Viral hepatitis 2022.pptx

Viral hepatitis is a systemic disease with primary inflammation of the liver by any one of a heterogenous group of hepatotropic viruses.
Most common-HepA,HepB,HepC,HepD and E.
Others-herpses simplex,cytomegalovirus,Epstein Barr virus and yellow fever
 2.4B of the world infected with one/more hep Virus1
Viral hepatitis is responsible for approximately 1·34 million deaths annually1
HepB and C responsible for 90% of these fatalities,10% others1
WHO estimates that 296 million people were living with chronic hepatitis B infection in 2019, with 1.5 million new infections each year2
Hepatitis B is estimated to account for 87 890 deaths annually in sub-Saharan Africa3

1. Hepatitis B Virus and others viruses causing Hepatitis Dr.Hamisi Mkindi Dr.Lusato Bwire

2. Outline Introduction Epidemiology Molecular Virology Life cycle Diagnsosis -Biomarkers How HBV evade immune system Natural hx of HBV Treatment and Prevention

3. Introduction Viral hepatitis is a systemic disease with primary inflammation of the liver by any one of a heterogenous group of hepatotropic viruses. Most common- HepA,HepB,HepC,HepD and E. Others- herpses simplex,cytomegalovirus,Epstein Barr virus and yellow fever

4. Epidemiology   2.4B of the world infected with one/more hep Virus 1 Viral hepatitis is responsible for approximately 1·34 million deaths annually 1 HepB and C responsible for 90% of these fatalities,10% others 1 WHO estimates that 296 million people were living with chronic hepatitis B infection in 2019, with 1.5 million new infections each year 2 Hepatitis B is estimated to account for 87 890 deaths annually in sub-Saharan Africa 3 1. Update on global epidemiology of viral hepatitis and preventive strategies. Jefferies, Meryem . s.l . : World J Clin Cases, 2018.

5. Epi-Cont …. A seroprevalence of HBV infection in the country was reported to be 6% in the general population of Dar es Salaam 4 Chronic HBV infection is common among Tanzanian HCWs-7% 5 High endemic areas-perinatal/horizontal transmission-WHO A cquired in adulthood - chronic hepatitis < 5 % of cases,in infancy and early childhood -chronic hepatitis in about 95% 4. Kilonzo , Semvua . Journal Of Tropical Medicine. Hindawi . [Online] 2018. https://www.hindawi.com/journals/jtm/2018/4239646/#introduction. 4239646.

6. Molecular-Virology VIRUS Hep A Hep B Hep C Hep D Hep E Family Picornaviridae Hepadnaviridae Flaviviridae Deltavirus Hepevirus Envelope No Yes Yes Yes No Stability Acid stable Acid sensitive Acid sensitive Acid sensitive Acid/Heat stable Transmission Fecal-oral parenteral parenteral Parenteral Fecal-oral Prevalence High High moderate Low,regional regional Chronic D’se Never Often,5-10% adult,90% infacts -HPC Often,80%,HPC Often,Co Inf.HBV Never,low immune,pregnant severe form Genome ssRNA pdsDNA ssRNA ssRNA ssRNA

7. 12/21/2021 https://wdrfree.com/stock-vector/viral-dna 7

8. 12/21/2021 8

9. LIFE CYCLE

10. Clinical Presentation Illness ranges from asymptomatic to fulminant Jaundice,Fatigue ,Abdominal pain ,Loss of appetite ,Nausea , vomiting and Joint pain and fever Biomarkers

11. Biomarkers Terms HBsAg / Anti-HBs HBeAg / Anti- HBe IgM anti- HBc / IgG anti- HBc

12. Serologic Patterns

13. Serological pattern cont …

14. Patterns cont … 6 genotypes reported HBV-S gene mutation Tanzania,phylogenetic analysis of S-gene sequence revealed HBV genotype A1 (HBV/A1) to be the most common in 86.1 %- Chronicity,HCC . Not responding to nucleotide analogs but rather interferons

15. Immune system evasion Sequestration in sites that are inaccessible to the immune system. Mutations within the pre-core/core genes of HBV can result in loss of expression of the hepatitis e antigen ( HBeAg ) M utations in the envelope gene that lead to a loss of detectable HBsAg expression and viral persistence in the face of anti- HBsAg antibodies Disrupting function of activated T cells

16. Natural History of HBV Two major determinants of the outcome of acute HBV are age and immunocompetence at time of infection. Children-Initial infection subclinical-chronicity Four stages of natural history

17. Natural History of HBV

18. Natural History of HBV

19. Treatment HBV

20. Prevention Universal vaccination of infants beginning at birth (≥3 intramuscular doses)-WHO reccomendation • Prenatal maternal HBsAg screening and if HBsAg positive, hepatitis B immune globulin 0.5 mL at birth along with vaccination. • Tenofovir 300 mg starting in the third trimester in women with HBV DNA >108 IU/mL (some authorities recommend antiviral therapy for mothers with HBV DNA >106 IU/mL)

21. Vaccination

22. References 1. Update on global epidemiology of viral hepatitis and preventive strategies. Jefferies, Meryem . s.l . : World J Clin Cases, 2018. 2. WHO. World Helath Organization. [Online] 2021. who.int/news-room/fact-sheets/detail/hepatitis-b. 3. The lancet. [Online] 2017. www.thelancet.com/journals/langas/article/PIIS2468-1253(17)30295-9/fulltext. 4. Kilonzo , Semvua . Journal Of Tropical Medicine. Hindawi . [Online] 2018. https://www.hindawi.com/journals/jtm/2018/4239646/#introduction. 4239646. 5. A.Mueller . BMC Infectious Disease. Biomed Central. [Online] 2015. https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-015-1129-z.