Hepatitis is an inflammation of the liver that can be caused by viruses or other factors. There are five main hepatitis viruses: Hepatitis A, B, C, D, and E. Hepatitis B and C cause chronic liver disease and put people at high risk for cirrhosis and liver cancer. Hepatitis B is diagnosed through blood tests detecting antigens and antibodies. Treatment involves antiviral medication lasting 6 months to a year. Hepatitis C is diagnosed through blood tests detecting antibodies and RNA. New antiviral drugs can cure most cases of Hepatitis C infection within 12 weeks of treatment. There are vaccines to prevent Hepatitis A and B but currently no vaccine for Hepatitis C.

1. HEPATITIS
Presented by/ Hams Hamed

2. outline
Definition of hepatitis
Causes of hepatitis
Types of hepatitis viruses
Hepatitis B virus
Hepatitis C virus

3. Definition of hepatitis:
Hepatitis is an inflammation of the liver,
the condition can be self-limiting or can
progress to fibrosis (scarring), cirrhosis or
liver cancer.

4. CAUSES OF
HEPATITIS
NON-
VIRAL
Giant cell
hepatitis
Ischemic
hepatitis
Non-
alcoholic
fatty liver
hepatitis
Autoimmune
hepatitis
Toxic and
drug
induced
hepatitis
Alcoholic
hepatitis
VIRAL
A, B, C, D,
E

6. HEPATITIS B & C VIRUSES

7. ROUTE OF TRANSMISSION

8. RISK OF TRANSMISSION:
Risk of transmission mainly depend on:
Environmental
Viability (ability to
survive outside the
human body)
Frequency of the
disease occurring
in population
Viral load
Number of viruses
in patient’s blood

9. DIRECT INFECTION
through a cut on the skin
(percutaneous), as a result of:
An accidental bite by the
patient during a dental
procedure.
Needle wound during an
anesthetic procedure.
Cut with a sharp object such as
a scalpel blade.
INDIRECT INFECTION
Aerosols of saliva.
Gingival fluid.
Natural organic particles
(dental caries tissue) mixed
with air and water.
e.g. blood splash to the eye.

10. SIGNS AND SYMPTOMS

12. HEPATITIS B VIRUS

13. HEPATITIS B VIRUS
Prevalence:
The world can be divided into three areas where
the prevalence of chronic HBV infection is:
High (>8%), Intermediate (2-8%), and Low (<2%).
Egypt is of intermediate endemicity (2–8%),
nearly 2-3 million Egyptians are chronic carriers.

14. HEPATITIS B VIRUS
Incubation period:
Symptoms begin an average of 90 days
 (range: 60–150 days) after exposure to HBV.
Diagnosis: (serology)
Detection of hepatitis B virus infection involve serum
or blood tests that detect either viral antigens (proteins
produced by the virus) or antibodies produced by the
host.

15. HEPATITIS B VIRUS
Diagnosis: (serology)
• indicating infectious person.
• Used to make hepatitis B vaccine.(HBsAg)
• Indicating recovery and immunity.
• In successfully vaccinated person.(anti-HBs)
• Indicating replicating virus.
• Person has high level of HBV.(HbeAg)

16. HEPATITIS B VIRUS
Treatment:
Acute hepatitis B infection does not usually require
treatment as most adults clear the infection
spontaneously.
Treatment of chronic infection may be necessary to
reduce the risk of cirrhosis and liver cancer.
Treatment lasts six months to year depending on
medication and genotype.
Antiviral drugs lamivudine (Epivir), adefovir (Hepsera).

17. HEPATITIS B VIRUS
Vaccination:
Vaccine by 3 injections : 1st dose at base line, 2nd dose
after one month, 3rd dose after 6 months from 1st and
post vaccination (anti-HBs) antibody level one month
later if:
>100 IU/l ---Responder (85%-90% of individual)
10-100--- poor responder (need booster)
<10 ---non responder (repeat vaccination)

19. HEPATITIS C VIRUS

20. Source of infection for persons of hepatitis C

21. HEPATITIS C VIRUS
Prevalence:
About 170 million people are
living with HCV infection.
the prevalence is reported to be
the highest (approximately 10%) in
Egypt.

22. HEPATITIS C VIRUS
Incubation period:
The incubation period for hepatitis C virus
is (2 weeks to 6 months).
The average time period from exposure to
symptom onset is 4–12 weeks
 (range: 2–24 weeks).

23. HEPATITIS C VIRUS
Diagnosis:
Several blood tests are performed to test for HCV infection,
including:
Screening tests for antibody to HCV (anti-HCV)
Qualitative tests to detect presence or absence of virus (HCV
RNA polymerase chain reaction [PCR])
Quantitative tests to detect amount (titer) of virus (HCV RNA
PCR)

24. HEPATITIS C VIRUS
Treatment:
Therapy based on interferon and ribavirin, which required weekly
injections for 48 weeks, cured approximately half of treated patients,
but caused frequent and sometimes life-threatening adverse
reactions.
Recently, new antiviral drugs have been developed.
These medicines, called direct antiviral agents (DAA) are much more
effective, safer and better-tolerated than the older therapies.
Therapy with DAAs result can cure most persons with HCV infection
and treatment is shorter (usually 12 weeks) and safer.

25. HEPATITIS C VIRUS
vaccination:
There is no vaccine against HCV.
There are major challenges to the future development of a
hepatitis C vaccine.

26. Refrences:
http://www.cdc.gov/hepatitis/hcv/index.htm
https://en.wikipedia.org/wiki/Hepatitis
http://www.healthline.com/health/hepatitis#Diagnosis5
http://www.dentalcare.com/media/en-
US/education/ce307/ce307.pdf
http://www.ejgd.org/article.asp?issn=2278-
9626;year=2013;volume=2;issue=1;spage=13;epage=19;aulast=Setia