HEPATITIS
PRESENTED BY :- [Link] PRIYA
2nd PHARMAD
CONTENTS:-
INTRODUCTION
CLINICAL TERMS
TYPES OF VIRAL HEPATITIS
HEPATITIS A
HEPATITIS B
HEPATITIS C
HEPATITIS D
HEPATITIS E
HEPATITIS VACCINE
WHAT IS HEPATITIS ?
Viral hepatitis is a systemic disease with primary
inflammation of the liver by any one of a heterogenous
group of hepatotropic viruses.
The most common cause of viral hepatitis are the five
unrelated hepatotropic viruses HEPATITIS A,HEPATITIS
B,HEPATITIS C ,HEPATITIS D ,and HEPATITIS E
In addition to normal hepatitis viruses, other viruses that
can also cause liver inflammation include HERPES
SIMPLEX, CYTOMEGALOVIRUS, EPSTEIN BARR VIRUS or
YELLOW FEVER.
CLINICAL TERMS:-
❑ HEPATITIS:-Inflammation of liver
❑ ACUTE HEPATITIS :- Symptoms last less than 6 months
❑ CHRONIC HEPATITIS :- Inflammation of the liver for at
least 6 months
❑ CIRRHOSIS:-Replacement of liver tissue –fibrosis. These
changes lead to loss of liver function
❑ FULMINANT HEPATITIS:- Severe impairment of hepatic
functions or severe Necrosis of hepatocytes in the absence
of pre existing liver disease .
FEATURES OF DIFFERENT TYPES:-
HEPATITIS A
HEPATITIS A :-
A highly contagious liver infection caused by the
hepatitis A virus.
Hepatitis A virus (HAV), classified as hepatovirus, is a small,
unenveloped symmetrical RNA virus which shares many of
the characteristics of the picornavirus family, and is the
cause of infectious or epidemic hepatitis transmitted by –
fecal -oral route.
Symptoms include fatigue, nausea, abdominal pain,
loss of appetite and low-grade fever.
PATHOPHYSIOLOGY
Hepatitis A viruses
invade the body
Appears in feaces Multiplication
occurs in intestine
and reaches liver
Replication occurs
in the liver and
enters in intestine
SIGNS AND SYMPTOMS
• Yellow skin or eyes.
• Not wanting to eat.
• Upset stomach.
• Throwing up.
• Stomach pain.
• Fever.
• Dark urine or light- colored stools.
• Diarrhea.
DIAGNOSIS :-
1. Demonstration of feces, blood ,bile by
immunoelectron microscopy
2. Virus isolation
3. Detection of Antibody: By ELISA
4. Biochemical tests:- Alanine transferase,
Protein , bilirubin
5. Molecular diagnosis :- RT PCR OF FECES
PREVENTION:-
The best way to prevent hepatitis A is
through vaccination with the hepatitis A vaccine.
To get the full benefit of the hepatitis A vaccine,
more than one shot is needed. The number and
timing of these shots depends on the type of
vaccine you are given.
HEPATITIS B:-
✓ Hepatitis B ( is also known as serum Hepatitis ) is an
acute systemic infection with major Pathology in the Liver
caused by hepadanaviridae
✓ Transmitted by parenteral Route
✓ The acute illness causes Liver inflammation , vomiting ,
jaundice and rarely cause death . Chronic hepatitis B may
eventually cause cirrhosis and liver cancer.
✓ Hepatitis B is endemic throughout the world , especially in
tropical and deveolping countries
PATHOPHYSIOLOGY:-
SIGNS AND SYMPTOMS:-
• Fever.
• Fatigue.
• Loss of appetite.
• Nausea.
• Vomiting.
• Abdominal pain.
• Dark urine.
• Clay-coloured bowel movements.
DIAGNOSIS :-
❖ Serology
❖ Liver chemistry tests
AST, ALT,ALP and TPTAL BILIRUBIN
❖ Histology -- Immunoperoxidase staining
❖ HBV Viral DNA – Most accurate marker of viral DNA
and detected by PCR
❖ Liver Biopsy – To determine grade (inflammation)
and stage (fibrosis ) in chronic HEPATITIS
PREVENTION:-
❑ VACCINATION:-
-highly effective recombinant vaccines
❑ HEPATITIS B IMMUNOGLOBULIN (HBIG):-
-exposed within 48 hours of the incident /neonates
whose mothers are HBsAg and HBeAg positive
❑ OTHER MEASURES:-
- Screening of blood donors , blood and body fluid
precautions.
HEPATITIS C
HEPATITIS C :-
HepatitisC is a liver infection caused by
the hepatitis C virus (HCV). Hepatitis C is
spread through contact with blood from an
infected person. Today, most people
become infected with the hepatitis C virus
by sharing needles or other equipment
used to prepare and inject drugs.
PATHOPHYSIOLOGY:-
SIGNS AND SYMPTOMS:-
Pain areas: in the abdomen
Gastrointestinal: bleeding, bloating, fluid in the abdomen,
or nausea
Whole body: fatigue, fever, or loss of appetite
Skin: web of swollen blood vessels in the skin or yellow
skin and eyes
Also common: depression or weight loss
DIAGNOSIS:-
HCV ANTIBODY- ELISA used to diagnose Hepatitis C
infection ,not useful in the acute phase as it takes at least
4 weeks after infection before antibody appears
HCV –RNA:- Various techniques are available e.g. PCR and
branched DNA .May be used to diagnosis HCV Infection in
the acute Phase
HCV Antigen :- An EIA for HCV antigen is available . It is
used in the same capacity as HCV – RNA tests but is much
easier to carry out
PREVENTION
➢ Only general Prophlyaxis such as blood , tissue ,organ
screening is possible
➢ No specific active or Passive immunizing agent is available
➢ TREATMENT:-
➢ Ribavirin- there is less experience with ribavirin than
interferon . However , recent studies suggest that a
combination of interferon and ribavirin is more effective
than interferon alone
HEPATITIS D
HEPATITIS D:-
A serious liver disease caused by infection with the
hepatitis D virus.
Hepatitis D only occurs amongst people who are infected
with the Hepatitis B virus. Transmission requires contact
with infectious blood. At-risk populations include
intravenous drug abusers and men who have sex with men.
PATHOPHYSIOLOGY:-
SIGNS AND SYMPTOMS:-
• Yellow skin and eyes (jaundice)
• Stomach upset.
• Pain in your belly.
• Throwing up.
• Fatigue.
• Not feeling hungry.
• Joint pain.
• Dark urine.
DIAGNOSIS:-
HDV infection is diagnosed by high levels of anti-HDV
immunoglobulin G (IgG) and immunoglobulin M (IgM), and
confirmed by detection of HDV RNA in serum. However, HDV
diagnostics are not widely available and there is no
standardization for HDV RNA assays, which are used for
monitoring response to antiviral therapy.
PREVENTION:-
1. Avoid sharing drug equipment
2. Practice safe sex. ...
3. Avoid dental, medical or cosmetic procedures that
penetrate the skin with unsterilized equipment. ...
4. Wear latex gloves if you are likely to be in contact with
someone else's blood or bodily fluids.
HEPATITIS E
HEPATITS E
Hepatitis E is an inflammation of the liver caused by infection
with the hepatitis E virus (HEV). Every year there are an
estimated 20 million HEV infections worldwide, leading to an
estimated 3.3 million symptomatic cases of hepatitis E
The hepatitis E virus is mainly transmitted through drinking
water contaminated with faecal matter.
PATHOPHYSIOLOGY:-
SIGNS AND SYMPTOMS:-
• Fever.
• Fatigue.
• Loss of appetite.
• Nausea.
• Vomiting.
• Abdominal pain.
• Jaundice.
• Dark urine.
DIAGNOSIS
Definitive diagnosis of hepatitis E infection is usually based on
the detection of specific anti-HEV immunoglobulin M (IgM)
antibodies to the virus in a person's blood; this is usually
adequate in areas where the disease is common. Rapid tests are
available for field use.
PREVENTION:-
There is no specific antiviral therapy for acute hepatitis E.
Physicians should offer supportive therapy. Patients are typically
advised to rest, get adequate nutrition and fluids, avoid alcohol,
and check with their physician before taking any medications
that can damage the liver, especially acetaminophen.
VACCINE
?
ANY QUERIES
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