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HEPATITIS
PRESENTED BY:
ABC
WHAT IS HEPATITIS ?
• Hepatitis is a broad term that means inflammation of liver.
• It is most commonly caused by viruses but also be caused by
drugs(alcohol), chemicals, autoimmune diseases and metabolic
abnormalities.
ETIOLOGY OF HEPATITIS
Viral Hepatitis
Alcoholic
Hepatitis
Auto immune
Hepatitis
Non- alcoholic
Steatohepatitis
Viral Hepatitis
TYPES OF HEPATITIS
• Five types of hepatitis have been identified: Hepatitis A, B, C, D , E.
• Hepatitis A is always an acute, short-term disease,
• while hepatitis B, C, and D are most likely to become ongoing and chronic.
• Hepatitis E is usually acute but can be particularly dangerous in pregnant women.
• The hepatitis A and E viruses typically cause only acute, or short-term, infections.
TYPES OF HEPATITIS VIRUSES
A B C D E
Source of Feces Blood,
Blood derived Body
fluids
Blood,
Blood derived
Body fluids
Blood,
Blood derived
Body fluids
Feces
Route of
Transmission
Feco-oral Percutaneous
Permucosal
Percutaneous
Permucosal
Percutaneous
Permucosal
Feco-oral
Chronic
Infection
No Yes Yes Yes No
Prevention Pre Post
Exposure
Immunization
Pre Post Exposure
Immunization
Blood donor
screening
Blood donor
screening
Pre Post
Exposure
Immunization
Ensure Safe
Drinking water
HEPATITIS A VIRUS
• Naked RNA virus
• One stable serotype only
• Difficult to grow in cell culture: primary marmoset cell culture and
also in vivo in chimpanzees and marmosets
• 4 genotypes exist, but in practice most of them are group 1
HEPATITIS A VIRUS TRANSMISSION
• Close personal contact(e.g., household contact, sex contact, child
day care centers)
• Contaminated food, water (e.g., infected food handlers, raw
shellfish)
• Blood exposure (rare) (e.g., injecting drug use, transfusion)
LABORATORY DIAGNOSIS
1. Demonstration of Virus in feces: By: Immunoelectron microscopy
2. Detection of Antibody :By ELISA
3. Molecular Diagnosis : RT PCR of feces
4. Biochemical tests:
i. Alanine aminotransferase (ALT)
ii. Bilirubin
iii. Protein
HEPATITIS B VIRUS
• A member of the hepadnavirus group
• Circular partially double-stranded DNA viruses
• Replication involves a reverse transcriptase.
• Endemic in the human population and hyperendemic in many parts of the
world.
• A number of variants
• It has not yet been possible to propagate the virus in cell culture
HBV: MODES OF TRANSMISSION
• Parenteral - IV drug abusers, health workers are at increased risk.
• Sexual - sex workers and homosexuals are particular at risk.
• Perinatal (Vertical) – mother (Hbe Ag+) →infant.
LABORATORY DIAGNOSIS
• A Variety of serological tests are used for the diagnosis of acute and chronic
hepatitis B infection.
• HBsAg - used as a general marker of infection.
• HBs Ab - used to document recovery and/or immunity to HBV infection.
• Anti-HBc IgM - marker of acute infection. Anti-HBc IgG - past or chronic
infection.
• Hbe Ag - indicates active replication of virus and therefore infectiveness.
• HBV-DNA - indicates active replication of virus, more accurate than Hbe Ag
especially in cases of escape mutants.
HEPATITIS C
• Shape: spherical, icosahedral,
• Nucleic Acid: ss (+) RNA
• HCV has been classified into a total of six
genotypes (type 1 to 6) on the basis of
phylogenetic analysis.
LABORATORY DIAGNOSIS
• HCV antibody - generally used to diagnose hepatitis C infection. Not useful in the
acute phase as it takes at least 4 weeks after infection before antibody appears.
• HCV-RNA - various techniques are available e.g. PCR and branched DNA. May be
used to diagnose HCV infection in the acute phase. However, its main use is in
monitoring the response to antiviral therapy.
• HCV-antigen - an EIA for HCV antigen is available. It is used in the same capacity
as HCV-RNA tests but is much easier to carry out.
HEPATITIS D (DELTA)
Shape: Spherical, 36-38 nm,
HBV capsid, HDV nucleoprotein
Nucleic Acid: (-) ss RNA, circular
Satellite Virus : replicates Only in the
presence of HBV
MODES OF TRANSMISSION
• Percutaneous exposure (injecting drug users)
• Per mucosal
• Sexual contact
• The mode of transmission of HDV is similar to that of HBV.
LABORATORY DIAGNOSIS
• Anti-HDV
• HDV Antigen
HEPATITIS E VIRUS
• unenveloped RNA virus, 32-34nm in diameter
• +ve stranded RNA genome, 7.6 kb in size.
• very labile and sensitive
• HEV has a fecal-oral transmission route.
• Hepatitis E usually resolves on its own within four to six
weeks
LABORATORY DIAGNOSIS
• Anti-HEV IgM and IgG.
• HEV RNA quantification.
Hepatitisfull presenta and full all .pptx
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Hepatitisfull presenta and full all .pptx

  • 2. WHAT IS HEPATITIS ? • Hepatitis is a broad term that means inflammation of liver. • It is most commonly caused by viruses but also be caused by drugs(alcohol), chemicals, autoimmune diseases and metabolic abnormalities.
  • 3. ETIOLOGY OF HEPATITIS Viral Hepatitis Alcoholic Hepatitis Auto immune Hepatitis Non- alcoholic Steatohepatitis
  • 5. TYPES OF HEPATITIS • Five types of hepatitis have been identified: Hepatitis A, B, C, D , E. • Hepatitis A is always an acute, short-term disease, • while hepatitis B, C, and D are most likely to become ongoing and chronic. • Hepatitis E is usually acute but can be particularly dangerous in pregnant women. • The hepatitis A and E viruses typically cause only acute, or short-term, infections.
  • 6. TYPES OF HEPATITIS VIRUSES A B C D E Source of Feces Blood, Blood derived Body fluids Blood, Blood derived Body fluids Blood, Blood derived Body fluids Feces Route of Transmission Feco-oral Percutaneous Permucosal Percutaneous Permucosal Percutaneous Permucosal Feco-oral Chronic Infection No Yes Yes Yes No Prevention Pre Post Exposure Immunization Pre Post Exposure Immunization Blood donor screening Blood donor screening Pre Post Exposure Immunization Ensure Safe Drinking water
  • 7. HEPATITIS A VIRUS • Naked RNA virus • One stable serotype only • Difficult to grow in cell culture: primary marmoset cell culture and also in vivo in chimpanzees and marmosets • 4 genotypes exist, but in practice most of them are group 1
  • 8. HEPATITIS A VIRUS TRANSMISSION • Close personal contact(e.g., household contact, sex contact, child day care centers) • Contaminated food, water (e.g., infected food handlers, raw shellfish) • Blood exposure (rare) (e.g., injecting drug use, transfusion)
  • 9. LABORATORY DIAGNOSIS 1. Demonstration of Virus in feces: By: Immunoelectron microscopy 2. Detection of Antibody :By ELISA 3. Molecular Diagnosis : RT PCR of feces 4. Biochemical tests: i. Alanine aminotransferase (ALT) ii. Bilirubin iii. Protein
  • 10.
  • 11. HEPATITIS B VIRUS • A member of the hepadnavirus group • Circular partially double-stranded DNA viruses • Replication involves a reverse transcriptase. • Endemic in the human population and hyperendemic in many parts of the world. • A number of variants • It has not yet been possible to propagate the virus in cell culture
  • 12.
  • 13. HBV: MODES OF TRANSMISSION • Parenteral - IV drug abusers, health workers are at increased risk. • Sexual - sex workers and homosexuals are particular at risk. • Perinatal (Vertical) – mother (Hbe Ag+) →infant.
  • 14.
  • 15. LABORATORY DIAGNOSIS • A Variety of serological tests are used for the diagnosis of acute and chronic hepatitis B infection. • HBsAg - used as a general marker of infection. • HBs Ab - used to document recovery and/or immunity to HBV infection. • Anti-HBc IgM - marker of acute infection. Anti-HBc IgG - past or chronic infection. • Hbe Ag - indicates active replication of virus and therefore infectiveness. • HBV-DNA - indicates active replication of virus, more accurate than Hbe Ag especially in cases of escape mutants.
  • 16. HEPATITIS C • Shape: spherical, icosahedral, • Nucleic Acid: ss (+) RNA • HCV has been classified into a total of six genotypes (type 1 to 6) on the basis of phylogenetic analysis.
  • 17.
  • 18.
  • 19. LABORATORY DIAGNOSIS • HCV antibody - generally used to diagnose hepatitis C infection. Not useful in the acute phase as it takes at least 4 weeks after infection before antibody appears. • HCV-RNA - various techniques are available e.g. PCR and branched DNA. May be used to diagnose HCV infection in the acute phase. However, its main use is in monitoring the response to antiviral therapy. • HCV-antigen - an EIA for HCV antigen is available. It is used in the same capacity as HCV-RNA tests but is much easier to carry out.
  • 20. HEPATITIS D (DELTA) Shape: Spherical, 36-38 nm, HBV capsid, HDV nucleoprotein Nucleic Acid: (-) ss RNA, circular Satellite Virus : replicates Only in the presence of HBV
  • 21. MODES OF TRANSMISSION • Percutaneous exposure (injecting drug users) • Per mucosal • Sexual contact • The mode of transmission of HDV is similar to that of HBV.
  • 23.
  • 24. HEPATITIS E VIRUS • unenveloped RNA virus, 32-34nm in diameter • +ve stranded RNA genome, 7.6 kb in size. • very labile and sensitive • HEV has a fecal-oral transmission route. • Hepatitis E usually resolves on its own within four to six weeks
  • 25. LABORATORY DIAGNOSIS • Anti-HEV IgM and IgG. • HEV RNA quantification.