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    Hepatitis 1 (Viral Hepatitis)

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    Louis Tan
    Viral hepatitis can be caused by several viruses, including hepatitis A, B, C, D, and E viruses. The document outlines the characteristics of each virus, including their transmission routes, geographic distribution, outcomes of infection, and approaches for diagnosis, prevention, and treatment. Chronic infection is possible for hepatitis B, C, and D viruses and can lead to long-term liver damage if left untreated. Vaccination and harm reduction strategies are important for preventing the spread of viral hepatitis.

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    Hepatitis 1 (Viral Hepatitis)

    Uploaded by

    Louis Tan
    4 views47 pages
    Viral hepatitis can be caused by several viruses, including hepatitis A, B, C, D, and E viruses. The document outlines the characteristics of each virus, including their transmission routes, geographic distribution, outcomes of infection, and approaches for diagnosis, prevention, and treatment. Chronic infection is possible for hepatitis B, C, and D viruses and can lead to long-term liver damage if left untreated. Vaccination and harm reduction strategies are important for preventing the spread of viral hepatitis.

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    Viral Hepatitis slides for medical students

    Original Title

    Hepatitis 1 (Viral hepatitis)

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    Viral hepatitis can be caused by several viruses, including hepatitis A, B, C, D, and E viruses. The document outlines the characteristics of each virus, including their transmission routes, geographic distribution, outcomes of infection, and approaches for diagnosis, prevention, and treatment. Chronic infection is possible for hepatitis B, C, and D viruses and can lead to long-term liver damage if left untreated. Vaccination and harm reduction strategies are important for preventing the spread of viral hepatitis.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    4 views47 pages

    Hepatitis 1 (Viral Hepatitis)

    Uploaded by

    Louis Tan
    Viral hepatitis can be caused by several viruses, including hepatitis A, B, C, D, and E viruses. The document outlines the characteristics of each virus, including their transmission routes, geographic distribution, outcomes of infection, and approaches for diagnosis, prevention, and treatment. Chronic infection is possible for hepatitis B, C, and D viruses and can lead to long-term liver damage if left untreated. Vaccination and harm reduction strategies are important for preventing the spread of viral hepatitis.

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    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 47

    Hepatitis 1 (Viral hepatitis)

    Learning outcomes
    The student will be able to
    •List the causes of hepatitis
    •Describe the microbial characteristics of
    hepatitis viruses
    •Outline the outcome of viral hepatitis
    •Briefly describe the serological diagnosis of
    viral hepatitis
    •Discuss the prevention and control of viral
    hepatitis
    Hepatitis
    • Definition: inflammation of the liver
    • Causes
    – drugs
    – toxins
    – alcohol
    – viral infections (A, B, C, D, E)
    – other infections (bacteria, parasites)
    – physical injury / damage
    Hepatitis

    • Acute Hepatitis: Short-term hepatitis.


    – Body’s immune system clears the virus from the
    body within 6 months

    • Chronic Hepatitis: Long-term hepatitis.


    – Infection lasts longer than 6 months because the
    body’s immune system cannot clear the virus from
    the body
    Viral hepatitis
    Causes of viral hepatitis

    1. Hepatitis A virus (HAV) : Viral hepatitis A


    2. Hepatitis B virus (HBV) : Viral hepatitis B
    3. Hepatitis C virus (HCV) : Viral hepatitis C
    4. Hepatitis D virus (HDV) : Viral hepatitis D
    5. Hepatitis E virus (HEV) : Viral hepatitis E
    Viruses that can cause sporadic hepatitis

    • Cytomegalovirus
    • Herpes simplex virus
    • Enteroviruses
    • Epstein – Barr virus
    • Rubella virus
    • Yellow fever virus
    Characteristics of hepatitis viruses
    Outcomes of HAV infection
    HAV – hepatitis A virus
    Geographic Distribution of HAV Infection

    Anti-HAV Prevalence
    High
    Intermediate
    Low
    Very Low
    HAV Prevention
    General prevention
    Observation of proper hygiene (e.g., sewage disposal
    and hand washing )

    Specific prevention immunoprophylaxis


    active immunization : inactivated HAV vaccine
    passive immunization : immune serum globulin
    Hepatitis E virus - HEV

    • Fecal oral or water borne transmission


    • Cause large epidemics in Asia, north and west Africa
    and Mexico
    • Fulminant hepatitis occur in pregnancy
    • No chronic carrier
    • No vaccine
    HBV, HCV, HDV
    Healthy Liver Cirrhosis Liver
    Geographic Distribution of Chronic HBV
    Infection

    HBsAg Prevalence
    8% - High
    2-7% - Intermediate
    <2% - Low
    HBs antigen
    HBs Antigen
    1. Spherical particles measuring 22 nm in
    diameter- HBs Ag

    2. Tubular or filamentous forms with same


    diameter but may be over 200 nm long &
    result from overproduction of HBs Ag
    Transmission of Hepatitis BB
    HBV - Transmission
    • Parenteral
    • Sexual
    • Vertical

    • High risk group – parenteral drug abusers,


    institutionalized persons, health care
    personnel, individuals who have received
    blood transfusion, haemodialysis patients and
    staff, highly promiscuous persons and
    newborn infants born to mothers with
    hepatitis B.
    Hepatitis B virus - HBV
    HBV : transmission & outcomes of infection
    Clinical & serologic events acute HBV infection
    Chronic Hepatitis B
    HBs antigen
    • Hepatitis B surface antigen

    • HBs Ag positive/presence indicates that the person


    is infectious

    • HBs Ag is used to make Hepatitis B vaccine

    • HBs Ag & Anti HBc IgM indicates acute HB infection

    • HBs Ag & Anti HBc IgG indicates chronic HB carrier


    HBs antibody (HBs Ab / Anti HBs)
    • Its presence indicates immunity against HBV
    infection

    • Presence of both Anti HBs & Anti HBc


    indicates immunity after natural HB infection

    • Presence of Anti HBs alone indicates


    immunity after hepatitis B vaccination
    HBc antibody (HBc Ab / Anti HBc)
    • Indicates previous or ongoing HB infection
    • Usually persists for life after exposure to HB
    infection

    HBc IgM Ab / IgM Anti HBc


    • Indicates recent infection with HBV (≤ 6
    months)
    • indicates acute infection of HBV
    HBV infection prevention & treatment
    • No antiviral therapy is typically used in acute
    hepatitis B.
    Chemotherapy : For chronic hepatitis B,
    entecavir or tenofovir are the drugs of choice
    Immunoprophylaxis & immunotherapy
    • HB vaccine (subunit vaccine) produced in
    yeasts by recombinant DNA technique
    • Hepatitis B immune globulin (HBIG)
    Prevention of HBV & HCV
    • Promote vaccination against hepatitis B
    • Ensure needle and syringe programmes to avoid
    sharing injecting equipment
    • Promote safe sex
    • Ensure adequately sterilized medical equipment
    • Promote hepatitis B and C testing and counselling
    services
    • Raise awareness for the diseases and their transmission
    modes, especially among high risk populations
    Hepatitis C virus - HCV

    • a Flavivirus, genus hepacivirus


    • six genotypes and multiple subgenotypes
    multiple subspecies (quasispecies) often
    occur in the blood of an infected individual
    at the same time
    • Can causes chronic infection & hepatocellular
    carcinoma (HCC)
    Hepatitis C virus - HCV

    Specimen : blood

    Test:
    •Anti HCV/ HCV ab  current or past infection
    of HCV
    •Viral load
    •Genotyping
    HCV treatment

    • Sofosbuvir for the treatment of genotypes


    1, 2, 3, and 4

    • combination of peginterferon, ribavirin and a


    protease inhibitor
    Hepatitis D virus - HDV

    • Delta virus, etiologic agent of delta hepatitis

    • Causes infection only in the presence of HBV


    infection

    • HD Ag/ delta Ag (+) in early acute HDV infection

    • HD Ab/Anti HD indicates past or present


    infection with HDV
    HDV serological test
    Lab diagnosis of viral infection
    • Smeared, staining and microscopy
    • Culture
    • Antigen detection
    • Antibody detection
    • Nucleic detection
    Lab diagnosis of viral infection
    • Smeared, staining and microscopy +
    • Culture +
    • Antigen detection +++
    • Antibody detection +++
    • Nucleic detection ++
    Lab diagnosis of viral infection
    • Smeared, staining and microscopy
    • Culture
    • Antigen detection (Ag ? Ab √)
    • Antibody detection (Ab ? Ag √)
    • Nucleic detection (nucleic acid probe / PCR)
    Presence /absence
    Quantitative (viral load)

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