Viral Hepatitis - An Overview of the etiology.ppt

Viral Hepatitis

1. Viral Hepatitis
Dr.J.Karthikesh MD

2. Types
HAV – self limiting, fecal-oral route
HBV – parenteral transmission, chronic
HCV – transfusion associated
HDV – (delta) superinfection with HBV
HEV – water borne infection
HGV – parenteral transmission

3. HBV – it is a DNA virus
All others are RNA viruses

4. Hepatitis A
Causes infectious hepatitis
Benign, self limiting disease
Incubation period – 15-45 days
Spreads by fecal-oral route
5-14 yrs commonly affected

5. Hepatitis B
Called as Serum Hepatitis
Incubation period – 30 – 180 days
Parenteral transmission – blood and
blood products, IV drug abusers, renal
dialysis, sexual contact, mother to fetus,
hospital workers
Affects any age
Produces severe symptoms

6. Hepatitis B
Acute Hepatitis B
Chronic hepatitis B
Cirrhosis of liver
Fulminant hepatitis
Asymptomatic carrier stage
Hepatocellular carcinoma

7. Acute Hepatitis
Four phases
Incubation period – varies for each virus
Pre-icteric phase – anorexia, vomiting,
fatigue, malaise arthralgia, headache
Icteric phase – clinical jaundice, dark
colored urine, clay colored stools, pruritus
Post – icteric phase – recovery in 1 to 4
weeks.

8. Morphological changes
1. Hepatocellular injury
Ballooning degeneration – cell swelling
with granular clumps around nuclei
Councilman bodies – acidophilic
degeneration with extrusion of nucleus
Dropout necrosis – small clusters of
hepatocytes undergo necrosis
Bridging necrosis – portal to portal, portal
to central, central to central

9. Morphology
2. Inflammatory infiltrate
Portal inflammation
3. Kupffer cell hyperplasia
4. Cholestasis
5. Regeneration

10. Chronic hepatitis
Defined as continuing or relapsing hepatic disease
for more than 6 months with symptoms along with
biochemical, serologic, and histopathological
evidence of inflammation and necrosis.
Causes are mainly HBV, HCV and combined HBV
and HDV
Types :
Chronic persistent hepatitis
Chronic active hepatitis
Chronic lobular hepatitis

11. Pathological changes
Piecemeal necrosis
Portal tract lesions
Intralobular lesions
Bridging fibrosis