Hepatits b

Hepatits b

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  Hepatitis B SHAHID
• 2.
  • Caused byhepatitis B virus (HBV), belonging to the group of hepadna viruses. • It is small, circular, 3200 base- pair size, HBV DNA codes for four sets of viral products and has a complex, multi particle structure. • The hepatitis B virus is 42nm in diameter and composed of 27 nm nucleocapsid core containing hepatitis B core antigen(HBcAG), surrounded by outer lipo protein coat (also called envelope) containing the surface antigen (HBsAG) • while another soluble antigen in the nucleocapsid is called hepatitisB e antigen (HBeAg)]. • Nucleocapsid core also bas DNA polymerase enzyme.
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  • Virion alsoreferred to as Dane particle (ds DNA) • The corresponding antibodies are: • Anti-HBs • Anti-HBc • Anti-HBe. • HBsAg-positive serum containing HBeAg is more likely to be highly infectious than HBeAg-negative or anti-HBe positive serum
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  Epidemiology • Incubation periodis about 90 days (50-150 days). • Humans are the only source of infection • Major route of transmission is parenteral but occasionally non- parenteral • Serum HBsAg is positive in 30% cases of Down's syndrome, lepromatous leprosy, leukaemia, Hodgkin's disease, polyarteritis nodosa, patients on chronic haemodialysis and needle using drug addicts.
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  MODES OF TRANSMISSION Sexual - sex workers and homosexuals are particular at risk.  Parenteral – IV drug users, Health Workers are at increased risk.  Perinatal - Mothers who are HBeAg positive are much more likely to transmit to their offspring than those who are not. Perinatal transmission is the main means of transmission in high prevalence populations.
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  HIGH-RISK GROUPS FORHBV INFECTION People from endemic regions Babies of mothers with chronic HBV Intravenous drug abusers People with multiple sex partners Hemodialysis patients Health care personnel who have contact with blood
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  Clinical Features • Prodromalsymptoms usually last for a few days to 2 weeks before the onset of jaundice • characterised by fever, chills, headache, malaise and prominent GI symptoms like anorexia ,Nausea, vomiting and diarrhoea follow. • Patients with HB V infection have polyarthralgia and occasionally a "serum sickness syndrome" with skin rashes and polyarthritis • upper abdominal pain, sometimes severe (due to stretching of liver capsule). • Urine is dark with yellowish discolouration of sclera.
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  • With onsetof clinical jaundice constitutional symptoms diminish. • Liver becomes palpable and tender. • Enlarged cervical lymph nodes and splenomegaly. • As obstruction to biliary canaliculi increases (cholestatic phase), jaundice deepens, stools become paler, urine becomes darker and liver becomes more palpable.
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  • Recovery phase-graduallyappetite improves and gastrointestinal symptoms subside; jaundice decreases, stools and urine become normal, and liver size decreases. Over a period of 3-6 weeks, majority recover • Complete clinical and biochemical recovery occurs in 3-4 months from the onset in hepatitis B and C.
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