d'Herelle miu t v virus rng: khi thm
chng vo vi khun trn thch agar, s to ra nhng vng vi khun b cht.
ng pha long chnh xc mt dch huyn ph nhng virus trn v khm
ph ra rng nhng dch pha long cao nht (mt virus thp nht), thay v
git cht ton b vi khun, to nhng vng ring bit gm nhng c th b
cht. Tnh ton din tch nhng vng ny v nhn vi h s pha long cho
php ng tnh c s lng virus trong dch huyn ph gc. Phage c
bo trc s l mt gii php iu tr tim nng cho nhng bnh nh thng
hn v t, nhng trin vng ca chng b lng qun cng vi s pht trin
ca penicillin. Nghin cu v phage cung cp ci nhn su hn v s bt
hot v kch hot gen, v mt c ch hu hiu cho vic a nhng gen bn
ngoi vo bn trong vi khun.
- Cho n cui th k 19, virus c nh ngha da trn s ly nhim
ca chng, kh nng chng lc, v vic chng i hi phi c mt vt ch.
Virus tng ch c nui trong thc vt v ng vt. Nm 1906, Ross
Granville Harrison pht minh ra mt phng php nui dng m trong
bch huyt, v sau nm 1913, E. Steinhardt, C. Israeli, v R. A. Lambert
s dng phng php ny pht trin virus vaccinia trong nhng mnh
vn ca m gic mc chut lang nh. Nm 1928, H. B. Maitland v M. C.
Maitland nui virus vaccinia trong nhng th huyn ph ca thn g bm
nh. Phng php ca h khng c p dng rng ri cho ti thp nin
1950, khi poliovirus c nui quy m ln phc v vic sn xut vaccine.
- Mt bc t ph khc n vo nm 1931, khi nh bnh hc Hoa K
Ernest William Goodpasture nui dng virus cm v vi loi virus khc
trong trng g th tinh. Nm 1949, John Franklin Enders, Thomas
Weller, v Frederick Robbins cng nui cy virus bi lit trong t bo phi
ngi, virus u tin c nui m khng s dng m th rn ca ng vt
hay trng. Cng trnh ny cho php Jonas Salk to ra mt vc-xin bi lit
hiu qu.
- Nhng hnh nh u tin ca virus thu nhn c l nh s pht minh
ra knh hin vi in t nm 1931 ca hai k s ngi c Ernst Ruska v
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Max Knoll. Nm 1935, Wendell Meredith Stanley - mt nh sinh ha v

virus hc ngi M - nghin cu virus khm thuc l v nhn thy chng
c to thnh phn ln t protein. Mt thi gian ngn sau, virus ny
c phn tch thnh cc phn protein v ARN ring bit. Virus khm thuc
l l dng virus u tin c tinh th ha v cu trc ca n do c
lm sng t chi tit. Nhng hnh nh nhiu x tia X u tin ca virus kt
tinh c Bernal v Fankuchen thu c vo 1941. Da trn nhng tm
hnh ny, Rosalind Franklin khm ph ra cu trc ADN hon thin ca
loi virus ny vo nm 1955. Cng trong nm , Heinz Fraenkel-Conrat v
Robley Williams chng minh c l chit xut ARN v v protein ca
virus khm thuc l c th t lp rp li to thnh nhng virus c chc
nng, cho thy c ch n gin ny c th l cch virus sinh ra trong t bo
vt ch.
- Na sau ca th k 20 nh du mt k nguyn vng cho s khm ph
virus vi hu ht trong s hn 2.000 loi virus ng vt, thc vt v vi
khun c pht hin trong nhng nm ny. Nm 1957, virus arteri
nga v virus gy bnh tiu chy b (mt loi pestivirus) c pht
hin. Nm 1963, virus vim gan siu vi B cng c Baruch Blumberg
khm ph, v nm 1965, Howard Temin m t loi retrovirus u tin.
Sau , enzym phin m ngc (Reverse transcriptase), loi enzym quan
trng m retrovirus s dng phin m ARN ca chng thnh ADN, c
miu t ln u vo nm 1970, mt cch c lp bi Howard Martin Temin
v David Baltimore. Nm 1983, nhm nghin cu ca Luc Montagnier ti
Vin Pasteur Php, ln u tin phn lp mt loi retrovirus c bit
vi tn gi ngy nay l virus suy gim min dch ngi (HIV).
2. PHN LOI VIRUS:
C nhiu cch phn loi. Theo hnh th, theo tm quan trng hoc
triu chng lm sng. Hin nay c hai cch phn loi cn c s dng:
2.1. Phn loi theo triu chng hc
Cch phn loi c in theo kh nng gy bnh ca virus, n thun li
cho lm sng nhng thng khng chnh xc, bi v mt virus c th gy ra
nhiu bnh cnh lm sng, ngc li mt bnh cnh lm sng cng c th do
nhiu loi virus gy nn.

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- Virus gy bnh ph bin:virus i qua ng mu gy pht ban ngoi

da: bnh u ma, u b, bnh si, rubella, st vng, st xut huyt, bnh
do virus ng rut.
- Bnh h thng thn kinh: bnh bi lit, bnh do Coxsackie, ECHO,
di, vim no, Herpes simplex, si, u, nhim trng chm.
- Bnh ng h hp: cm, cm, virus hp bo, adenovirus.
- Virus gy bnh khu tr da, c, nim mac:Herpes simplex tp 1 gy
bnh quanh nim mc ming, tp 2 gy bnh nim mc ng sinh dc,
Herpangina, zona.
- Virus gy bnh mt:adenovirus, Newcastle virus, Herpes virus, au
mt thnh dch do Enterovirus tp 70.
- Virus gy bnh gan:virus gy vim gan A, B, c, D, E; Herpes virus,
Rubella virus.
- Virus gy vim da dy, rut: Rotavirus, Norwalkvirus.
- Virus ly lan qua ng tnh dc:HIV, Cytomegalovus, Papillioma
virus, Herpes virus, HBV.
2.2. Phn loa i theo ho b chi va nhn AND ho c ARN
Hi n nay c chia thanh 22 ho khac nhau: 8 ho virus cha nhn AND
va 14 ho virus cha ARN
- Cac ho virus cha AND g m co:
Parvoviridae
Polyomaviridae
Papillomaviridae
Adenoviridae
Iridoviridae
Poxviridae
Hepadnaviridae

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- Cac ho virus cha ARN g m co:

Reoviridae
Picornaviridae
Astroviridae
Retroviridae
Caliciviridae
Flaviride
Filoviridae
..
3. C IM VI SINH VT HOC CU A VIRUS:
3.1. Kich thc:
- Virus c kch thc rt nh, nh hn vi khun rt nhiu ln, qua c
lc vi khun v ch c th quan st c bng knh hin vi in t. Hu ht
virus c kch thc trong gii hn t 50- 300nm. n v o kch thc virus
l nanomet (nm)
1nm = 1/1000 micromet.
- Mi loi virus c kch thc nht nh, khng thay i trong sut qu
trnh pht trin. Da vo kch thc, chia virus lm 3 loi:
- Loi nh: kch thc di 100 nm
- Loi trung bnh: 100 - 200 nm
- Loi to: 200- 300 nm
3.2. Hinh da ng:
Mi virus thng c hnh dng nht nh, mang tnh c trng. Cc loi
hnh th virus thng gp:
- Hnh cu: virus cm, si, bi lit, HIV.
- Hnh khi a din: Adenovirus, Herpesvirus
- Mt s dng hnh th khc : hnh que (virus khm thuc l), hnh si
(virus cm nui lu trn phi g), hnh vin gch (Poxvirus), hnh vin n
(virus di), hnh di trng ( bacteriophage T4).

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Hinh 1: Cac hinh da ng cua virus

3.3. C u truc:
3.3.1 Cu trc chung (cu trc c bn):
a.
Acid nucleic (AN):
Mi loi virus u phi c mt trong hai acid nucleic: Hoc ARN (acid
ribonucleic) hoc ADN (acid deoxyribonucleic). Nhng virus c cu trc
ADN phn ln u mang ADN si kp. Ngc li, virus mang ARN th ch
yu dng si n.
Cc acid nucleic (AN) ca virus ch chim t 1 ti 2% trng lng ca
ht virus nhng c chc nng c bit quan trng:
- AN mang mi mt m di truyn c trng cho tng virus.
- AN quyt nh kh nng gy nhim trng ca virus trong t bo
cm th.
- AN quyt nh chu k nhn ln ca virus trong t bo cm th.
- AN mang tnh bn khng nguyn c hiu ca virus.
b. Thnh phn capsid:
Capsid l cu trc bao quanh acid nucleic. Bn cht ha hc ca capsid l
protein. Capsid c to bi nhiu n v capsid bao gm cc phn t
protein c sp xp c trng cho tng virus. Cc n v capsid c gi
l cc capsomer. Cng vi phn li AN ca virus, phn v capsid ca

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virus c th sp xp i xng xon, i xng khi hoc i xng phc hp.

Cu trc capsid ca virus c chc nng quan trng:
- Bao quanh AN ca virus bo v khng cho enzym nuclease v
cc yu t ph hy AN khc.
- Protein capsid tham gia vo s bm ca virus vo nhng v tr c
hiu ca t bo cm th (vi cc virus khng c bao envelop).
- Protein capsid mang tnh khng nguyn c hiu ca virus.
Capsid gi cho hnh thi v kch thc ca virus lun c n nh.
3.3.2 Cu trc ring:
Cu trc ring cn c gi l cu trc c bit, ch c mt s loi vus
nht nh thc hin nhng chc nng c trng cho virus .
a. Cu trc bao ngoi (envelop):
- Mt s virus (Herpesvirus, HIV, virus cm, virus vim gan B), c
thm bao ngoi, bc bn ngoi v capsid. Bao ngoi ca virus c cu to
phospholipid hoc glycoprotein. Bao ngoi thng c to nn t mng
bo tng hoc mng nhn ca t bo ch. Nhng virus khng c bao ngoi
gi l virus trn (Adenovirus, virus vim gan A, Reoviridae).
- Bao ngoi thng cha cc khng nguyn, tham gia vo qu trnh
bm ca virus, tham gia vo giai on lp rp v gii phng virus ra khi t
bo. Bao ngoi cn gi tnh n nh ca kch thc virus. Cc virus c bao
ngoi cha lipid d b bt hot bi cc dung mi nh ether, mui mt.
- Mt s virus c cc gai nh (spikes) nm trn b mt bao ngoi. Cc
gai nh ny l nhng glycoprotein, gip virus bm ln b mt ca t bo
ch. V d: gp 120 ca HIV, gip virus bm vo v tr thch hp trn b mt
t bo ch. T ngng kt hng cu (hemagglutinin: HA) ca virus cm, gip
virus bm ln mng hng cu ca mt s loi ng vt v loi ngi, gy
hin tng ngng kt hng cu. T ngng kt hng cu kch thch sinh
khng th ngn ngng kt hng cu, ng dng xc nh tn ca chng
virus mi phn lp c hoc chn on huyt thanh bnh nhn.
- Chc nng ring ca envelop:
Tham gia vo s bm ca virus trn cc v tr thch hp ca t bo
cm th.
Tham gia vo giai on lp rp v gii phng virus ra khi t bo sau
chu k nhn ln.
Envelop tham gia vo hnh thnh tnh n nh kch thc v hnh thi
ca virus.
To nn cc khng nguyn c hiu trn b mt virus. Mt s khng
nguyn ny c kh nng thay i cu trc.
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Hinh 2: C u truc chung cua virus

b. Enzym:
Trong thnh phn cu trc ca virus c mt s enzym, l nhng
enzym cu trc, chng gn vi cu trc ca ht virus hon chnh. Cc enzym
cu trc c th gp: Neuraminidase, ADN hoc ARN polymerase, men sao
chp ngc (Reverse transcriptase). Mi enzym cu trc c nhng chc
nng ring trong chu k nhn ln ca virus trong t bo cm th v chng
cng mang tnh khng nguyn ring, c hiu mi virus.
V d: ARN polymerase ph thuc ARN (tng hp ARN), ADN
polymerase (tng hp ADN), ADN polymerase ph thuc ARN (enzyme
sao m ngc RT, gip tng hp ADN trung gian t ARN HIV),
Neuraminidase (khng nguyn NA, c virus cm, gip virus giai on
thot ra khi t bo).
3.4. Nui cy:
Virus khng nui c trn mi trng nhn to m ch nui c trn
h thng t bo sng gm: ng vt cm th, phi g v trn cc t bo nui
invitro.
3.4.1. ng vt cm th:
Mi loi virus c mt vi ng vt cm th ring. Cc ng vt th
nghim thng c s dng l chut nht trng, chut (chut cn non
ang b m), kh, th, g ... ng gy nhim ty thuc vo tng loi virus

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v ng vt: ung, tim, nh mi, mt. Sau gy nhim cc virus c th c

tm thy no, phi, gan, hch, mu ... ca ng vt b bnh.
3.4.2. Phi g:
Thng dng nht l cc phi g 7 - 10 ngy tui.
3.4.3. T bo nui:
Cc t bo sau khi c tch ring r c th c nui trong ng
nghim bng cc mi trng nui c bit. Ti y, cc t bo bm vo
thnh ng nghim v phn chia nhiu ln to thnh mt lp t bo y ng
nghim, gi l nui t bo mt lp. Cc loi t bo thng c dng
nui virus:
+ T bo nui mt ln: c ngun gc t phi g, thn kh, phi ngi...
c c im ch nui c mt ln, khng th cy truyn nhiu ln c.
+ T bo thng trc: l loi t bo c th cy truyn c nhiu ln.
V d: t bo BHK-21 (dng t bo t thn chut Hamster), t bo Vero (t
no thn kh xanh chu Phi), t bo mui C6/36, cc t bo c c tnh ung
th nh t bo Hela, Hep - 2.
+ T bo lng bi ca ngi: l loi t bo gi nguyn c s lng
nhim sc th ban u, khng c tnh cht ung th, c th cy truyn c
nhiu ln (t 20- 50 ln). V d: nguyn bo si lng bi ca ngi nh
dng t bo MRC-5.
T bo nui c cha trong ng nghim, trong chai hoc a petri,
cng vi mi trng thch hp nh Eagle's v huyt thanh ng vt. Cc
virus trong nui t bo c th c pht hin trong cc t bo nui hoc
ngay trong dch nui.
3.5. Tinh ch t ky sinh cua virus:
Virus khng c cu to t bo, khng c qu trnh trao i cht, khng
t sinh sn c. Bi v chng khng c c quan siu cu trc nh ribosom,
khng c ngun nng lng c lp, khng c h thng enzyme chuyn ha.
V vy virus ch th hin c qu trnh sng ca mnh khi k sinh trong cc
t bo sng, thc cht l s dng cc acid amin, cc nucleotid, cc enzyme,
ngun nng lng, cc ribosom... ca t bo sng tng hp nn cc virus
mi. Tnh k sinh trong t bo sng l tuyt i bt buc ca virus. ngoi
t bo sng, virus ging nh vt v sinh, thm ch kt tinh di dng tinh
th.
3.6. Sc khng:
Virus thng b hy d dng nhit cao 500C 600C/30
pht (tr mt s ngoi l nh virus vim gan B, papovavirus ). Ngc li
nhit thp li l iu kin tt bo qun virus. lnh su (-350C, 900C) nhiu virus c th gi c hot tnh trong nhiu nm. trng thi
ng kh virus c th gi c hot tnh nhim trng trong nhiu nm.
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Cc khng sinh ni chung khng c tc dng c ch hoc dit

virus (tr cc khng sinh c tc dng nh hng n qu trnh sinh tng hp
acid nucleic nh rifampicin...).
- Cc virus cha lipid d b hy bi cc dung mi ha tan lipid nh:
mui mt, ether.
Cc tia x, tia cc tm c tc dng ph hy acid nucleic ca
virus.
Cc virus thng bn vng pH t 5 - 9. Mt s virus bn
vng vi pH acid (3-5) nh Enterovirus.
4. S XM NHP VO T BO VA NHN LN CU A VIRUS:
Thc cht s nhn ln ca virus trong t bo sng (t bo cm th) l
qu trnh virus truyn thng tin di truyn ca chng cho t bo ch, bt t
bo ch hot ng theo thng tin ca virus v tng hp nn cc thnh phn
ca virus.
4.1. Cach nhn ln cua virus:
Cch nhn ln ca virus tu thuc vo loi acid nucleic. Trong qu
trnh nhn ln ca virus c s tham gia ca nhiu enzyme ca c virus v
ca c t bo ch.
- Cch nhn ln ca virus cha ADN
ADN virus ---------- Nhn bn-------------ADN virus
Virus mi

ARNm virus ------Ribosome------- capsid

- Cch nhn ln ca virus cha ARN: Virus c ARN, nhn ln
cn n ADN: V d Retrovirus gm HIV-1, HIV-2 v HTLV-1 cha ARN
1 si (+). Cc thng tin di truyn ca virus c m ha trong phn t ARN
ca virus s c sao chp ngc to ra mt phn t ADN trung gian
(bnh thng thng tin ch c truyn t ADN sang cho ARN), qu trnh
ny cn n enzyme sao chp ngc reverse transcriptase (RT) hay enzyme
ADN- polymerase ph thuc ARN.
4.2. Cc giai on ca qu trnh nhn ln :
Qu trnh nhn ln ca virus l mt qu trnh lin tc, nhng ngi
ta c th phn chia ra lm 5 giai on.
- Giai oan h p phu cua virus :
Virus di chuy n trong cac dich
gian bao tim n t bao cam thu .
Sau o virus se g n vao cac thu th trn b m t t bao. Cac virus khac nhau
11

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co nhng thu th khac nhau nhng thng la cac glycoprotein. S g n virus

vi thu th phan anh s phu h p ngu nhin gia c u truc b m t cua virus
vi cac thanh ph n b m t t bao. VD: virus Rhino g n vi ICAM-1 va virus
Epstein-Barr nh n bi t thu th CD21 trn t bao lympho B. S hin din hay
v n m t cac thu th ong vai tro quan tro ng quy t inh
tinh hng bao va
sinh bnh
ho c cua virus. Khng phai t t ca t bao trong c th ky chu cam
thu u mang thu th c n thi t. VD nh virus Polio chi co th g n vao cac t
bao trong h th n kinh trung ng va h tiu hoa. Mi t bao cam thu co th
cha ti 100.000 thu th cho 1 loa i virus nh t inh.

- Giai oan xm nhp cua virus :

Sau khi g n vao mang t bao, virus c a vao bn trong t
bao. Trong 1 s trng h p virus xm nh p qua trung gian cac thu th , cung
co trng h p virus xm nh p trc ti p qua mang sinh ch t. M t s trng
h p khac co s hoa mang cua virion vi mang sinh ch t cua t bao. Enzym
ci vo cua t bao se giup virus ci vo. Coi vo la s tach acid nucleic ra khoi
thanh ph n c u truc bn ngoai cua virus. B gen cua virus c phong thich
nh la 1 acid nucleic t do hay nh la 1 nucleocapsid. Cac nucleocapsid
thng cha cac polymerases. giai oa n nay kha nng gy nhim cua
virus t bao me bi m t i.
- Giai oan t ng hp cac thanh ph n c u truc cua virus:

y la giai oa n phc ta p nh t cua qua trin h nhn ln cua

virus. Qua trinh t ng h p trong chu ky tng trng cua virus xay ra sau khi
virus ci bo ao ngoai. V n thi t y u cua qua trin h sao chep la cac ARN
thng tin c hi u phai c sao chep t acid nucleic cua virus s bi u
hin va nhn i thng tin di truy n c thanh cng. Cac virus khac nhau
s du ng cac con ng khac nhau t ng h p ARN thng tin, tuy thu c vao
c u truc acid nucleic cua virus.

Trong qua trinh nhn ln cua virus, t t ca cac a i phn t

c hi u cua virus c t ng h p trong 1 trin h t co t chc cao. M t s
nhim trung do ADN- virus gy ra thi cac protein sm c t ng h p ngay
sau khi bi nhim va cac protein mu n chi c ta o thanh sau khi ADN c
t ng h p. Ng c la i, h u h t (nhng khng phai t t ca) cac thng tin di
truy n cua ARN virus u bi u hin cung 1 luc. Thay i ln nh t trong
phng cach bi u hin gen c tim th y cac ARN virus. M t s virus co
men polymerase (virus Orthomyxo, virus Reo), 1 s s du ng thng tin gen
phu (subgenomic menages), i khi hin h thanh bi s ghep n i (virus
Orthomyxo, virus Reo) va m t s virus t ng h p cac ti n ch t polyprotein
ln sau khi x ly va che tach se ta o thanh san ph m gen cu i cung( virus
Picorna, virus Retro).

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Pha m vi hoa t ng cua cac men c hi u cua virus lin

quan n cac qua trinh nay thay i mi nhom. ADN-virus nhn ln trong
nhn thng s du ng ADN, ARN polymerase va cac enzym x ly cua t bao
ky chu. Cac virus ln hn nh virus Herpes, virus Pox thi c l p vi chc
nng t bao hn cac virus nho. y la 1 ly do ma cac virus co kic h thc ln
hn thi nhay cam hn vi cac thu c khang virus vi nhng qua trinh c
trng cua virus nh la nhng mu c tiu sn co thu c tac du ng.

Cac vi tri bn trong t bao ni ma cac s kin khac nhau

xay ra trong qua trin
h nhn ln thay i theo nhom. M t cach t ng quat,
protein virus c t ng h p t bao ch t, ADN c sao chep nhn, va b
gen ARN thng c nhn i trong t bao ch t, m c du cung co nhi u
ngoa i l .
- Giai oan l p rap:
Cc protein v ca virus s t lp rp vi acid nucleic to
thnh virus mi. Qu trnh lp rp c th thc hin nhn t bo ch
(herpesvirus) hoc bo tng (virus cm). Vic lp rp thnh cng s to ra
cc virus hon chnh, c kh nng gy nhim, cn gi l cc virion. Vic lp
rp sai, thiu acid nucleic, ch c v capsid, s to ra cc virus khng hon
chnh (defective virus). Vic lp rp sai, c v capsid ca virus v c acid
nhn ca t bo ch s to ra cc virus gi (pseudovirion).
- Giai oan giai phong cac hat virus ra khoi t bao :
Cc virus sau khi c lp rp s tin ti st mng t bo
thot ra ngoi bng cch ny chi hoc theo kiu t ph v lm hu hoi t
bo.
Thi gian nhn ln ca virus thng ngn hn rt nhiu vi
khun. T virus ban u, mt t bo virus c th to ra hng trm, hng ngn
virus sau khong mt thi gian khong 5- 6 gi (virus cm), hoc 1- 2 ngy
(virus Adeno, virus si...). V vy nhim trng cp tnh do virus thng c
c im l bnh ngn, khi bnh t ngt.

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Hinh 3: Chu ky nhn ln cua virus

5. HU QUA CU A S NHN LN:
Khi virus xm nhp vo c th sng v nhn ln trong cc t bo to
ra cc th h virus mi ng thi virus cng to ra mt phn ng ca c th
v c biu hin mc ton thn hoc mc t bo.
5.1. i vi toan thn:
- Virus gy ra mt qu trnh nhim trng cho c th sinh vt di dng
mt nhim trng cp tnh, nhim trng mn tnh, nhim trng tim tng v
nhim trng virus chm.
- i vi h thng min dch ca c th, virus kch thch to ra mt p
ng min dch c hiu vi cc khng nguyn ca virus bao gm c p ng
min dch t bo v min dch dch th.
- Nhim trng do virus c th gy ra tnh trng gim st min dch tm

thi (tr em sau mc bnh si), hay suy gim min dch vnh vin (nhim
HIV/AIDS). Trong trng hp ny ngi bnh thng b bi nhim hoc
nhim trng c hi.
5.2. i vi cac t bao bi nhim virus:
C th c nhiu hu qu khc nhau ty thuc vo bn cht sinh hc ca
t bo v ca virus.
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T bo b hy hoi.

T bo v virus cng tn ti: provirus (tin virus).

T bo sinh ra cc ht vi: V d: Tiu th Negri ch thy

trong bo tng ca cc t bo thn kinh b nhim virus di, c th quan st
c khi nhum v soi bng knh hin vi quang hc.
-

T bo b tn thng nhim sc th.

T bo tng sinh v hn to ra khi u hoc ung th.

Kch thch t bo sinh Interferon: Interferon (IFN) l nhng

glycoprotein c trng lng phn t thp, do cc t bo tit ra sau khi b
nhim virus. IFN c tc dng c ch s nhn ln ca virus.
6. CAC PHNG PHAP CHUN OAN NHIM VIRUS
6.1. B nh ph m:
Mu n cho vic ch n oan chinh xac c n phai l y b nh ph m
ung ky thu t. C n phai bi t ro thi gian nhim virus va c quan nhim
virus. T t nh t la l y b nh ph m sm trong vong 1-3 ngay u. Ly bnh
phm phn lp virus tu theo c quan virus gy bnh, tu theo thi gian
nhim virus. Bnh phm c th l dch hng mi, mu, dch no tu, nc
tiu, phn. Bnh phm c bo qun lnh, xt nghim sm trong mt vi
gi u.
Cc bnh phm c kh nng bi nhim vi khun (nh nc
hng mi, nc tiu, phn) cn x l dit khun v nm bng khng sinh.
6.2. Phng phap phn lp virus
Virus bt buc k sinh trong t bo sng nhn ln. V vy t
bo nui, phi g, ng vt th nghim c s dng nui cy phn lp
virus.
Phn lp virus trn 2 loi t bo: t bo nui trong ng nghim
(hay t bo nguyn pht mt lp nh t bo thn kh, t bo thai ngi), t
bo thng trc (Vero, Hep 2, Hela, t bo mui C6/36). Mi loi virus
nhy cm vi mt s t bo nht nh. Bnh phm c cy vo t bo
thch hp v nhit 35-37oC.
Tu theo chu k nhn ln ca virus m theo di thi gian di
hay ngn pht hin t bo b tn thng (cc hoi t hay plaque
forming unit). Mt s virus khng gy hiu ng t bo (CPE) nh virus cm,

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nhng chng c t ngng kt hng cu (haemagglutinin), v vy pht hin

c virus bng hin tng hp ph hng cu (haemadsorption).
Nui cy virus trn t bo cn theo di mt thi gian di (trn 4
tun) v ph thuc vo nhiu yu t nh loi bnh phm, c t c trong
bnh phm, ly nhim vi khun v c im dng t bo nui. Mt s virus
cha nui cy c trn t bo nh virus vim gan B, virus vim gan C,
parvovirus.
-

Mt s virus (virus cm...) c th phn lp trn phi g.

C th gy bnh thc nghim trn ng vt: chut nht mi

sinh, kh, mui...
Sau khi nui cy virus, xc nh virus nghi ng bng cc k
thut min dch nh phn ng c ch ngng kt hng cu, phn ng trung
ho, phn ng min dch hunh quang vi khng huyt thanh c hiu type,
k thut hin vi in t, k thut sinh hc phn t nh PCR.
6.3. Phng phap huy t thanh hoc:
Phng php ny pht hin khng th c trong huyt thanh
bnh nhn. Khng th IgM xut hin u tin, theo sau l IgG. Khng th
IgM mt sau vi tun, trong khi IgG tn ti vi nm. V vy chn on huyt
thanh nhim trng virus cn xc nh s tng hiu gi khng th hoc s c
mt ca IgM. xc nh s tng hiu gi khng th cn ly mu bnh nhn
hai ln, ln u ly sau khi khi pht bnh 3-4 ngy, ln sau cch ln u 2-3
tun. Tu theo k thut xt nghim, c th ly mu tnh mch khng chng
ng tch ly huyt thanh hoc ly mu mu c chng ng (ly huyt
tng).
-

Cc phn ng huyt thanh thng s dng:

Phn ng ngng kt th ng: ngng kt latex, ngng kt

hng cu th ng.

Phn ng sc k min dch (immunochromography): pht

hin nhanh khng th trong huyt thanh hoc huyt tng bnh nhn.

Phn ng ELISA: thng dng pht hin khng th

(IgM, IgG) trong nhiu trng hp nhim virus. V d: HIV, cc virus vim
gan, SARS, cm, si, quai b, Rubella, thu u-zona, herpes.

Phn ng kt hp b th: t lm v k thut phc tp.

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Phn ng trung ho (tin hnh trn t bo nui).

Phn ng Western blot: khng nh chn on (v d

trong nhim HIV).
6.4. Phng phap sinh hoc phn t:
K thut sinh hc phn t: pht hin virus v nh lng virus. V d:
k thut PCR pht hin ADN virus (virus vim gan B), RT-PCR pht hin
ARN virus trong bnh phm (virus cm, SARS, HIV), realtime PCR xc
nh s lng bn sao ca virus trong mt n v th tch mu (nh lng
HIV, HBV).
7. NG LY CU A VIRUS:
Virus c truy n qua cac ng: tim truyn, v t thng (VD: HIV,
Vim gan B, C); thng qua ng mi, do cc git kh dung t ho (VD:
cum H5N1, virus Da i, virus EBOLA,); giao phi, vt cn t (VD: HIV,
ZIKA, virus Da i,)

Hinh 4: ng ly truyn cua virus

8. PHONG BNH:
8.1. Phong b nh khng c hi u:
- Pht hin sm v cch ly bnh nhn.
- T iu chnh hnh vi, s dng cc phng tin phng trnh ly
lan, v sinh c nhn.
- Kh trng, tit trng dng c, mi trng, cc cht thi ca
bnh nhn.
-

Dit cn trng truyn bnh (mui, ve).

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8.2. Phong b nh c hi u:
S du ng cac loa i vaccin virus. Mu c ich cua cac loa i vaccin virus
la dung ap ng min dich
cua ky chu nga bnh
virus. Chung nga la
cach co hiu qua nh t nga cac trng h p nhim virus tr m tro ng. Cac
vaccin thng dung:
- Vaccin s ng giam c lc.
- Vaccin tai t h p.
- Vaccin ch t.

9. IU TRI:
9.1. Hoa dc tri li u khang virus:
iu tr mt nhim trng do virus ngi ta cn lu mt s im
sau y:
Khng sinh khng c tc dng ngn cn qu trnh nhn ln ca
virus, do vy khng c dng iu tr cn nguyn gy bnh. Tuy vy
khng sinh vn cn c dng chng bi nhim vi khun trong cc bnh
nhim trng do virus.
Nhim trng do virus dn n mt tnh trng suy gim min
dch tm thi hoc i khi vnh vin (nh i vi virus HIV). V vy trong
iu tr nhim trng do virus cn phi lu s dng mt s thuc kch thch
min dch. V d: leuvamisol, isoprinosine.
Thuc khng virus: mt s thuc iu tr c hiu i vi cc
nhim trng do virus, nhng cn rt t v hiu qu cha cao.
Thuc iu tr c hiu cho virus phi c nhng yu cu sau:
Thuc phi xm nhp c vo trong t bo, c bit l cc t
bo b nhim virus.
Thuc ngn cn qu trnh tng hp ra cc virus nhng khng
hoc t nh hng n hot ng ca t bo.
c c nhng thuc diu tr virus, ngi ta phi nghin
cu rt k cc qu trnh nhn ln ca tng loi virus v tm cch tc ng
vo tng giai on ca chng.

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9.2. Cac loa i thu c khang virus:

Bng: Mt s thuc khng virus v c ch tc ng
Thuc
Acyclovir

Zidovudin (AZT)

C ch tc ng
c ch ADN polymerase virus,
dn n c ch tng hp acid
nucleic virus
c ch ADN polymerase virus
c ch ADN polymerase virus
c ch ADN polymerase virus
c ch ADN polymerase virus
c ch RT (reverse trancriptase)
c ch tng hp ADN virus
c ch RT

Didanosine (ddI)
Zalcitabin (ddC)

c ch RT
c ch RT

Stavudin (d4T)
Saquinavir
Indinavir
Ritonavir
Amantadin
Rimantadin
Ribavirin
Oseltamivir (Tamiflu)

c ch RT
c ch protease
c ch protease
c ch protease
Ngn cn ci v virus
Ngn cn ci v virus
ngn cn tng hp ARNm virus
c ch neuraminidase virus

Cidofovir
Foscanet
Vidarabine
Ganciclovir
Lamivudin (3TC)

iu tr virus
Herpesvirus

Herpesvirus, CMV
Herpesvirus, HBV
Herpesvirus, HBV
Cytomegalovirus
HIV (t 1995)
HBV
HIV (ln u: 1987)
HBV
HIV (t 1991)
HIV (t 1992)
HBV
HIV (t 1994)
HIV (t 1995)
HIV (t 1996)
HIV (t 1996)
Virus cm A
Virus cm A
Virus cm A, B
Virus cm A, B

9.3. Interferon:
Interferon c hiu qu cao khi dng giai on u nhim
virus. Interferon c dng iu tr mt s bnh nhim virus nh vim gan
B, vim gan C, di, st xut huyt, herpes.
Hin c nhiu loi Interferon c sn xut trn th trng nh
Interferon alfa 2a, Interferon alfa 2b, Interferon beta... Tc dng iu tr ca
cc loi ny tng t nh nhau. Gn y, ngi ta c cp n Pefylated
Interferon c tc dng hp thu chm, thi tr chm, ch cn mt mi cho mt
tun, kt qu khng thua km so vi Interferon 3ln/tun.

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9.4. Globulin min dch:

Mt s globulin min dch c hiu c s dng iu tr nh:
globulin min dch chng virus vim gan B, virus di, virus Rubella.
10. MT S BNH VIRUS THNG GP:
10.1. Cc loi bnh nhim trng do virus:
Nhim trng virus c th phn chia thnh cc loi ph thuc vo triu
chng bnh v thi gian tn ti ca virus trong c th:
Nhim virus cp tnh c c im ni bt l thi gian bnh
ngn, khi pht t ngt, rm r. V d: vim gan virus A cp, nhim virus
cm.
Nhim virus khng c triu chng: virus trong c th mt
thi gian ngn ri thi tr ra nhanh.
Nhim virus mn tnh: Virus tn ti dai dng c km theo cc
triu chng lc ban u, xen k cc thi k khng triu chng l nhng thi
k ti pht ca bnh (thi k hot ng). V d: Vim gan virus B mn tnh.
Nhim virus tim tng: virus tn ti dai dng trong t bo ch.
Virus trong c th di dng tin virus (provirus), acid nucleic ca chng
gn vo b gen ca t bo ch. Khi c mt kch thch no (nh chn
thng, stress, gim min dch...) virus c th nhn ln v ti hot ng gy
bnh cp tnh cho c th. V d: Herpers simplex virus, virus thu u- zona
tn ti trong hch thn kinh.
Ngi lnh mang virus: virus tn ti dai dng trong c th,
khng c triu chng, nhng c km theo thi virus ra mi trng xung
quanh. Trng thi ny thng c hnh thnh sau khi bnh phc v ng
vai tr quan trng trong dch t hc v bnh nhn tr thnh ngun ly rt
nguy him. V d: ngi mang virus vim gan B.
Nhim virus chm: y l mt hnh thi rt c bit do nhim
trng virus. Thi gian nung bnh (khng c triu chng) ko di trong nhiu
thng hoc nhiu nm, tip theo l s pht trin chm nhng khng ngng
tng ln ca triu chng v kt thc bng nhng tn thng rt nng hoc t
vong. V d: bnh vim no ton b bn cp gy x cng- SSPE (Subacute
sclerosing parencephalitis) m nguyn nhn l virus si, bnh Kuru v gn
y bnh di cng c xp vo nhm ny.

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10.2. Mt s virus gy bnh thng gp:

- Cc virus gy bnh ng h hp: virus cm, Coronavirus (nh virus
SARS).
- Cc virus gy bnh h thng thn kinh: virus bi lit, virus di, virus
vim no Nht Bn.
- Cc virus gy bnh da, nim mc: Herpesvirus, virus si, virus thu
u-zona.
- Cc virus gy bnh ng tiu ho: Rotavirus.
- Cc virus gy bnh vim gan: virus vim gan A, B, C, D,E.
- Cc virus gy bnh st xut huyt: Dengue
- Cc virus gy bnh khc: virus gy hi chng suy gim min dch
(HIV)
Bnh do virus Ebola (tng c bit n l bnh St xut huyt do
virus Ebola) l bnh nguy hi m, thng dn n t vong, vi t l t vong
ln n 90%. Bnh tn cng ngi v ng vt c v (kh, grila, tinh
tinh). c gy ra bi bi bn trong nhm nm loi virus Ebola, h
Filoviridae, b Mononegavirales. Nhng loi virus l Bundibugyo virus
(BDBV), Ebola virus (EBOV), Sudan virus (SUDV) v Reston virus
(RESTV).
- Virus Zika (vit tt l ZIKV) l mt virus thuc h Flaviviridae c
phn lp ln u tin t mt con kh Rhesus trong rng Zika ca Uganda vo
nm 1947. ZIKV c quan h gn gi vi cc virus khc thuc
h Flaviviridae c lan truyn bi mui nh st xut huyt, st vng da,
st Ty sng Nile, v vim no Nht Bn do virus. ZIKV gy ra bnh c
gi l st Zika, c biu hin lm sng nh pht ban dt sn (maculopapular
rash) khp c th, st, au khp, v kh chu. Zika hay cn gi l "bnh u
nh", gy hu qu cho thai nhi ca ngi mc bnh vi biu hin l u nh
bt thng, km pht trin tr tu, virus ny hin din khp ni trn th gii,
chu trnh truyn bnh lin quan n mui, t me sang con v c th ly lan
qua ng tnh dc,do ZIKV tr thnh mt tc nhn gy bnh mi ni
quan trng tc ng trn phm vi ton cu cha lng trc c.
- Virus gy ung th:

Human papilloma virus (HPV): Hu ht HPV gy nhim trng

tim tng khng triu chng v gy mn cm lnh tnh da.

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Polyomavirus: Virus Polyoma l tc nhn gy u no v ung th

ty. Mi y thy c lin quan n ung th tuyn tin lit ngi.

Hepatitis B virus (HBV) v hepatitis C virus (HCV): Virus

vim gan B v C gy vim gan ngi. Tin trin ca vim gan B v C c
th dn n vim gan mn tnh, x gan v ung th gan.

Epstein- Barr virus (EBV) (Human Herpes Virus-4): Virus ny

gy bnh ung th vm hng, ung th lymphoma Burkitt, ung th t bo
lympho B, lymphoma Hodgkin.

Kaposi.

Human Herpes Virus-8 (HHV-8): Virus ny gy sarcoma

Herpes simplex virus (HSV): Virus Herpes simplex type 2

thng gy ung th c t cung. Nhng ngi nhim c 2 virus HPV v
HSV-2 c nguy c cao ung th c t cung.

Human T cell lymphotropic virus (HTLV): Retrovirus c mt

s loi virus c kh nng gy ung th ngi v ng vt, trong HTLV1 v HTLV-2 gy ung th t bo bch cu lympho T ngi. Kh nng gy
bnh ca HTLV-2 hn ch trong khi HTLV-1 c kh nng gy ung th cao.
HTLV-1 ph bin khp th gii.

TI LIU THAM KHO

1. L Thanh Bo c cng s (2004). Virus hc. B mn Vi sinh, Trng
i hc Y Dc TP.HCM
2. http://www.benhvien103.vn/vietnamese/bai-giang-chuyen-nganh/visinh-vat/dai-cuong-virut/1165/https://vi.wikipedia.org/wiki/Virus
3. WHO Technical Report, Series No 323, WHO Expert Group on
Requirements for Biological Substances. Geneva: World Health
Organnization; 1995.

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