University of Raparin

College of science
MLS department

Hepatitis B

prepared by:
Mina Zana
Nozhin Ahmed
Hoshyar omer
Hawkar Ismail
 Outlines

• introduction
• history
• virus
• Signs and symptom
• Transmission
• Replication of hepatitis B virus
• complications
• diagnosis
• treatment
 Introduction
• Hepatitis B is one of the world’s major unconquered disease.
Some 300 million people are chronic carriers of the virus, and
a significant majority pf these go on to develop cirrhosis or
cancer of the liver. It is estimated that up up to 2 billion people
have been exposed to this virus at some time in their life.
 History
• The history of modern research on viral hepatitis
began in the year 1963, when Nobel Prize winner
Baruch S. Blumberg (1925–2011) reported for the
first time publicly on the discovery of a new antigen
named Australia antigen (AuAg)
• Four years after discovering the hepatitis B virus,
Drs. Blumberg and Millman developed the first
hepatitis B vaccine, which was initially a heat-treated
form of the virus
 virus
• hepatitis B is caused by the hepatitis B virus (HBV). an
enveloped virus containing a partially double stranded,
circular DNA genome, and classified within the family of
hepadnavirus.
• The virus interferes with the functions of liver while
replicating in hepatocytes. The immune system is then
activated to produce a specific reaction to combat and possibly
eradicate the infection agents. As a consequence of
pathological damage, the liver becomes inflamed.
• HBV may be the cause of up to 80% of all cases of
hepatocellular carcinoma world wide.
 signs and symptoms

• They usually appear about one to four months after you've

been infected:
• Abdominal pain
• Dark urine
• Fever
• Joint pain
• Loss of appetite
• Nausea and vomiting
• Weakness and fatigue
• Yellowing of your skin and the
whites of your eyes (jaundice)
 transmission

• The virus is passed from person to person through blood,

semen or other body fluids.
• Common ways that HBV can spread are:
• Sexual contact
• Drug abuse
• Accidental needle sticks
• Blood transfusion
• Mother to child
• In the the dentist
• *It does not spread by sneezing or coughing
 replication of hepatitis B virus
• the HBV virion binds to a receptor at the surface of the
hepatocyte.
• * Viral nucleocapsids enter the cell and reach the nucleus
where the viral genome is delivered.
• * Reverse transcription: one of mRNAs is replicated with a
reverse transcriptase making the DNA that will eventually be
the core of the progeny virion.
• * RNA intermediate: HBV replicates through an RNA
intermediate and produces and release antigenic decoy
particles.
• * Integration: some DNA integrates into host genome causing
carrier state.
 complications
• Having a chronic HBV infection can lead to serious
complications, such as:
• Chronic hepatitis
• cirrhosis(Scarring of the liver)
• Hepato-cellular carcinoma (HCC)
• Other conditions. People with chronic hepatitis B may develop
kidney disease or inflammation of blood vessels
 diagnosis
• Anti-Hbe-virus no longer replicating. However, the patient can
still be positive for HBsAg which is made by integrated HBV.
• HBV-DNA-indicates active replication of virus, more accurate
than HBeAg especially in cases of escape mutants. Used
mainly for monitoring response to therapy
• Liver ultrasound- A special ultrasound called transient
elastography can show the amount of liver damage.
• Liver biopsy- your doctor inserts a thin needle through your
skin and into your liver and removes a tissue sample for
laboratory analysis to check for liver damage.
• And some liver enzyme and protein(ALT, AST, ALP, GGT…)
 treatment
• Treatment for hepatitis B depends on how long you have been
infected for:
• short-term(Acute) hepatitis B does not usually need specific
treatment, but may require treatment to relieve the symptoms.
• No treatment can prevent acute hepatitis from becoming
chronic.
• long-term(chronic) No curative treatment , but tries to delay or
prevent development of complications like liver damage and
cirrhosis. There two types of treatment currently given:
 treatment
• INTERFERON: Interferon alfa-2b (Intron A) is a man-made
version of a substance produced by the body to fight infection.
It boosts immune system to fight infection and is given
weekly.
• ANTIVIRAL DRUGS: Several antiviral medications
including entecavir (Baraclude), tenofovir (Viread),
lamivudine (Epivir), adefovir (Hepsera) and telbivudine
(Tyzeka), they try to stop the virus multiplication in the body,
These drugs are taken by mouth
 Hepatite D
• Hepatite D, also known as the hepatitis delta virus, is an infection that
cause the liver to become inflamed. This swelling can impair liver function
and causes long term liver problems including cirrhosis and cancer.
• The condition is caused by the hepatitis D virus(HDV) .

symptoms
* Joint pain
* Abdominal pain
* Vomiting
* Loss of appetite
* Dark urine
* Fatigue
 Transmitted
* urine
* Vaginal fluid
* Semen
* Blood
* Birth ( from mother to her newborn)

• Hepatitis D diagnosed by HDV Ab test (IgM and IgG) immunohistochemical staining

for HDAg ,ELISA and PCR.
• hepatitis D prevented by vaccinating HBV susceptible person with hepatitis B vaccine.

• The relationship between hepatitis B and hepatitis D:-

• Hepatitis B is a life-threatening liver infection that is caused by hepatitis B virus,
whereas, hepatitis D infection only occurs in people who are infected with the hepatitis
B virus. It replicates autonomously within hepatocytes, but requires hepatitis B surface
antigen for proliferation.
 References
• Burrell, C.J., Howard, C.R. and Murphy, F.A., 2016. Fenner
and White's Medical Virology. Academic Press.