Hepatitis A(Infectious hepatitis)
- RNA picorna virus
- Feco-oral route of infection
- Mild self limiting disease,active immunization available.
Hepatitis B(Serum hepatitis)
- DNA hepadnavirus
- Parenteral/sexual transmission
- 1-2% mortality,95% cases resolve
- Primary HCC,cirrhosis
Hepatitis C(Post transfusion hepatitis)
- RNA flavi virus
- Parenteral/Sexual transmission
- a/c disease usually subclinical with high rate of chronicity 4%mortality
- a/w Primary HCC,cirrhosis,no vaccine.
Hepatitis D(Delta hepatitis)
- Defective enveloped RNA virus requires hep B as helper virus to replicate.
- Co infection/superinfection
- Coinfection-Both hep B and D acquired at same time- severe
- Superinfection-Hep D infection in a patient already infected with hep B-High mortality.
- Cirrhosis,fulminant hepatitis
Hepatitis E(Enteric Hepatitis)
- RNA calcivirus
- Feco oral route
- Severe, high mortality rate-20%
- No c/c infection,not associated with cancer.
Tips to remember
- Hep C- Chronic,Cirrhosis,Carcinoma,carriers
- Hep D- Defective,Dependent on Hep B
- Hep E- Expectant mothers,Epidemics.
Hepatitis B serology
- HBsAg– First virologic marker detectable in serum after HBV infection.Indicates ACTIVE infection, either acute/chronic.
- Anti HBs-HBsAg antibody,provides immunity, persists for years.
- HBcAg- Not detectable in blood
- Anti HBc– Positive during window period.IgM anti HBc indicator of recent disease and IgG anti HBc indicator of Chronic disease.
- HBeAg– Indicates active viral replication and high infectivity.
- Anti HBe– When present in HBs Ag carrier, blood is less infectious.
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