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CLASSIFICATION and MODE OF TRANSMISSION

Hepatitis A virus (HAV)


-Hepatitis A virus is a small, icosahedral, naked ssRNA virus, the sole member of the
genus Hepatovirus in the family Picornaviridae. HAV infects people of all ages. In the
United States, children between ages of 5 to 14 years have the highest rate of infection,
with almost 30% of all cases occurring in children younger than 15 years. The WHO
estimates that 1.5 million clinical cases of HAV infection occur each year.
Mode of transmission
Fecal-oral route and is usually acquired through close personal contact or via
contaminated food. The risk factors for HAV infection include sexual or household
contact with an infected person, daycare contacts, foodborne, waterborne outbreaks, IV
drug use and international travel.
Hepatitis B virus
Hepatitis B virus (HBV) is an enveloped, partially dsDNA virus that belong to the family
Hepadnaviridae. The virus contains the hepatitis B surface antigen (HBsAg) that
circulates in blood stream as 22-nm particles. The whole virus has total diameter of
about 45 nm. The virion also contains a core antigen (HBcAg) and hepatitis Be antigen
(HBeAg). Eight genotypes of HBV have been identified (A to H), and several studies
have shown a difference in clinical outcome based on the genotype.

Mode of transmission
The main mode of transmission or through sexual, perianal, and parenteral routes. In
the United States, heterosexual and male homosexual contact is the most common
routes of transmission.
High-risk group include IV drug users, MSM, individuals from endemic areas, health
care personnel, people with tattoos or body piercing, and infants born to HBV-positive
mothers. However, almost one third of the patients who become infected have no
known risk factor.

Hepatitis C virus
Hepatitis C Virus is an ssRNA virus in the genus Hepacivirus, family Flaviviridae; it
accounts for about 90% of all previous cases in NANB hepatitis. Currently, fewer than
1000 new cases occur annually in the United States, with only 850 seen in 2012.
However, because of its ling incubation period, it is estimated approximately 20,000
acute infections occur each year. This was ultimately reduce because of factors such as
safer use of needles by IV drug abusers and reduction of post- transfusion infections as
result of better testing.
Mode of transmission
Although perianal and sexual transmission of infection occur, and parenteral
transmission has been identified as a major route for infection, HCV antibody has been
detected in patients in whom the routes of transmission are poorly understood or who
have no evidence of identifiable risk factors.

Hepatitis D virus
Hepatitis D virus (HDV), also known as the delta hepatitis virus, is a defective 1.7 –kb
ssRNA virus that requires HBV for replication. HDV requires the HBV HBsAg for its
envelope. HDV is the sole member of the genus Deltavirus, and the genus is not
currently assigned to a family.

Mode of transmission
HDV is transmitted primarily by parenteral means, although transmission by mucosal
contact has been implicated in epidemics in endemic areas. At-risk groups in the United
States are primarily IV drug users, although limited number of MSM in certain parts of
the country are also at risk.

Hepatitis E virus
Hepatitis E virus (HEV) is a small (32-34 nm), naked, ssRNA virus classified in the
genus Hepevirus, family Hepeviridae. HEV has been identified as a cause of epidemics
of enterically transmitted hepatitis in developing countries in Asia, Africa, Central
America.
Mode of transmission
HEV is transmitted by the fecal-oral route, particularly in contaminated drinking water.