The document discusses the main hepatitis viruses (A, B, C, D, E and G). It provides details on the epidemiology, clinical features, laboratory diagnosis, prophylaxis, and treatment of hepatitis A and B viruses. Hepatitis A and E are transmitted via the fecal-oral route, while hepatitis B and C are bloodborne and can be transmitted sexually or through contaminated needles. The document outlines the typical symptoms of hepatitis A infection and notes there is no antiviral treatment, only symptomatic treatment. Prophylaxis for hepatitis A involves vaccination and improved sanitation.

1. HEPATITIS VIRUSES
Dr. Ashish V. Jawarkar
M.D. (Pathology)

2. Dr. Ashish Jawarkar Hepatitis viruses 2
Hepatitis
 Infection of liver
 Hepatitis viruses – A, B, C, D, E and G
 B – DNA virus
 All others – RNA viruses
 Cause icteric jaundice
 Type A and E – food borne, feco oral route
 Type B and C – Blood borne, parenteral and
sexual routes

3. Dr. Ashish Jawarkar Hepatitis viruses 3
Hepatitis A
 Epidemiology
 Clinical features
 Lab diagnosis
 Prophylaxis
 Treatment

4. Dr. Ashish Jawarkar Hepatitis viruses 4
Epidemiology
 Common in children
 Feco oral route – contaminated water
or milk
 Over crowding and poor sanitation
 Ingested, reaches intestine,
penetrates epithelium, reaches liver
through blood

5. Dr. Ashish Jawarkar Hepatitis viruses 5
 Epidemiology
 Clinical features
 Lab diagnosis
 Prophylaxis
 Treatment

6. Dr. Ashish Jawarkar Hepatitis viruses 6
Clinical features
 2-6 weeks incubation period –
asymptomatic
 Clinical symptoms – malaise,
anorexia, nausea, vomitting and
abdominal pain
 Yellow urine

7. Dr. Ashish Jawarkar Hepatitis viruses 7

8. Dr. Ashish Jawarkar Hepatitis viruses 8
 Epidemiology
 Clinical features
 Lab diagnosis
 Prophylaxis
 Treatment

9. Dr. Ashish Jawarkar Hepatitis viruses 9
Lab diagnosis
 Raised bilirubin in serum
(indirect>direct)
 Yellow urine – bilirubin present
 Demonstration of antibodies by ELISA
 IgM – recent infection
 IgG – remote infection

10. Dr. Ashish Jawarkar Hepatitis viruses 10
 Epidemiology
 Clinical features
 Lab diagnosis
 Prophylaxis
 Treatment

11. Dr. Ashish Jawarkar Hepatitis viruses 11
Prophylaxis
 Improved sanitation
 Vaccine is available
 Natural infection leads to life long
immunity

12. Dr. Ashish Jawarkar Hepatitis viruses 12
 Epidemiology
 Clinical features
 Lab diagnosis
 Prophylaxis
 Treatment

13. Dr. Ashish Jawarkar Hepatitis viruses 13
Treatment
 No antiviral drug available
 Treatment is symptomatic

14. Dr. Ashish Jawarkar Hepatitis viruses 14
TYPE B HEPATITIS
 Over 350 million HBV carriers in the
world
 One million die anually

15. Dr. Ashish Jawarkar Hepatitis viruses 15
 Epidemiology
 Clinical features
 Lab diagnosis
 Prophylaxis
 Treatment

16. Dr. Ashish Jawarkar Hepatitis viruses 16
Epidemiology
 Hepatitis B virus structure

17. Dr. Ashish Jawarkar Hepatitis viruses 17
In the serum of Hep B patients we
can see – Australia antigen or

18. Dr. Ashish Jawarkar Hepatitis viruses 18
Dane particle

19. Dr. Ashish Jawarkar Hepatitis viruses 19
Developed countries
 Adolscents and young adults
 Infection occurs through
contaminated syringes and needles
 Drug addicts
 Homosexuals

20. Dr. Ashish Jawarkar Hepatitis viruses 20
Developing countries
 Children
 Vertical transmission from mother to
baby
 Horizontal transmission among
infants and neonates

21. Dr. Ashish Jawarkar Hepatitis viruses 21
Everywhere
 Razors, nail clippers, acupuncture,
tatooing, circumscision, ear or nose
piercing
 Barbers, dentists and doctors may
get infected

22. Dr. Ashish Jawarkar Hepatitis viruses 22
Carriers
 Those who donot have symptoms but
are HbsAg positive

23. Dr. Ashish Jawarkar Hepatitis viruses 23
Screening of blood donors
 Compulsory

24. Dr. Ashish Jawarkar Hepatitis viruses 24
 Epidemiology
 Clinical features
 Lab diagnosis
 Prophylaxis
 Treatment

25. Dr. Ashish Jawarkar Hepatitis viruses 25
Clinical features
 No symptoms in carriers
 Similar to HAV in acute phase

26. Dr. Ashish Jawarkar Hepatitis viruses 26
 Epidemiology
 Clinical features
 Lab diagnosis
 Prophylaxis
 Treatment

27. Dr. Ashish Jawarkar Hepatitis viruses 27
Lab diagnosis
 Demonstration of viral antibodies and
antigens in serum -

28. Dr. Ashish Jawarkar Hepatitis viruses 28

29. Dr. Ashish Jawarkar Hepatitis viruses 29
 HBsAg infection
 IgM anti HBcAg recent infection
 IgG anti HBcAg remote infection
 HBeAg infective
 Anti HBsAg immunity after
vaccination

30. Dr. Ashish Jawarkar Hepatitis viruses 30
 Epidemiology
 Clinical features
 Lab diagnosis
 Prophylaxis
 Treatment

31. Dr. Ashish Jawarkar Hepatitis viruses 31
Prophylaxis
 Avoid multiple partners
 Avoid drug abuse
 Use of disposable syringes and
needles
 Screening of Blood, organ and semen
donors
 Universal immunisation (vaccination)

32. Dr. Ashish Jawarkar Hepatitis viruses 32
Immunisation - Passive
 administer HBIG (Hepatitis B
immunoglobulin)
 Administer soon after accidental
exposure
 Can be administered to baby born to
a carrier mother

33. Dr. Ashish Jawarkar Hepatitis viruses 33
Active immunisation - vaccine
 Consists of HBsAg particles
 Given as a routine to all babies

34. Dr. Ashish Jawarkar Hepatitis viruses 34
 Epidemiology
 Clinical features
 Lab diagnosis
 Prophylaxis
 Treatment

35. Dr. Ashish Jawarkar Hepatitis viruses 35
Treatment
 Acute phase – no treatment required,
patients recover
 Chronic phase – become carriers, can
give antivirals like lamivudine and
adefovir to keep replication in check

36. Dr. Ashish Jawarkar Hepatitis viruses 36
Hepatitis C Virus
 Also blood borne
 Most common cause of post
transfusion hepatitis in developed
countries
 Most common cause of post hepatitis
– hepatocellular carcinoma

37. Dr. Ashish Jawarkar Hepatitis viruses 37
Hepatitis E virus
 Feco oral route
 Second common cause of hepatitis
after hepatitis A in developing
countries
 Generally mild and self limiting illness
 Unusually high mortality (20-40 %) in
pregnancy

38. Dr. Ashish Jawarkar Hepatitis viruses 38