Hepatitis A
Hepatitis A
Hepatitis A
WHAT IS HEPATITIS?
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Hepat (liver) + itis (inflammation)= Hepatitis
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Hepatitis can be caused by drugs , toxins , alcohol, viral
infections ,other infections (parasites, bacteria) ,physical
damage.
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Hepatitis is acute when it lasts less than six months and
chronic when it persists more than 6 months
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Viral Hepatitis is defined as the inflammation of liver such
as swelling of liver and does not work properly caused by
group hepatic group of viruses HAV, HBV, HCV, HDV, HEV
HEPATITIS A- OVERVIEW
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Hepatitis A Virus is typical enterovirus classified as
member of the picornavirus family
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. It has a single-stranded RNA genome and a
nonenveloped icosahedral nucleocapsid and replicates
in the cytoplasm of the cell.
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It is also known as enterovirus 72. It has one serotype,
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Transmission through fecal-oral route
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Human are the important reservior
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It cause acute form of disease
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Children are the most frequently infected group, and
outbreaks occur in special living situations such as
summer camps and boarding schools.
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Common-source outbreaks arise from fecally
contaminated water or food such as oysters grown in
polluted water and eaten raw
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After the virus enters the body, there is an incubation
period lasting 3 to 4 weeks until illness begins
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Infection of hepatocyte by
HAV
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Replication in hepatocyte
cytoplasm
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Leads to hepatocellular
damage
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HAV-specific CD8+ T
lymphocytes, natural killer
cells destroy infected
hepatocytes (Host's immune
response to HAV hepatic
injury)
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Infection usually self-limiting
(does not become chronic
results in life-long immunity
(IgG antibodies
SYMPTOMS
DIAGNOSIS
1. LAB TEST
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Enzyme linked immunosorbent assay used for detecting
Antibody HAV IgM and Antibody HAV IgG in blood
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HAV IgG made by body when you’re first exposed to hepatitis
A. They stay in your blood for about 3 to 6 months and Anti
HAV IgG appears more slowly and persist for decades.
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HAV is detected in the stool from about 2 weeks prior to the
onset of jaundice and 2 weeks thereafter and which can be
detected using electron microscopy
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Elevated serum aminotransferase levels indicate diagnosis
2.OBJECTIVE EXAMINATION
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INSPECTION
– TACHYCARDIA, HYPOTENSION,TACHYPNEA
– JAUNDICE, RASH, PETECHIAE
– ICTERIC SCLERA
– CERVICAL LYMPHADENOPATHY
– HEPATOMEGALY , ,SPLENOMEGALLY , ASCITES (seen during
severe case)
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PALPATION
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GREATER TENDERNESS
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FIRM BLUNTNESS /ROUNDNESS IRREGULARITY OF
LIVER EDGE
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PERCUSSION
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INCREASED DULLNESS
COMPLICATION
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Cholestatic hepatitis: characterized by prolonged
jaundice
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Relapsing hepatitis: symptoms relapse after acute
illness
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Autoimmune hepatitis: chronic hepatitis
characterized by hyperglobulinemia
TREATMENT
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No antiviral therapy is available
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Active immunization with a vaccine containing inactivated
HAV is available recommended for travelers to developing
countries, for children ages 2 to 18 years, and for men who
have sex with men
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Passive immunization with immune serum globulin prior to
infection or within 14 days after exposure can prevent or
mitigate the disease
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combination vaccine that immunizes against both HAV and
HBV called Twinrix is available. It contains the same
immunogens as the individual HAV and HBV vaccines.