VIRAL HEPATITIS

Dr. SHAMI POKHREL

LECTURER
Dept. of Pediatrics, LMC
 Hepatitis A
• Etiology
• Mode of infection
• Incubation period
• Infectivity period
• Pathogenesis
 Clinical feature
• Inapparant
• Subclinical
• Anicteric
• Icteric
• Acute onset
• Prodormal phase
• Icterus last for 1 to 4 weeks
 Investigations
• ALT
• AST
• GGTP
• Serum bilirubin, ALP
• Anti-HAV IgM
• PCR
 Complications
• Fulminant hepatitis
• Cholestasis
• Relapsing hepatitis A
• Autoimmune hepatitis
• Extrahepatic manifestations
 Treatment
• Supportive
• Bed rest
• Diet rich in carbohydrates and proteins
• Fat restriction
 PREVENTION
• Pre exposure prophylaxis

• Ig for susceptible travelers to HAV endemic countries

• It provides efficacy for up to 3 months

• HAV vaccine given any time before travel is preferred for

pre exposure prophylaxis in healthy persons, but Ig
ensures an appropriate prophylaxis in children younger
than 12 months old
 PREVENTION
• If travel is planned in <2 weeks, older patients,
immunocompromised hosts, and those with
chronic liver disease or other medical
conditions should receive both Ig and the HAV
vaccine
 PREVENTION
• Post exposure
• Not effective more than 2 wks after the
exposure
• Exclusively used for children <12 months old,
immunocompromised hosts, those with
chronic liver disease or in whom vaccine is
contraindicated
 Prevention

• Passive immunization
• Within 2 wks of the exposure
• Efficacy last for 6 months
• Active immunization
• Formalin inactivated
• Live attetunated
• A mother of 6 months old visits OPD seeking
advice on what should she do regarding her
child recently exposed to HAV after they came
from vacation of 5 days from Nigeria. It their
second day back from the country. What is
your advice?