Lecture 2 Hepatitis (A-E) Viruses Hepatitis A 1. Clinical feature: Jaundice/ abdominal pain/ vomiting 2. Complications: Fulminant hepatitis/ Cholestatic/ hepatitis Relapsing hepatitis 3. no chronic sequelae/ its acute 4. Transmitted fecal-orally 5. There is a vaccine (is given for chronic liver disease) 6. Laboratory diagnosis (by ELA): a. Detection of IgM→ acute infection b. Detection of IgA→ past infection 7. Acquiring HAV in young → no or simple symptoms and the older the age →the more symptoms will appear and even HBV share this aspect with HAV. Hepatitis C 1. causing liver cirrhosis. 2. Serology: Firstly, we test HCV antibodies → If the patient is positive against Hep C antibodies, we have 2 possible scenarios either he has chronic hepatitis C infection or that he had the infection and fully recovered. so, to be sure we make another test: the HCV-RNA test → if it came positive, it means he has a chronic hepatitis C virus. 3. No vaccine Hepatitis E HEV usually silent except in pregnant women Hepatitis B 1. Clinical feature: Jaundice 2. Percutaneous/permucosal/vertical/ Parenteral transmission 3. Has a vaccine (suppress viral load only) 4. Spectrum of Chronic Hepatitis B Diseases a. Chronic hepatitis B b. Cirrhosis of Liver c. Hepatocellular Carcinoma (without causing cirrhosis) 5. Firstly, increase in HBsAg (indicate active replicating) then it will decline. Then the window period where only IgM anti-HBc is +ve 6. When pregnant mother is infected with hepatitis B We measure the titer in the third trimester if it is high, we give her a treatment to suppress the viral load. Then at the stage of delivery, the child should be given IVIG as soon as possible and in the other hand we give him the vaccine Hepatitis D 1. Can't be infectious on its own, it can only infect people who are already infected with hepatitis B. 2. co-infection a. someone gets infected with HBV & HDV at the same time from the same source. b. Sever acute disease c. Low risk of chronic disease 3. super-infection: a. someone who suffers from HBV from a long time and acquire HDV later on b. chronic infection c. high risk of chronic liver disease

Hepatitis (A-E) Viruses

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