This document summarizes Hepatitis B and C. It describes that Hepatitis B is caused by the HBV virus and can range from mild to chronic liver disease or cancer. Over 350 million people worldwide have chronic Hepatitis B. The virus is classified in the family Hepadnaviridae and genus Orthohepadnavirus. It is transmitted through blood, sexual contact, and from mother to child. Hepatitis C is caused by the HCV virus and transmitted through blood. There is no vaccine for Hepatitis C, but screening blood and safe injection practices can help prevent transmission.

1. Vishal L. Kulkarni
Dept. of Microbiology
Hepatitis B & C

2. Hepatitis B
 It is a liver disease caused by the hepatitis B virus
(HBV).
 It ranges in severity from a mild illness, lasting a few
weeks (acute), to a serious long-term (chronic)
illness that can lead to liver disease or liver cancer.

3. Hepatitis B is Serious – Global
Impact
 It’s a common disease!
 Over 350 million people in the world have chronic
hepatitis B

4. HBV classification and morphology :
 Family -Hepadnaviridae.
 Genus- Orthohepadnavirus
 42 nm DNA virus with outer envelope and inner
core.
 Blumberg in 1965 discovered , named as Australia
antigen.
 Later it was found to be surface component of HBV.

5. Morphology ….
 Spherical particles 22 nm in diam.
 Filamentous or tubular 22 nm
with varying length
 Called as HBs Ag surface components which are
produced in excess.
 Third type double walled spherical structure 42 nm diameter
called as Dane particle

6. HBV structure

7. Hepatitis B virus

8. Epidemiology:
 Natural infection occurs only in humans.
 No animal reservoir.
 Virus is maintained in large pools of carrier.
 Usually occur as sporadics.
 Occasional outbreaks occur in hospitals, orphanages
and institutions for mentally handicapped.
 India falls in intermediate group: carrier rate 2-7%.
High in southern part of India .

9. Carrier :
- Person with detectable HBsAg in blood for more than
six months.
Super carrier:
- High titres of HBsAg+HBeAg+ DNA polymerase
+HBV in circulation.
- Elevated transaminases. Highly infectious.
Simple carrier:
- Low titres of HBsAg
- Negative for HBeAg, DNA polymerase ,HBV. Low
infectivity

10. Modes of
transmission
:
Parenteral
Perinatal
Sexual

11. Parenteral:
 Blood and blood products of carrier and patients.
 HBV is highly infectious than HIV.
 0.00001 ml can be infectious..!
 Objects like shared syringes, needles, sharp items,
endoscopes, razors, nail clippers ,combs,
accupunture, ritual circumcision.
 Direct contact with skin lesions like eczema,
pyoderma and scratches.

12. How the HBV is transmitted

13. Perinatal:
 Quite common from carrier mother to baby.
 If mother HBeAg positive – high risk (60-90%)
 If mother HBeAg negative- low risk (5-15%)
 Infection usually acquired during birth.

14. Sexual:
 more common in developed countries, particularly in
promiscuous homosexuals.
 Can also occur by artificial insemination.
 Saliva ,breast milk, semen, vaginal secretion ,urine,
bile and feces also contains virus.

15. High Moderate
Low/Not
Detectable
blood semen urine
serum vaginal fluid feces
wound exudates saliva sweat
tears
breastmilk
Concentration of Hepatitis B Virus
in Various Body Fluids

16. High risk occupational groups:
 Medical and paramedical personnel.
 Staff of blood bank
 Dialysis units
 Medical laboratories
 Mental health institutions
 Barbers and Sex workers

17. LAB DIAGNOSIS:
Serological demonstration of viral markers :
HBsAg :
 first marker to appear in the blood.
 Being detectable in blood even before onset of
clinical illness.
 Disappears in 2 months.
 Then anti-HBs appears.
 Presence of anti-HBsAg alone indicates vaccination

18. Symptoms
HBeAg anti-HBe
Total anti-HBc
IgM anti-HBc anti-HBsHBsAg
0 4 8 12 16 20 24 28 32 36 52 100
Acute Hepatitis B Virus Infection with Recovery
Typical Serologic Course
Weeks after Exposure
Titre
18

19. HBcAg:
 Not demonstrable in circulation.
 Antibody appears after 1-2 wk of appearance HBsAg.
 Earliest antibody marker to be seen in blood.
IgM anti- HBc: acute infection
IgG anti- HBc: remote infection
HBeAg:
 Appears concurrently with HBsAg.
 Indicator of active intrahepatic viral replication.
 Its presence denotes high infectivity.

20. Prophylaxis :
 Avoiding risky practices like promiscuous
sex, injectable drug abuse, direct or indirect
contact with blood, semen or other body fluids of patients
and carrier.
 Use of disposable syringes, needles.
 Screening of blood, semen and organ donors.
 Health education
 Immunization : Best method

21.  Passive Immunisation-
 HBIG (0.5 ml IM)
 Active Immunisation-
 HBsAg Vaccine (0.5 ml IM ; 0, 1 and 6 month)
 Post exposure prophylaxis-
 HBIG 300-500IU, within 48 hrs
 Full course of vaccination

22. Hepatitis C Virus
 HCV is small (50-60 nm) virus with single stranded
RNA.
 Enveloped virus- carrying
glycoprotein spikes
 Shows considerable genetic and
antigenic diversity.
 Has not been grown in culture, but cloned in E.coli.

23. How infection occurs
 Source of infection- carriers
 Mode-

24. Lab diagnosis
 Detection of viral antigen-
 IF of blood and biopsy specimen
 Detection of nucleic acid –HCV RNA by RT-
PCR

25. Immunoblotting
 Detection of specific antibodies
 ELISA
 Recombinant immunoblot techniques
RT PCR

26.  Prophylaxis-
 No vaccine available
 General measures-
- blood screening, safe blood and safe injection
practices.

27. Thank You…