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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