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Similar to Viral hepatitis, All types of Hepatitis virus
Viral hepatitis, All types of Hepatitis virus
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- 2. Definition Viral hepatitisis a systemic viral infection in which necrosis and inflammation of liver cells produce a characteristic cluster of clinical , biochemical and cellular changes.
- 3. Types Hepatitis Avirus Hepatitis B virus Hepatitis C virus Hepatitis D virus Hepatitis E virus Hepatitis G virus
- 4. HEPATITIS A Reservoir---Human. Infective material---faeces , blood, & serum. Mode of transmission--- faeco –oral route, sexual, contaminated food &water. Infective period---2 weeks before onset of jaundice & 1 week after. Incubation period-10-50 days
- 6. Clinical Manifestation Prodromal period– 4 to 7 days Anorexia ,nausea ,& vomiting Muscular aches Fever 2-5 day till jaundice appears Abdominal pain Icteric stage -- jaundice on 3rd or 4th day
- 7. Immunologic & BiologicalEvents
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- 9. Management Mostly self-limiting Bed rest Hospitalization Diet
- 10. Vaccines KILLED VACCINE LIVEVACCINE HEPATITIS A BIOVAC A 0.5 ml SC SINGLE DOSE LIVE
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- 12. HEPATITIS B Mostcommon serious liver infection Caused by HBV Easily transmitted by blood Causes hepatocellular carcinoma Incubation Period- 50-180 days
- 14. Hepatitis B Virus Modesof Transmission
- 15. Spectrum of ChronicHepatitis B Diseases Chronic Persistent Hepatitis – asymptomatic Chronic Active Hepatitis - symptomatic exacerbations of hepatitis Cirrhosis of Liver Hepatocellular Carcinoma
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- 18. Treatment Interferon Lamivudine Adefovir Entecavir Successful response to treatment will result in the disappearance of HBsAg, HBV-DNA, and seroconversion to HBeAg. Telbivudine (Tyzeka, Sebivo) Approved in October 2006 by the FDA for adults. Several clinical trials have reported it to be more effective than lamivudine and adefovir.
- 19. Prevention Vaccination HepatitisB Immunoglobulin Other measures - screening of blood donors, blood and body fluid precautions.
- 20. Hepatitis B Vaccine HEPATITISB REVAC B SHANVAC B ₹175 ₹60 1ml 2ml IM 0,1,6 months Immunocompromised pts KILLED
- 21. HEPATITIS C VIRUS Is a single stranded RNA virus Bears no genomic resemble to HBV or HDV Transmission– blood &blood products drug users who share needles Incubation period-- 2-6 months Diagnosis antibodies to HCV
- 23. Treatment & Prevention TREATMENT Interferon Ribavirin PREVENTION Screening of blood, organ, tissue donors High-risk behavior modification Blood and body fluid precautions
- 24. HEPATITIS D VIRUS HDV Similar to HBV The delta agent is a defective virus Transmission: Percutanous exposures -Injecting drug use Permucosal exposures -Sex contact
- 26. Prevention HBV-HDV Coinfection: -Preor post exposure prophylaxis to prevent HBV infection. HBV-HDV Superinfection: -Education to reduce risk behaviors among persons with chronic HBV infection.
- 27. HEPATITIS E VIRUS Unenveloped RNA virus Very labile and sensitive HEV a water borne disease Incubation period- 2-9 Weeks No specific treatment No vaccine
- 29. Prevention Avoid drinkingwater (and beverages with ice) of unknown purity, Uncooked shellfish Uncooked fruit/vegetables not peeled or prepared by traveler. Vaccine available
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- 33. Source of virus feces blood/ blood-derived bodyfluids blood/ blood-derived body fluids blood/ blood-derived body fluids feces Route of transmission fecal-oral percutaneous permucosal percutaneous permucosal percutaneous permucosal fecal-oral Chronic infection no yes yes yes no Prevention pre/post- exposure immunization pre/post- exposure immunization blood donor screening; risk behavior modification pre/post- exposure immunization; risk behavior modification ensure safe drinking water Type of Hepatitis A B C D E
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Editor's Notes
- #19 Interferon - for HBeAg +ve carriers with chronic active hepatitis. Response rate is 30 to 40%. alpha-interferon 2b (original) alpha-interferon 2a (newer, claims to be more efficacious and efficient) Lamivudine - a nucleoside analogue reverse transcriptase inhibitor. Well tolerated, most patients will respond favorably. However, tendency to relapse on cessation of treatment. Another problem is the rapid emergence of drug resistance. Adefovir – less likely to develop resistance than Lamivudine and may be used to treat Lamivudine resistance HBV. However more expensive and toxic Entecavir – most powerful antiviral known, similar to Adefovir Successful response to treatment will result in the disappearance of HBsAg, HBV-DNA, and seroconversion to HBeAg. Telbivudine (Tyzeka, Sebivo) Approved in October 2006 by the FDA for adults. Several clinical trials have reported it to be more effective than lamivudine and adefovir.
- #20 Vaccination - highly effective recombinant vaccines are now available. Vaccine can be given to those who are at increased risk of HBV infection such as health care workers. It is also given routinely to neonates as universal vaccination in many countries. Hepatitis B Immunoglobulin - HBIG may be used to protect persons who are exposed to hepatitis B. Other measures - screening of blood donors, blood and body fluid precautions.
- #24 Interferon - may be considered for patients with chronic active hepatitis. The response rate is around 50% but 50% of responders will relapse upon withdrawal of 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. Protease inhibitors - The first protease inhibitors licensed were boceprevir (Victrelis) and telaprevir. They have been superseded by newer drugs such as Simeprevir (Olysio) and sofosbuvir (Sovaldi). In 2014, the FDA approved the combination of ombitasvir/paritaprevir/ritonavir and dasabuvir (Viekira Pak ) for the treatment of genotype 1 chronic hepatitis C infection in adults.
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