Serology in hepatitis b

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  • 1. • Prashiddha Dhakal• Anju Shah• Aseem Poudel• Ashok Sapkota• Lalit Karki• Mamta Yadav• Navin Yadav• Pratik Kumar• Sujata Pandey• Swostika Sedhai
  • 2.  Inflammation of liver parenchymaINFECTIOUS CAUSE NON-INFECTIOUS CAUSE• Hepatotrophic viruses- • Alcohol HAV,HBV,HCV,HDV,HEV,HGV • Drugs• Other viruses- • Toxins Yellow fever virus, CMV • Metabolic• Bacteria- Leptospira icterohaemorrhagiae• Fungus- Amanita phalloides• Protozoa Entamoeba histolytica
  • 3. Hepatitis B Virus– Hepadnaviridae family – DNA virus – Double-shelled particles – Outer lipoprotein envelope (surface Ag) – Inner viral nucleocapsid (core) – seven genotypes – four major subtypes. – All HBV subtypes share one common antigenic determinant - "a.“
  • 4. • 42 nm virion, 27nm nucleocapsid core• Small circular• 3 particulate forms-spherical, tubular, double spherical• HBV DNA codes for 4 sets of viral products
  • 5. Genomic Structure of HBVGenes Regions Gene productsS S Major protein (S) S+Pre S2 Middle protein (M) S+Pre S1 Large protein (L) HBsAg & S2C C HBcAg C+Pre C HbeAgP DNA polymeraseX HBxAg which contribute in carcinogenesis by binding to p53.
  • 6.  Antigen Detection- HBsAg,HBcAg,HBeAg Antibody Detection-Anti HBc, Anti-HBe, Anti-HBs DNA Detection- HBV DNA
  • 7. Acute Hepatitis B Virus Infection with Recovery Typical Serologic CourseTiter HBsAg 0 4 8 12 16 20 24 28 32 36 52 100 Weeks after Exposure
  • 8. Acute Hepatitis B Virus Infection with Recovery Typical Serologic CourseTiter HBV DNA HBsAg 0 4 8 12 16 20 24 28 32 36 52 100 Weeks after Exposure
  • 9. Acute Hepatitis B Virus Infection with Recovery Typical Serologic Course HBeAgTiter HBV DNA HBsAg 0 4 8 12 16 20 24 28 32 36 52 100 Weeks after Exposure
  • 10. Acute Hepatitis B Virus Infection with Recovery Typical Serologic Course Symptoms HBeAg Total anti-HBcTiter IgM anti-HBc HBV DNA HBsAg Window Period 0 4 8 12 16 20 24 28 32 36 52 100 Weeks after Exposure
  • 11. Acute Hepatitis B Virus Infection with Recovery Typical Serologic Course Symptoms HBeAg anti-HBe Total anti-HBcTiter IgM anti-HBc HBV DNA HBsAg 0 4 8 12 16 20 24 28 32 36 52 100 Weeks after Exposure
  • 12. Acute Hepatitis B Virus Infection with Recovery Typical Serologic Course Symptoms HBeAg anti-HBe Total anti-HBcTiter IgM anti-HBc HBV DNA HBsAg anti-HBs Window Period 0 4 8 12 16 20 24 28 32 36 52 100 Weeks after Exposure
  • 13. Treatment and Prevention Interferon therapy - For HBeAg +ve carriers with chronic active hepatitis. Response rate is 30 to 40%. Drugs- Lamivudine, Adefovir, Entecavir Vaccination- Recombinant vaccines genetically engineered by cloning the S gene of HBV in Baker’s yeast
  • 14. Hepatitis B Immunoglobulin – Efficacious within 48 hours of the incident. It may also be given to neonates whose mothers are HBsAg and HBeAg positive. Other measures – Screening of blood donors, blood and body fluid precautions.
  • 15.  Persons born in hyperendemic areas Homosexuals Injection drug users Patients on dialysis HIV infected patients Pregnant women Family and household contacts and sexual contacts of HBV-infected persons.
  • 16. • Anju Shah• Aseem Poudel• Ashok Sapkota• Lalit Karki• Mamta Yadav• Navin Yadav• Prashiddha Dhakal• Pratik Kumar• Sujata Pandey• Swostika Sedhai