Viral Hepatitis in a nutshell. I don't own the information within the slides, I've only made the PowerPoint presentation.

1. Hepatitis
Viral hepatitis in a nutshell
Designed by : Mohammed Riyadh Fadhil
Ibn Sina University, College of Medicine
Under supervision of : Prof. Khaldoun Al Juburi

2. What is hepatitis ?
 Hepatitis means inflammation of the liver. It is most commonly a result of a viral
infection or liver damage caused by drinking alcohol, or (less often) an
autoimmune response. The most common hepatitis types include:
 Hepatitis A
 Hepatitis B
 Hepatitis C
 Hepatitis D
 Hepatitis E
 Alcoholic hepatitis
 Autoimmune hepatitis

3.  The different types of hepatitis can differ in severity. Hepatitis tends to be
categorised either as acute (short-term infection) or chronic (long-term infection).
People may not develop any symptoms until the liver stops working properly.
Hepatitis symptoms may include:
 Muscle/joint pain
 Fever
 Nausea
 Diarrhoea
 Abdominal pain
 Loss of appetite
 Dark urine
 Itchy skin

4.  Advanced stages of hepatitis can cause jaundice (yellowing of the skin and the
whites of the eyes), swelling in the legs, confusion, and blood in stool or vomit.
 Long-term inflammation of the liver can lead to liver fibrosis, which is the result of
the wound-healing response to repeated injury, i.e. the liver is replacing dead liver
cells with scar tissue. Excessive scarring can lead to liver cirrhosis which prevents
the liver from working properly. Without interventions, liver cirrhosis may lead to
liver cancer and/or liver failure. For people with liver cancer or failure, a liver
transplant can sometimes be the only hope for long-term survival, as there are no
available medical devices to permanently replicate the functions of the liver.

5. Viral hepatitis – Different virus types
 According to the WHO, ~325 million people are living with chronic viral hepatitis.

6.  These five hepatitis viruses are often not clinically distinguishable during the acute
stage of viral hepatitis. However, they do have different characteristics, such as type
of transmission and incubation periods.

7. HAV
 HAV can be transmitted through food and water that is contaminated with the
faeces of a person with HAV. Therefore, transmission is associated with poor
sanitation, lack of safe water, drug use, or living with or being a sexual partner of
someone with HAV. Most people fully recover from HAV infection and achieve life-
long immunity. However, recovery may take several weeks or months. The
spreading of HAV can be reduced by:
 Vaccination
 Supply of safe drinking water
 Adequate sanitation

8. HBV
 According to the WHO, an estimated 257 million people are living with HBV. This
virus can increase the risk of cirrhosis and liver cancer (also called hepatocellular
carcinoma). In 2015, 887,000 people with HBV died, mostly due to these
complications. HBV can survive outside of the body for at least 7 days. It is often
transmitted from mother to child and via exposure to HBV-infected blood and
different body fluids, such as saliva, and menstrual, vaginal and seminal fluids.
People at high risk of HBV infections include:
 Users of injectable drugs
 Healthcare workers
 Children born to mothers with HBV
 People travelling to parts of where HBV is more common

9. HCV
 While it was known for years that a pathogen other than HAV and HBV was causing
chronic hepatitis, the virus itself was only discovered in 1989. Until that point, HCV was
known simply as hepatitis non-A non-B virus. An estimated 71 million people are now
living with HCV, per WHO. Each year, ~399,000 people die from HCV, mostly due to
cirrhosis and liver cancer. Within 6 months following infection, the immune system of
15–45% of people spontaneously clears the infection; 55–85% of the remaining people
may develop chronic HCV infection. The spread of HCV can be prevented by:
 Hand hygiene
 Not sharing any drug-injection equipment, razors or toothbrushes with other people

10. HDV
 HDV is a satellite virus, unable to replicate in the absence of co-infection with HBV. As a result, it
only affects people with an HBV infection, but it can lead to the most severe forms of hepatitis.
Worldwide, ~15 million people are infected with HBV and HDV, according to WHO. A
simultaneous infection with HBV and HDV is often associated with full recovery (95%). In contrast,
an HDV superinfection in people with chronic HBV is often associated with a poorer prognosis.
HDV superinfection can quicken progression to cirrhosis in 70–90% of people with chronic HBV
infection. HDV can be prevented by prevention of HBV transmission.
HEV
 The transmission of HEV is similar to that with HAV, but also includes eating undercooked meat or
meat products derived from infected animals. In most cases, the HEV infection clears within 2–6
weeks. The prevention techniques are consistent with HAV. A vaccine to prevent HEV was
registered in China in 2011; however, it has not yet been approved by other countries.

11. Viral hepatitis – Is elimination possible?
 WHO has published data from 28 countries that show that there is a global
reduction of hepatitis viruses; however, many challenges remain. The World
Hepatitis Day provides an ideal opportunity to raise awareness of viral hepatitis. A
short tweet might already be enough to start a conversation and thereby slightly
shorten the journey to elimination of viral hepatitis.

12. THANK YOU