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Hepatitis viruses
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- 2. Hepatitis 2 Infection of liver Hepatitisviruses – 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. Hepatitis A 3 Epidemiology Clinical features Labdiagnosis Prophylaxis Treatment
- 4. Epidemiology 4 Common in children Fecooral route – contaminated water or milk Over crowding and poor sanitation Ingested, reaches intestine, penetrates epithelium, reaches liver through blood
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- 6. Clinical features 6 2-6 weeksincubation period – asymptomatic Clinical symptoms – malaise, anorexia, nausea, vomitting and abdominal pain Yellow urine
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- 9. Lab diagnosis Raisedbilirubin in serum (indirect>direct) Yellow urine – bilirubin present Demonstration of antibodies by ELISA 9 IgM – recent infection IgG – remote infection
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- 11. Prophylaxis Improved sanitationVaccine is available Natural infection leads to life long immunity 11
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- 13. Treatment No antiviral drugavailable Treatment is symptomatic
- 14. TYPE B HEPATITIS 14 Over350 million HBV carriers in the world One million die anually
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- 16. Epidemiology 16 Hepatitis Bvirus structure
- 17. In the serumof Hep B patients we can see – Australia antigen or 17
- 18. Developed countries 18 Adolscents andyoung adults Infection occurs through contaminated syringes and needles Drug addicts Homosexuals
- 19. Developing countries 19 Children Vertical transmissionfrom mother to baby Horizontal transmission among infants and neonates
- 20. Everywhere 20 Razors, nail clippers,acupuncture, tatooing, circumscision, ear or nose piercing Barbers, dentists and doctors may get infected
- 21. Carriers 21 Those whodonot have symptoms but are HbsAg positive
- 22. Screening of blooddonors 22 Compulsory
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- 24. Clinical features 24 No symptomsin carriers Similar to HAV in acute phase
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- 26. Lab diagnosis 26 Demonstrationof viral antibodies and antigens in serum -
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- 28. HBsAg 28 IgM anti HBcAg IgGanti HBcAg HBeAg Anti HBsAg infection recent infection remote infection infective immunity after vaccination
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- 30. Prophylaxis 30 Avoid multiple partners Avoiddrug abuse Use of disposable syringes and needles Screening of Blood, organ and semen donors Universal immunisation (vaccination)
- 31. Immunisation - Passive 31 administerHBIG (Hepatitis B immunoglobulin) Administer soon after accidental exposure Can be administered to baby born to a carrier mother
- 32. Active immunisation -vaccine 32 Consists of HBsAg particles Given as a routine to all babies
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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 34
- 35. Hepatitis C Virus 35 Alsoblood 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 36
- 37. Dr. Ashish JawarkarHepatitisviruses38