Hepatitis Viruses

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.

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