HEPATITIS

-DR.STEPHEN OMEGA BENITTA .M.B.B.S.,

07.06.2023
VIRAL HEPATITIS:
ACUTE VIRAL HEPATITIS
• CAUSE- any hepatitis virus
• Signs & symptoms occurs before
6 months
• Lobular disarray +hepatocyte
swelling
• Apoptotic hepatocyte
(councilman bodies)
CHRONIC VIRAL HEPATITIS
• By hepatitis B, C & D
• Sings & symptoms occurs after 6
months.
• symptoms mild or asymptomatic
• Piecemeal necrosis (patchy
necrosis)
HEP-A HEP-B(DNA) HEP-C HEP-D HEP-E
Infectious hepatitis Serum hepatitis Non – A ,Non-B Defective hepatitis Enteric hepatitis
hepatitis or post
trans-fusional
hepatitis

PICORNA VIRUS HEPADNA VIRUS FLAVI VIRUS DELTA VIRUS CALCI/HEPE VIRUS
Mild symptoms Occasionally severe Sub clinical Co-infection Mild symptoms
Super infection Normally but
extremely fatal in
pregnancy.
FECO-ORAL ROUTE PARENTRAL PARENTRAL PARENTRAL FECO-ORAL ROUTE
ROUTE/IV/SEX ROUTE/IV/SEX ROUTE/IV/SEX
Serology: Test: Serology:
HAV IgM ab- active Serology: -Enzyme HEV IgM ab – active
HAV IgG ab- markers immunoassay HEV IgG ab –
recovery/ -recombinant recovery , no
vaccination immunoblot vaccination
-HCV RNA
HEPATITIS B:
• Hep –B is a serious and common infectious diseases of the liver,
affecting million of people throughout the world.

• The severe pathological consequences of persistent HBV infection

include the development of chronic hepatic insufficiency, cirrhosis &
hepatocellular carcinoma.

• In addition , HBV carriers can transmit the disease for many years.
HEP-B STRUCTURE:
• Hepatitis virus is a DNA virus with a remarkably compact genomic
structure.
• It have circular partially double stranded DNA Viruses.
• Replication occurs by reverse transcriptase
• It is small , circular ,3200 base-pair size ,HBV DNA codes for four sets
of viral products and has a complex , Multi particle structure.
SIGNS & SYMPTOMS:
• Fever
• Fatigue
• Loss of appetite
• Nausea
• Vomiting
• Abdominal pain
• Dark urine
• Clay coloured bowel movements
• Joint pain
• Jaundice
• hepatomegaly
DIAGNOSIS MARKER:
• HBsAg – used as a general marker of infection.
• HBsAb – used to document recovery and /or immunity to HBV
infection.
• Anti – HBc IgM- marker of acute infection
• Anti-HBc IgG – past or chronic infection
• HBeAg – indicates active replication of virus and therefore
infectiveness.
TREATMENT:
• In acute hepatitis B the treatment is basically symptomatic
• Rest
• Anti emetic to control vomiting
• Hepatotropic agents
CHRONIC HEPATITIS B:
• INTERFERON- for HBeAg +ve carriers with chronic active hepatitis .

• LAMUVUDINE – a nucleoside analogue reverse transcriptase inhibitor

• tendency of relapse on cessation of treatment
• another problem is the rapid emergence of drug resistance.

• Successful response to treatment will result in the disappearance of

HBsAg, HBV – DNA , and sero conversation to HBeAg
RECOMMENDATION FOR PRE
EXPOSURE IMMUNIZATION WITH
HEP-B:
• Infant (universal immunization)
• Infant & adolescents not vaccinated previously
• Person with occupational risk
• Haemodialysis patients
• Recipients of blood & blood products
• Susceptible drug abusers
• Sexually active men or women
• Household contacts and sex partners of HBV carriers
• International traveller to area
• Transplant candidates.
FACTORS FOR DECREASED VACCINE
RESPONSE:
• Smoking
• Obesity
• HIV infection
• Immunocompromised patients
• Prematurity
• Genetic factor
• Haemodialysis
• Chronic disease
• Freezing of vaccine
• Accelerated schedule.
Thankyou…