Escolar Documentos
Profissional Documentos
Cultura Documentos
13 December 2007
HEPATITIS A – E VIRUSES: An Overview e.g. household contact, sex contact, child day
Viral Hepatitis – Historical Perspectives care centers
o Contaminated food, water
“Infectious”
Infectious”
Enterically e.g. infected food handlers, raw shellfish
A E transmitted
o Blood exposure
Rare
Viral “NANB”
NANB”
hepatitis
e.g. injecting drug use, transfusion
C
Hepatitis B Virus
C. Mode of Transmission
o Close personal contact
virns 1 of 5
Microbiology – Hepatitis A-E Viruses: An Overview by Dra de Castro Page 2 of 5
IgM anti-HBc
more likely to transmit to their offspring than
HBsAg anti-HBs those who are not
Perinatal transmission is the main means of
transmission in high prevalence population
H. Laboratory Diagnosis
0 4 8 12 16 20 24 28 32 36 52 100
o A battery of serological tests are used for the
Weeks after Exposure
diagnosis of acute and chronic hepatitis B
infection
o HBsAg
Progression to Chronic Hepatitis B Virus Infection
Typical Serologic Course Used as a general marker of infection
o HBsAb
Acute Chronic Used to document recovery and/or immunity
(6 months) (Years)
toHBV infection
HBeAg anti-HBe
o Anti-HBc IgM
HBsAg
Total anti-HBc Marker of acute infection
o Anti-HBc IgG
Titer
Chronic Infection (%)
80 80
therapy
60 60
I. Treatment
Chronic Infection o Interferon
40 40 For HBeAg positive carriers with chronic
active hepatitis
20 20 Response rate is 30 to 40%
Symptomatic Infection o Lamivudine
0 0
A nucleoside analogue reverse transcriptase
Older Children
Birth
1-4 yrs
inhibitor
1-6 mos
7-12 mos
and Adults
Titer
seroconversion to HBeAg
J. Prevention ALT
o Vaccination
Highly effective recombinant vaccines are
Normal
now available
Vaccine can be given to those who are at 0 1 2 3
Months
4 5 6 1 2 3
Years
4
Hepatitis D Virus
Microbiology – Hepatitis A-E Viruses: An Overview by Dra de Castro Page 4 of 5
A. Clinical Features
o Incubation period: Average 40 days
Range 15-60 days
HDV is a defective single-stranded RNA virus that o Case-fatality rate: Overall, 1%-3%
requires the helper function of HBV to replicate. HDV
Pregnant women, 15%-
requires HBV for synthesis of envelope protein composed
25%
of HBsAg, which is used to encapsulate the HDV genome.
A. Clinical Features o Illness severity: Increased with age
o Coinfection o Chronic sequelae: None identified
severe acute disease B. Serological course
low risk of chronic infection
o Superinfection
usually develop chronic HDV infection high
risk of severe chronic liver disease
may present as an acute hepatitis
B. Mode of Transmission
o Percutaneous exposures
Injecting drug use
o Permucosal exposures
Sex contact
C. Serological course
C. Epidemiologic Features
o Most outbreaks associated with faecally
contaminated drinking water
o Several other large epidemics have occurred
since in the Indian subcontinent and the USSR,
China, Africa and Mexico
o In the U.S. and other nonendemic areas, where
outbreaks of hepatitis E have not been
documented to occur, a low prevalence of anti-
HEV (<2%) has been found in healthy
populations. The source of infection for these
persons is unknown
o Minimal person-to-person transmission
D. Geographic Distribution
E. Prevention
o Avoid drinking water (and beverages with ice) of
unknown purity, uncooked shellfish, and
uncooked fruit/vegetables not peeled or prepared
by traveler
o IG prepared from donors in Western countries
does not prevent infection
o Unknown efficacy of IG prepared from donors in
endemic areas
o Vaccine?
♥end♥
D. Geographic Distribution
E. Prevention Thoughts brought about by watching Just Like
o HBV-HDV Coinfection Heaven and Prozac Nation successively. :)
Pre or postexposure prophylaxis to prevent I have no need of food. I have no need of sleep. I have
o HBV-HDV Superinfection no needs other than occasionally chewing a breath mint.
YOU ARE THE BEST THING THAT’S EVER HAPPENED TO
Education to reduce risk behaviors among
ME.. probably because it haven’t happened to me yet.
persons with chronic HBV infection
Now, I can pass into the next act, so poetically called:
euphoria.
Hepatitis E Virus
Microbiology – Hepatitis A-E Viruses: An Overview by Dra de Castro Page 5 of 5
xoxo