Master Of Medicine

Hepatitis A(Infectious hepatitis)

1. RNA picorna virus
2. Feco-oral route of infection
3. Mild self limiting disease,active immunization available.

Hepatitis B(Serum hepatitis)

1. DNA hepadnavirus
2. Parenteral/sexual transmission
3. 1-2% mortality,95% cases resolve
4. Primary HCC,cirrhosis

Hepatitis C(Post transfusion hepatitis)

1. RNA flavi virus
2. Parenteral/Sexual transmission
3. a/c disease usually subclinical with high rate of chronicity 4%mortality
4. a/w Primary HCC,cirrhosis,no vaccine.

Hepatitis D(Delta hepatitis)

1. Defective enveloped RNA virus requires hep B as helper virus to replicate.
2. Co infection/superinfection
3. Coinfection-Both hep B and D acquired at same time- severe
4. Superinfection-Hep D infection in a patient already infected with hep B-High mortality.
5. Cirrhosis,fulminant hepatitis

Hepatitis E(Enteric Hepatitis)

1. RNA calcivirus
2. Feco oral route
3. Severe, high mortality rate-20%
4. 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

1. HBsAg- First virologic marker detectable in serum after HBV infection.Indicates ACTIVE infection, either acute/chronic.
2. Anti HBs-HBsAg antibody,provides immunity, persists for years.
3. HBcAg- Not detectable in blood
4. Anti HBc- Positive during window period.IgM anti HBc indicator of recent disease and IgG anti HBc indicator of Chronic disease.
5. HBeAg- Indicates active viral replication and high infectivity.
6. Anti HBe- When present in HBs Ag carrier, blood is less infectious.