hepatitis Disease diagnosis and treatment

Hepatitis

1. HEPATITIS
NAME : ARSH BAZAZ
PRESENTED TO : DR. OWAIS BHAT, SCIENTIST D
ENROLLMENT NO. 2016Cukmr05
DEPARTMENT : BIOTECHNOLOGY

2. CONTENTS
Introduction
Types of hepatitis
Life cycle
Diagnosis
Prevention and treatment

3. INTRODUCTION
•It is a general term used to describe inflammation of liver.
•It can be caused by several viruses, chemicals, drugs, alcohol, certain genetic
disorders or by an overactive immune system that causes autoimmune hepatitis.
•Currently 11 viruses are recognised as causing hepatitis. Two are herpesvirus -
Cytomegalovirus and Epstein-Barr virus.
•It can be acute or chronic.
•Of the nine human hepatotropic viruses, only five are well characterized; hepatitis
G and TTV are more recently discovered viruses.

4. HEPATITIS B
•Hepatitis B(serum hepatitis) is caused by the
hepatitis B virus (HBV), a ds DNA virus.
•Serum from individuals infected with hepatitis B
contains three distinct antigenic particles:
spherical, tubular and Dane particle.
•The hepatitis B virus is normally transmitted
through blood or other body fluids (saliva, sweat,
semen) and shared intra-venous needles.
•The virus can also pass through the placenta to
the fetus of an infected mother.
•Prescott, Harley and Klein’s Microbiology.

5. •Worldwide, HBV infects over 200 million
people.
•The clinical signs of hepatitis B vary widely.
Mostcases are asymptomatic. However,
sometimesfever, loss of appetite, abdominal
discomfort,nausea, fatigue, and other symptoms
graduallyappear following an incubation period
of 1 to 3months.
•Overall prevalence of HBV was 2.4% in
southKashmir, 2.21% in males and 2.62% in
females.
•During 2015-2017, 393 cases of hepatitis
werereported in many districts of Kashmir.
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6. HEPATITIS C
•Hepatitis C is caused by the envelopedhepatitis
Cvirus (HCV), which has an 80nm diameter, a lipid
coat, contains a single strand of linear RNA.
•Symptoms may include fever, jaundice ,nausea ,
fatigue.
•The nucleocapsid consists of genomic RNA and
many copies of core proteins.
•Lipid bilayer envelope has envelope glycoprotein
E1 and E2 embedded.
https://upload.wikimedia.org/wikipedia/commons/thumb/7/78/Hegasy_
Hep_C_Virus_EN-01.jpg/330px-Hegasy_Hep_C_Virus_EN-01.jpg

7. •This virus is transmitted by contact with virus-contaminated blood, by the fecal-
oral route, by in utero transmission from mother to fetus, sexually, or through
organ transplantation.
•HCV accounted for more than 90% of hepatitis cases developed after a blood
transfusion.
•Worldwide, hepatitis C has reached epidemic proportions, with more than 1
million new cases reported annually.
•Furthermore, HCV is the leading reason for liver transplantation in the
United States.

8. HEPATITIS D
•HDV is a unique agent in that it is dependent on the
hepatitis B virus to providethe envelope protein
(HBsAg) for its RNA genome.
•HDV is spread via superinfection or coinfection.
•It affects globally, nearly 5% of people who have
chronic infection with HBV.
•It has a largeHDAg(27kDa) and a
smallHDAg(24kDa).
•Symptoms include fever, jaundice, nausea, fatigue,
dark urine.
https://www.researchgate.net/publication/338600212/figure/fig1/AS:114312812130
28288@1702931672868/Hepatitis-D-virus-HDV-structure-A-Schematic-
representation-of-HDV-viral-particle.tif

9. HEPATITIS A
•Hepatitis A(infectious hepatitis) usually is transmitted
by fecal- oral contamination offood, drink and other
unhygienic practices.
•The hepatitis A virus is an icosahedral, linear, positive-
strand RNA virus that lacks anenvelope. 5’ end is linked
toVpgviralprotein.
•Occasionally viremia occurs and the viruses may spread
to theliver.
•Symptoms last from 2 to 20 days and include anorexia,
general malaise, nausea, diarrhea,fever, and chills. If the
liver becomes infected, jaundiceensues.
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10. HEPATITIS E
•It has monopartite, positive-strand, RNA viral genome (7,900
nucleotides) which is linear.
•The virion is spherical, nonenveloped, and 32 to 34 nm in
diameter.
•Infection usually is associated with feces-contaminated drinking
water.
•HEV enters the blood from the gastrointestinal tract, replicates
in the liver and is subsequently excreted inthe feces.
•Symptoms include abdominal pain, anorexia, dark urine, fever,
hepatomegaly, jaundice, malaise, nausea,and vomiting.
HEPATITS E
https://microbenotes.com/wp-
content/uploads/2018/07/Structure-of-Hepatitis-E-Virus-1-
1024x593.jpg

11. HEPATITIS B GENOME REPLICATION
•After infecting the cell, the virus’s gapped DNA is released into the nucleus. There, host
repairenzymes fill the gap and seal the nick, yielding a covalently closed, circular DNA.
•Transcription of viral genes occurs and yields several mRNAs, including a large 3.4
kilobase RNA known as the pregenome (RNAs).
•mRNAs are translated to produce virus proteins including core proteins and a
polymerase.
•Reverse transcriptase subsequently reverse transcribes the RNA using a protein primer
to form a minus-strand DNA from the pregenome RNA.
•the remaining RNA fragment serves as a primer for synthesis of the gapped dsDNA
genome. Finally, the nucleocapsid is completed and the progeny virions are released.
•CD8+ T cells recognise HBV-derived peptides present on MHC 1 and kill cells by
perforin and granzyme pathway.

12. HEPATITIS B REPLICATION CYCLE
https://www.researchgate.net/publication/262787053/figure/fig1/AS:601677790994458@1520462572693/Hepati
tis-B-viral-replication-cycle-The-hepatitis-B-virus-virion-enters-the-hepatocyte.png
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9/MediaObjects/41575_2019_196_Fig1_HTML.png

13. DIAGNOSIS
•Diagnosis of HBV is made by detection of HBsAg in unimmunized individuals or HBc
antibody.
•Diagnosis of HCV is made by enzyme-linked immunosorbent assay (ELISA), which detects
serum antibody to a recombinant antigen of HCV, and nucleic acid detection by PCR.
•Serological tests for the detection of anti-delta antibodies and anti-hepatitis A antibody.
•LFT : Blood tests to check levels of liver enzymes (AST and ALT).
•Liver biopsy.
•Ultrasound : A special ultrasound called transient elastography can show liver damage.

14. PREVENTION AND TREATMENT
General measures for prevention and control involve :
•Excluding contact with Hepatitis-infected blood and secretions, and minimizing accidental
needle-stick.
•Vaccination for hepatitis A and hepatitis B are the most effective preventive measures, include
: Energix-B, Recombivax.
•Control of infection is by simple hygienic measures, the sanitary disposal of excreta.
•Recommended treatments : For HBV: Adefovirdipivoxil, alpha-interferon,andlamivudin.
•HCV : Ribovirinand pegylated recombinant interferon-alpha.
•Liver transplantation is the only alternative to chemotherapy.

15. REFERENCE
•Prescott, Harley and Klein’s Microbiology.
•National institute of health (NIH), website.
•Harrisons principle of internal medicine.

16. THANK YOU