Professional Documents
Culture Documents
Hepatitis
HIV
Viral Hepatitis
• A systemic disease with primary inflammation of the liver by any one of a
heterogeneous group of hepatotropic viruses.
• Hepatitis A
• Hepatitis B
• Hepatitis C
• Hepatitis D
• Hepatitis E
Hepatitis D virus
Hepatitis A virus Hepatitis B virus Hepatitis C virus Hepatitis E virus
(HDV); ssRNA;
Agent (HAV); ssRNA; No (HBV); dsDNA; (HCV); ssRNA; (HEV); ssRNA; no
envelope from
envelope envelope envelope envelope
HBV
Parenteral,
ROT Fecal-oral; Enteric Parenteral Parenteral Fecal-oral; Enteric
Vertical, Sexual
Classification Picornavirus Hepadnavirus Flavivirus Deltavirus Hepevirus
Viral genome ssRNA dsDNA ssRNA -SSRNA (-ve) ssRNA
Nil (only with
Carrier state Nil Common Present Nil
HBV)
10-50 days (avg. 50-180 days (avg.
Incubation period 40-120 days 2-12 weeks 2-9 weeks
25-30) 60-90)
Yes (<5% of
Chronic infection No Yes (10% chance) Yes (>50% chance) no
coinfection
Specific
Ig and vaccine Ig and vaccine Nil Nil Nil
prophylaxis
LABORATORY TECHNIQUES EMPLOYED FOR
DIAGNOSIS OF VIRAL HEPATITIS:
• ELISA- most popular laboratory technique for measuring hepatitis
markers
• RIA
• PCR- common for detecting small amounts of viral antigen present in
the early stages of the infection
• Western Blot- used in special testing circumstances
• Peptide analysis- used in special testing circumstances
Hepatitis A
Epidemiological Determinants
Agent factors
• AGENT: The causative agent, the hepatitis A virus, is an enterovirus of
the Picornaviridae family.
• RESISTANCE: The virus is fairly resistant to heat and chemicals.
• RESERVOIR OF INFECTION: The human cases are the only reservoir of
infection.
• PERIOD OF INFECTIVITY: greatest from 2 weeks before to 1 week after
the onset of jaundice.
• INFECTIVE MATERIAL: Mainly man’s feces.
• VIRUS EXCRETION: HAV is excreted in the faeces for about 2 weeks
before onset of jaundice and for up to 2 weeks thereafter.
Host factors
• AGE: more frequent among children than in adults
Treatment
• No specific treatment exists for hepatitis A
Prevention
• Sanitation: Avoid drinking
water of unknown purity,
uncooked shellfish, and
uncooked fruit/vegetables
not peeled or prepared by
traveler
Hepatitis C
HCV
• The infection is often asymptomatic
• About 50 to 80 % of patients progress to chronic hepatitis.
• In addition to replicating in the liver the virus can multiply in
lymphocytes.
Mode of Transmission
• The primary route of Transmission are believed to be similar to those
of HBV
Clinical Features
• Infection is dependent on HBV replication, as HBV provides
an HBsAg envelop for HDV
• Coinfection: delta and HBV are transmitted together at the same
time
• Superinfection: delta infection occurs in a person already
harbouring HBV
Diagnosis
• Delta antigen is primarily
expressed in liver cell nuclei,
where it can be
demonstrated by
immunofluorescence.
• Anti-delta antibodies appear
in serum and can be
identified by ELISA.
• IgM antibody appears 2-3
weeks after infection and is
soon replaced by the IgG
antibody in acute delta
infection.
Prevention
• HBV-HDV Coinfection
• Pre or post exposure prophylaxis to prevent HBV infection. Screening of blood
donor for HBsAg
• HBV-HDV Superinfection
• Education to reduce risk behaviors among persons with chronic HBV infection.
HUMAN IMMUNODEFICIENCY VIRUS (HIV)
• the causative agent of HIV infection
• Family: Retroviridae Subfamily: Lentivirinae
• Has a marked preference for T-helper/inducer lymphocytes (CD4+)
which serves as the receptor sites for the virus