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hepatitis B virus


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hepatitis B virus

  1. 1. +Done by: Ahmad Mhd Al-dhlawiyHamad Emad Dhuhayr
  2. 2. +Contents … General concepts for hepatitis. Types of hepatitis. HBV Structure & Antigens. Transmission Epidemiology. Pathogenesis & Immunity. Clinical pictures. Laboratory Diagnosis. Treatment Prevention. References.
  3. 3. +General Concepts … VIRAL HEPATITIS :- is a serious disease caused by virus thatattacks the liver . There are various strains of viral hepatitis which cancause lifelong infection, cirrhosis ( scarring) of the liver , liver cancer, liver failure, and death. six medically important viruses are commonly described as “hepatitisviruses”:HAV,HBV,HCV,HDV,HEV,HGV
  4. 4. +Terms for Hepatitis …. Acute: Short term and/or severe. Chronic: Lingering or lasting - may or may not be severe Fulminant: Developing quickly and lasting a short time, highmortality rate. Cirrhosis: Hardening: may be the result of infection or toxins (e.g.alcohol) Jaundice: Yellowing of the skin, eyes, etc due to raised levels ofbilirubin in the blood due to liver damage. Hepatocellular carcinoma: is closely associated with hepatitisB, and at least in some regions of the world with hepatitis C virus.
  5. 5. +…Viral hepatitis
  6. 6. +…Viral hepatitis
  7. 7. +HBV Structure & Antigens …HBsAg = surface (coat) protein ( 4 phenotypes : adw, adr, ayw and ayr)HBcAg = inner core protein (a single serotype)HBeAg = secreted protein; function unknown
  8. 8. +…Replication
  9. 9. +Modes of Transmission for HBV Parenteral - IV drug abusers, health workers areat increased risk. Sexual - sex workers and homosexuals areparticular at risk. Perinatal - (Vertical) - mother(HBeAg+)→infant.
  10. 10. +
  11. 11. +
  12. 12. +Incidence of Hepatitis in KSA
  13. 13. +risk groups for HBV infection-High People from endemic regions Babies of mothers with chronic HBV Intravenous drug abusers People with multiple sex partners Hemophiliacs and other patients requiting bloodand blood product treatments Health care personnel who have contact with blood
  14. 14. +Concentration of Hepatitis B Virusin Various Body Fluids …High ModerateLow/NotDetectableblood semen urineserum vaginal fluid feceswound exudates saliva sweattearsbreastmilk
  15. 15. +…Pathogenesis & Immunity Virus enters hepatocytes via blood Immune response (cytotoxic T cell) to viral antigens expressed onhepatocyte cell surface responsible for clinical syndrome 5 % become chronic carriers (HBsAg> 6 months) Higher rate of hepatocellular ca in chronic carriers, especially thosewho are “e” antigen positive Hepatitis B surface antibody likely confers lifelong immunity (IgGanti-HBs) Hepatitis B e Ab indicates low transmissibility
  16. 16. +Clinical pictures …
  17. 17. +Possible Outcomes of HBV InfectionAcute hepatitis B infectionChronic HBV infection3-5% of adult-acquired infections95% of infant-acquired infectionsCirrhosisChronic hepatitis12-25% in 5 yearsLiver failureHepatocellularcarcinomaLiver transplant6-15% in 5 years 20-23% in 5 yearsDeathDeath
  18. 18. +Acute Hepatitis B Infection
  19. 19. +…Laboratory Diagnosis
  20. 20. +Treatment …Interferon alfa (Intron A) Response rateis 30 to 40%.Lamivudine (Epivir HBV)(relapse ,drug resistance)Adefovir dipivoxil (Hepsera)
  21. 21. +Prevention …Vaccination- highly effective recombinant vaccines.Hepatitis B Immunoglobulin (HBIG)-exposed within 48 hours of the incident/neonates whose mothers are HBsAg and HBeAgpositive.Other measures-screening of blood donors, blood and body fluidprecautions.
  22. 22. +Hepatitis B Vaccine Infants: several options that depend on status of themother If mother HBsAg negative: birth, 0-2m,4-6m If mother HBsAg positive: vaccine and Hep B immuneglobulin within 12 hours of birth, 1-2m, <6m Adults * 0,1, 6 months Routine booster doses are NOT routinely recommended for any group Vaccine recommended in All those aged 0-18 Those at high risk
  23. 23. +Referenceswebsite books Richard A, HARVEY, Pamela C,Champe, Bruce D, Fisher. Microbiology 2nd edition. Lippicott Williams &wilkins. Chapter 26. PP(273-282) Raphael Rubin, David S. Strayer. Rubin’s pathology 5th edition. Lippicott Williams & wilkins. Chapter 14.PP(637-640)