Viral Hepatitis along with serological markers.pdf

It is Pdf made for easy understanding of viral Hepatitis along with lots of images. It can be used for your seminars and also for education purposes. This includes a detailed analysis of Hepatitis B with it's morphology, Serological markers and some other brief information.

1. VIRAL HEPATITIS
Presented by :
Dhananjay A. Sanap - 160
Anup Sakhre - 156
Satyajeet Salgar - 157
Aditya Salve - 158
Viraj Samudre -159

2. INTRODUCTION
• Infection of liver caused by hepatotropic viruses
(Hepatic viruses A,B,C,D and E )
•Other viruses that can also cause liver inflammation include
Cytomegalovirus, Epstein-Barr virus ,or Yellow Fever

3. ETIOLOGIC CLASSIFICATION
HEPATITIS A HEPATITIS B HEPATITIS C HEPATITIS D HEPATITIS E

4. HEPATITIS A
•Benign self limiting disease
•Responsible for 20-25% of clinical acute hepatitis
•Incubation period -> 2-6 weeks
•Affected age group -> 5-14 years
•Transmission -> Feco-oral route
•Shed in stool -> 2-3 weeks before & after the onset of jaundice

6. CLINICAL FEATURES
•The illness is more likely to be symptomatic in older adolescents and
adult.
•It is characteristically an acute febrile illness with abrupt onset of
anorexia, nausea, vomiting and jaundice.
•Typical duration of illness is 7-15 days.
•Regional lymph nodes and spleen may be enlarged.
•Prolonged infection maylead to acute liver failure.

7. SEROLOGICAL MARKERS
•Anti-HAV ANTIBODY -
1) IgM - onset of acute hepatitis
2 ) IgG - After acute illness & provide life-long immunity

8. HEPATITIS B
•Caused by HBV
•Incubation period -> 4-26 weeks
Transmission-
1) Exposure to infectious blood or body fluid.
2) Possible forms of transmission include ->
Sexual contact
Blood transfusion
Reuse of contaminated syringe
Vertical transmission

9. Morphology
•Partially ds DNA.
•HBV occurs in 3 morphology forms in serum.
a)small particles - 2 forms , 22 nm diameter
exist as tubules or spheres
b) Large particles - 42 nm diameter also
calledas "Dane particle " double shelled
spherical particles .

10. CLINICAL
FEATURES
•Many acute cases of HBV infection in children are
asymptomatic.
•The illness is preceded in a few children by a serum
sickness like prodrome marked by skin lesions,
including purpuric, macular or maculopapular rashes.
•In the usual course of resolving HBV infection
symptoms are present for 6-8 week
•Also have features of fever, anorexia, nausea,
vomiting and jaundice.

11. •HBV infection causes more severe form of illness that includes:
acute hepatitis B, chronic hepatitis, progression to cirrhosis,
fulminant hepatitis and an asymptomatic carrier stage.
•HBV also plays role in the development of hepatocellular
carcinoma.
HBV Evokes -
1.Humoral immunity
2.Cell mediated immunity

12. SEROLOGICAL MARKERS
1.HBsAg> before the onset of symptoms appears after 6 week of infection
declines in 3-6 months.
2. HBeAg > soon after HBsAg present transiently 3-6 weeks indicator of continued
viral replication .
3.HBcAg > Cannot be detected in blood demonstrated in nuclei of hepatocellular in
chronic hepatitis & carrier state.

13. 4. Anti HBe Ab -> prognostic sign for
resolution of infection.
5. Anti HBs Ab -> appears late-3 months
after the onset.
6. Anti-HBc Ab ->1st. ab appears in serum,
before the onset of symptoms.

14. HEPATITIS C
•Major cause of chronic liver disease(80%)
•Key features-Persistence of infection & chronic hepatitis
• Late consequence results in cirrhosis & hepatocellular carcinoma
•Mode of transmission:
1. Parental: inoculations and blood transfusion 2. Vertical transmission
•Type of virus:
HCV is a small-enveloped virus with sSRNA
•Incubation period:
2-26 weeks(mean: 6-12 weeks)

15. CLINICAL FEATURES
•Infection tends to be mild and insidious in onset
•Chronic HCV infection is also clinically silent until a complication
develops.
•Progression of liver fibrosis is slow over several years, unless comorbid
factors are present, which can accelerate fibrosis progression.
•Also have features of fever, anorexia, nausea, malaise, vomiting and
jaundice.

16. SEROLOGICAL MARKERS
•HCV RNA - few days after exposure
•Anti HCV ab - within weeks to few months
☆S. Aminotransferase- 2- 12 weeks

17. HEPATITIS D
Defective virus, cause infection only in
presence of HBV
Small, SSRNA particle
Double shelled ->
outer shell- HBSAg
inner shell- HDVAg

18. CLINICAL FEATURES
• The symptoms of hepatitis D infection
are similar to HBV, but usually more severe
than those of the other hepatotropic
viruses
• In coinfection, acute hepatitis, which is
much more severe than for HBV alone, is
common, but the risk of developing
chronic hepatitis is low.
• In superinfection, acute illness is rare and
chronic hepatitis is common

19. SEROLOGICAL MARKERS
•HDV RNA: It is detectable in blood and liver before and in early days of
acute disease.
•Anti-HDV : IgM anti HDV Ab is most reliable indicator of recent HDV
exposure.

20. HEPATITISE
•Enterically transmitted virus By contamination of water supplies
Usually affects young or middle aged individuals.
•High mortality in pregnant women otherwise self limited disease.
•Not associated with chronic liver disease

21. CLINICAL FEATURES
1.ACUTE INFECTIONS -
•The incubation period of hepatitis E varies from 3 to 8 weeks. After a short
prodromal phase symptoms lasting from days to weeks follow.
•They may include jaundice, fatigue and nausea. Viral RNA becomes detectable
in stool and blood serum during incubation period.
•Serum IgM and IgG antibodies against HEV appear just before onset of
clinical symptoms.
•Recovery leads to virus clearance from the blood, while the virus may persist
in stool for much longer.
•Recovery is also marked by disappearance of IgM antibodies and increase of
levels of IgG antibodies.

22. CHRONIC INFECTIONS -
• While usually an acute disease, in immunocompromised subjects
particularly in solid organ transplanted patients-hepatitis E may cause a
chronic infection.
• Occasionally this may cause liver fibrosis and cirrhosis.

23. SEROLOGICAL MARKERS
1.Anti-HEV antibodies of both IgM and IgG class. Both fall rapidly after
acute illness but routine serologic testing for HEV antibodies is not
available.
2. HEV-RNA