HEPATITIS C,D,E VIRUS HEPATITIS E VIRUS

 Nonenveloped, single-stranded RNA virus that belongs

to the genus Hepevirus, in the family Hepeviridae
HEPATITIS C VIRUS  Transmitted by the FECAL-ORAL ROUTE
 An enveloped, single-stranded, positive-sense DNA virus  Most HEV infections are related to consumption of
belonging to the family of Flaviviridae and genus fecally contaminated drinking water.
Hepacivirus  Incubation period of 3-8 weeks.

TRANSMISSION SEROLOGICAL/MOLECULAR MARKERS

 Exposure to contaminated blood, with intravenous drug  IgM anti-HEV
use being the main source of infection.  Current Hepatitis E infection
 Blood transfusion was also a major cause of infection  IgG anti-HEV
before 1992.  Current or past Hepatitis E infection
 HEV RNA
OTHER RISK FACTORS;  Current Hepatitis E infection
 Organ transplantation before 1992  RT-PCR – stool samples
 occupational exposure to contaminated blood
 Chronic hemodialysis
 Possibly intranasal cocaine use
 Body piercing
 Tattoo

COMPLICATIONS
 85% develop chronic infection, with increased risk of
cirrhosis, hepatocellular carcinoma, or autoimmune
manifestations.

SEROLOGICAL/MOLECULAR MARKERS
 Anti-HCV
 Current or past Hepatitis C infection
 HCV RNA
 current Hepatitis C infection; viral load may be
used to monitor effectiveness of therapy.
 Also used to determine HCV genotype.

 Any positive result from an anti-HCV screening test

should be confirmed.
 Confirmatory method: RECOBINANT IMMUNOBLOT
ASSAY (RIBA)
 RIBA: detects antibodies to different HCV antigens that
have been mobilized onto a nitrocellulose strip by a
colorimetric reaction.

HEPATITIS D VIRUS
 Also known as DELTA HEPATITIS
 Parenterally transmitted infection
 Can only occur in the presence of Hepatitis B
 HDV is a defective virus that requires the help of
HBV for its replication and expression.
 HDV consists of a circular RNA genome ans a single
structural protein called HEPATITIS DELTA ANTIGEN

COMPLICATIONS
 Increased risk of developing fulminant hepatitis,
cirrhosis, or hepatocellular carcinoma.

SEROLOGICAL/MOLECULAR MARKERS
 IgM-anti-HDV
 Used to detect acute or chronic Hepatitis D
infections
 IgG-anti-HDV
 Recovery from Hepatitis D or chronic Hepatitis
D
 HDV RNA
 Active HDV infection; viral load may be used to
monitor effectiveness or therapy.