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Hepatitis viruses - Heptatitis A, B, C, D and E, clinical features, epidemiology and lab diagnosis

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This is a series of lectures on microbiology useful for undergraduate medical and paramedical students

This is a series of lectures on microbiology useful for undergraduate medical and paramedical students

Published in: Health & Medicine, Technology

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  • 1. HEPATITIS VIRUSES Dr. Ashish V. Jawarkar M.D. (Pathology)
  • 2. Dr. Ashish Jawarkar Hepatitis viruses 2 Hepatitis  Infection of liver  Hepatitis viruses – A, B, C, D, E and G  B – DNA virus  All others – RNA viruses  Cause icteric jaundice  Type A and E – food borne, feco oral route  Type B and C – Blood borne, parenteral and sexual routes
  • 3. Dr. Ashish Jawarkar Hepatitis viruses 3 Hepatitis A  Epidemiology  Clinical features  Lab diagnosis  Prophylaxis  Treatment
  • 4. Dr. Ashish Jawarkar Hepatitis viruses 4 Epidemiology  Common in children  Feco oral route – contaminated water or milk  Over crowding and poor sanitation  Ingested, reaches intestine, penetrates epithelium, reaches liver through blood
  • 5. Dr. Ashish Jawarkar Hepatitis viruses 5  Epidemiology  Clinical features  Lab diagnosis  Prophylaxis  Treatment
  • 6. Dr. Ashish Jawarkar Hepatitis viruses 6 Clinical features  2-6 weeks incubation period – asymptomatic  Clinical symptoms – malaise, anorexia, nausea, vomitting and abdominal pain  Yellow urine
  • 7. Dr. Ashish Jawarkar Hepatitis viruses 7
  • 8. Dr. Ashish Jawarkar Hepatitis viruses 8  Epidemiology  Clinical features  Lab diagnosis  Prophylaxis  Treatment
  • 9. Dr. Ashish Jawarkar Hepatitis viruses 9 Lab diagnosis  Raised bilirubin in serum (indirect>direct)  Yellow urine – bilirubin present  Demonstration of antibodies by ELISA  IgM – recent infection  IgG – remote infection
  • 10. Dr. Ashish Jawarkar Hepatitis viruses 10  Epidemiology  Clinical features  Lab diagnosis  Prophylaxis  Treatment
  • 11. Dr. Ashish Jawarkar Hepatitis viruses 11 Prophylaxis  Improved sanitation  Vaccine is available  Natural infection leads to life long immunity
  • 12. Dr. Ashish Jawarkar Hepatitis viruses 12  Epidemiology  Clinical features  Lab diagnosis  Prophylaxis  Treatment
  • 13. Dr. Ashish Jawarkar Hepatitis viruses 13 Treatment  No antiviral drug available  Treatment is symptomatic
  • 14. Dr. Ashish Jawarkar Hepatitis viruses 14 TYPE B HEPATITIS  Over 350 million HBV carriers in the world  One million die anually
  • 15. Dr. Ashish Jawarkar Hepatitis viruses 15  Epidemiology  Clinical features  Lab diagnosis  Prophylaxis  Treatment
  • 16. Dr. Ashish Jawarkar Hepatitis viruses 16 Epidemiology  Hepatitis B virus structure
  • 17. Dr. Ashish Jawarkar Hepatitis viruses 17 In the serum of Hep B patients we can see – Australia antigen or
  • 18. Dr. Ashish Jawarkar Hepatitis viruses 18 Dane particle
  • 19. Dr. Ashish Jawarkar Hepatitis viruses 19 Developed countries  Adolscents and young adults  Infection occurs through contaminated syringes and needles  Drug addicts  Homosexuals
  • 20. Dr. Ashish Jawarkar Hepatitis viruses 20 Developing countries  Children  Vertical transmission from mother to baby  Horizontal transmission among infants and neonates
  • 21. Dr. Ashish Jawarkar Hepatitis viruses 21 Everywhere  Razors, nail clippers, acupuncture, tatooing, circumscision, ear or nose piercing  Barbers, dentists and doctors may get infected
  • 22. Dr. Ashish Jawarkar Hepatitis viruses 22 Carriers  Those who donot have symptoms but are HbsAg positive
  • 23. Dr. Ashish Jawarkar Hepatitis viruses 23 Screening of blood donors  Compulsory
  • 24. Dr. Ashish Jawarkar Hepatitis viruses 24  Epidemiology  Clinical features  Lab diagnosis  Prophylaxis  Treatment
  • 25. Dr. Ashish Jawarkar Hepatitis viruses 25 Clinical features  No symptoms in carriers  Similar to HAV in acute phase
  • 26. Dr. Ashish Jawarkar Hepatitis viruses 26  Epidemiology  Clinical features  Lab diagnosis  Prophylaxis  Treatment
  • 27. Dr. Ashish Jawarkar Hepatitis viruses 27 Lab diagnosis  Demonstration of viral antibodies and antigens in serum -
  • 28. Dr. Ashish Jawarkar Hepatitis viruses 28
  • 29. Dr. Ashish Jawarkar Hepatitis viruses 29  HBsAg infection  IgM anti HBcAg recent infection  IgG anti HBcAg remote infection  HBeAg infective  Anti HBsAg immunity after vaccination
  • 30. Dr. Ashish Jawarkar Hepatitis viruses 30  Epidemiology  Clinical features  Lab diagnosis  Prophylaxis  Treatment
  • 31. Dr. Ashish Jawarkar Hepatitis viruses 31 Prophylaxis  Avoid multiple partners  Avoid drug abuse  Use of disposable syringes and needles  Screening of Blood, organ and semen donors  Universal immunisation (vaccination)
  • 32. Dr. Ashish Jawarkar Hepatitis viruses 32 Immunisation - Passive  administer HBIG (Hepatitis B immunoglobulin)  Administer soon after accidental exposure  Can be administered to baby born to a carrier mother
  • 33. Dr. Ashish Jawarkar Hepatitis viruses 33 Active immunisation - vaccine  Consists of HBsAg particles  Given as a routine to all babies
  • 34. Dr. Ashish Jawarkar Hepatitis viruses 34  Epidemiology  Clinical features  Lab diagnosis  Prophylaxis  Treatment
  • 35. Dr. Ashish Jawarkar Hepatitis viruses 35 Treatment  Acute phase – no treatment required, patients recover  Chronic phase – become carriers, can give antivirals like lamivudine and adefovir to keep replication in check
  • 36. Dr. Ashish Jawarkar Hepatitis viruses 36 Hepatitis C Virus  Also blood borne  Most common cause of post transfusion hepatitis in developed countries  Most common cause of post hepatitis – hepatocellular carcinoma
  • 37. Dr. Ashish Jawarkar Hepatitis viruses 37 Hepatitis E virus  Feco oral route  Second common cause of hepatitis after hepatitis A in developing countries  Generally mild and self limiting illness  Unusually high mortality (20-40 %) in pregnancy
  • 38. Dr. Ashish Jawarkar Hepatitis viruses 38

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