the viruses that cause infection for the liver

1. HEPATITIS VIRUSES
By
Ali Faris

2. Hepatitis
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Infection of liver
Hepatitis viruses – A, B, C, D, E and G
B – DNA virus
All others – RNA viruses
Cause icteric jaundice
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Type A and E – food borne, feco oral route
Type B and C – Blood borne, parenteral and
sexual routes

3. Hepatitis A
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Epidemiology
Clinical features
Lab diagnosis
Prophylaxis
Treatment

4. Epidemiology
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Common in children
Feco oral route – contaminated water
or milk
Over crowding and poor sanitation
Ingested, reaches intestine,
penetrates epithelium, reaches liver
through blood

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Epidemiology
Clinical features
Lab diagnosis
Prophylaxis
Treatment
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6. Clinical features
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2-6 weeks incubation period –
asymptomatic
Clinical symptoms – malaise,
anorexia, nausea, vomitting and
abdominal pain
Yellow urine

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Epidemiology
Clinical features
Lab diagnosis
Prophylaxis
Treatment
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9. Lab diagnosis
 Raised bilirubin in serum
(indirect>direct)
 Yellow urine – bilirubin present Demonstration of antibodies
by ELISA
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IgM – recent infection
IgG – remote infection

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Epidemiology
Clinical features
Lab diagnosis
Prophylaxis
Treatment
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11. Prophylaxis
 Improved sanitation Vaccine is
available
 Natural infection leads to life long immunity
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Epidemiology
Clinical features
Lab diagnosis
Prophylaxis
Treatment
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13. Treatment
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No antiviral drug available
Treatment is symptomatic

14. TYPE B HEPATITIS
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Over 350 million HBV carriers in the
world
One million die anually

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Epidemiology
Clinical features
Lab diagnosis
Prophylaxis
Treatment
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16. Epidemiology
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 Hepatitis B virus structure

17. In the serum of Hep B patients we
can see – Australia antigen or
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18. Developed countries
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Adolscents and young adults
Infection occurs through
contaminated syringes and needles
Drug addicts
Homosexuals

19. Developing countries
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Children
Vertical transmission from mother to
baby
Horizontal transmission among
infants and neonates

20. Everywhere
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Razors, nail clippers, acupuncture,
tatooing, circumscision, ear or nose
piercing
Barbers, dentists and doctors may
get infected

21. Carriers
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 Those who donot have symptoms but
are HbsAg positive

22. Screening of blood donors
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 Compulsory

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Epidemiology
Clinical features
Lab diagnosis
Prophylaxis
Treatment
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24. Clinical features
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No symptoms in carriers
Similar to HAV in acute phase

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Epidemiology
Clinical features
Lab diagnosis
Prophylaxis
Treatment
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26. Lab diagnosis
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 Demonstration of viral antibodies and
antigens in serum -

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28. HBsAg
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IgM anti HBcAg
IgG anti HBcAg
HBeAg
Anti HBsAg
infection
recent infection
remote infection
infective
immunity after
vaccination

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Epidemiology
Clinical features
Lab diagnosis
Prophylaxis
Treatment
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30. Prophylaxis
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Avoid multiple partners
Avoid drug abuse
Use of disposable syringes and
needles
Screening of Blood, organ and semen
donors
Universal immunisation (vaccination)

31. Immunisation - Passive
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administer HBIG (Hepatitis B
immunoglobulin)
Administer soon after accidental
exposure
Can be administered to baby born to
a carrier mother

32. Active immunisation - vaccine
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Consists of HBsAg particles
Given as a routine to all babies

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Epidemiology
Clinical features
Lab diagnosis
Prophylaxis
Treatment
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34. Treatment
 Acute phase – no treatment required, patients recover
 Chronic phase – become carriers, can give antivirals like lamivudine and
adefovir to keep replication in check
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35. Hepatitis C Virus
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Also blood borne
Most common cause of post
transfusion hepatitis in developed
countries
Most common cause of post hepatitis
– hepatocellular carcinoma

36. 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
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37. Dr. Ashish JawarkarHepatitis viruses38