Subtitle

 Reporters:
 Leader: Pasaquian, Kylle
 Secretary: Jimeno, Jeremy
 Member:
 Olvez, Von Vinci
 Q: What is hepatitis?
 Hepatitis is an inflammation of the liver. The condition can be self-
limiting or can progress to fibrosis (scarring), cirrhosis or liver cancer.
Hepatitis viruses are the most common cause of hepatitis in the
world but other infections, toxic substances (e.g. alcohol, certain
drugs), and autoimmune diseases can also cause hepatitis.
 There are 5 main hepatitis viruses, referred to as types A, B, C, D and E. These 5 types are of
greatest concern because of the burden of illness and death they cause and the potential for outbreaks
and epidemic spread. In particular, types B and C lead to chronic disease in hundreds of millions of
people and, together, are the most common cause of liver cirrhosis and cancer.
Hepatitis A and E are typically caused by ingestion of contaminated food or water. Hepatitis B, C
and D usually occur as a result of parenteral contact with infected body fluids. Common modes of
transmission for these viruses include receipt of contaminated blood or blood products, invasive medical
procedures using contaminated equipment and for hepatitis B transmission from mother to baby at
birth, from family member to child, and also by sexual contact.
Acute infection may occur with limited or no symptoms, or may include symptoms such as
jaundice (yellowing of the skin and eyes), dark urine, extreme fatigue, nausea, vomiting and abdominal
pain.
Q: What are the different hepatitis viruses?

Scientists have identified 5 unique hepatitis viruses, identified by the letters A, B, C, D, and E.
While all cause liver disease, they vary in important ways.

Hepatitis A virus (HAV) is present in the faeces of infected persons and is most often
transmitted through consumption of contaminated water or food. Certain sex practices can also
spread HAV. Infections are in many cases mild, with most people making a full recovery and remaining
immune from further HAV infections. However, HAV infections can also be severe and life threatening.
Most people in areas of the world with poor sanitation have been infected with this virus. Safe and
effective vaccines are available to prevent HAV.

Hepatitis B virus (HBV) is transmitted through exposure to infective blood, semen, and other
body fluids. HBV can be transmitted from infected mothers to infants at the time of birth or from
family member to infant in early childhood. Transmission may also occur through transfusions of HBV-
contaminated blood and blood products, contaminated injections during medical procedures, and
through injection drug use. HBV also poses a risk to healthcare workers who sustain accidental needle
stick injuries while caring for infected-HBV patients. Safe and effective vaccines are available to
prevent HBV.
 Hepatitis C virus (HCV) is mostly transmitted through exposure to infective blood. This may
happen through transfusions of HCV-contaminated blood and blood products, contaminated
injections during medical procedures, and through injection drug use. Sexual transmission is also
possible, but is much less common. There is no vaccine for HCV.

Hepatitis D virus (HDV) infections occur only in those who are infected with HBV. The dual
infection of HDV and HBV can result in a more serious disease and worse outcome. Hepatitis B
vaccines provide protection from HDV infection.

Hepatitis E virus (HEV) is mostly transmitted through consumption of contaminated water

or food. HEV is a common cause of hepatitis outbreaks in developing parts of the world and is
increasingly recognized as an important cause of disease in developed countries. Safe and effective
vaccines to prevent HEV infection have been developed but are not widely available.
The breakthrough understanding of hepatitis came in 1963 when Dr. Baruch Blumberg discovered an antigen that
detected the presence of hepatitis B (HBV) in blood samples.

At the time, Dr. Blumberg was actually researching the genetics of disease susceptibility. He did not set out to
discover hepatitis, but his work led to a major breakthrough and increased understanding of the disease.

In the 1950s, Dr. Blumberg started to explore whether inherited traits could make different groups of people
more or less susceptible to the same diseases. He and his team travelled around the world visiting native
populations in remote locations to collect blood samples for analysis. The intention was to look for genetic
differences to see whether these differences were associated with a particular disease.

Specifically, they studied hemophiliac patients who had received from donors. The consequence of receiving
other people’s blood is that the immune system produces “antibodies” against the foreign blood serum proteins ,
or “antigens” from the donors.

Dr. Blumberg and his team identified an unusual antigen from a blood sample of an Australian Aborigine, which
they called the Australian antigen. After further research, this turned out to be the antigen that caused hepatitis
B, which was officially recognized in 1967.
Just two years later in 1969, Dr. Blumberg and his colleague, Dr. Irving Millman , invented the hepatitis B vaccine.
The US Food and Drug Administration named it the first “anti-cancer” vaccine because the prevention of chronic
hepatitis infections results in the prevention of primary liver cancer due to HBV (approximately 80% of people with
chronic hepatitis B will develop liver cancer). More than 500,000 people die each year from liver cancer.

The hepatitis B vaccine has been administered to millions of people, particularly in Asia and Africa, thus saving
many, many lives.

In the early 1970s, the cause of infectious hepatitis was found and named and Hepatitis A virus (HAV). In 1989
hepatitis C virus (HCV) WAS ISOLATED. UNFORTUNATELY , there is no vaccine for hepatitis C, but in 80% of cases,
carriers who complete a treatment course can be cured.

In 1990 hepatitis E virus (HEV) and in 1995, hepatitis G virus (HGV), were identified.

In 1976, Dr. Baruch Blumberg was awarded the Noble Prize for medicine in recognition of his discovery of the
hepatitis B virus. He died on 5 April 2011 at the age of 85 years old.
Dr. Buruch Blumberg
Hepatitis is a fairly common disease that mainly affects the liver.

There are 6 strains of viruses that causes hepatitis.

 Hepatitis A virus (HAV), Hepatitis B virus (HBV), Hepatitis C virus (HCV), Hepatitis D virus (HDV),
Hepatitis E virus (HEV), Hepatitis G virus (HGV).
 These viruses may cause acute hepatitis.
- HBV and HCV can cause hepatocellular carcinoma, liver failure and chronic liver disease.

Each of the hepatitis viruses cause similar liver damage. The inflammatory process is activated
throughout the whole liver, and hepatocytes are destroyed by cytotoxic cytokines and natural killer
cells, both parts of the inflammatory process. Cellular necrosis takes place. If inflammation affects the
periportal areas, cholestasis, or the interruption of the flow of bile takes place. The liver is usually able
to repair itself and regain complete function if no other complications.
 The antigen-antibody complexes that are formed from the interaction of the immune system with the
infection circulate throughout the body , which activates the compliment system. The person feels malaise, rash,
arthritis, fever and angioedema from this activation. Abnormal proteins are also produced in the blood, termed
crygloblinemia. The person may also develop vasculitis and glomerulonephritis (Lewis, et al.,2011, pg.1062).

There are 3 phases during a typical course of acute hepatitis.

1. Prodomal phase. This phase begins about 2 weeks after exposure to hepatitis. The infection is easily
transmitted during this phase. The signs and symptoms are malaise, fatigue, anorexia, nausea, vomiting,
cough, hyperalgia, low-grade fever. This stage ends when jaundice appears.
2. Icteric phase. This phase is characterized by dark urine, jaundice and clay-colored stools. The liver becomes
enlarged, tender and smooth and the person feels pain if the liver is percussed. This is known as the actual
phase of illness. It begins 1-2 weeks after the prodromal phase and continues for 2-6 weeks.
3. Recovery phase. The recovery begins when the jaundice starts to clear. The liver stays enlarged and tender but
the other symptoms starts to diminish. It usually begins 6-8 weeks after exposure. The liver regains normal
function 2-12 weeks after the jaundice begins.
Chronic hepatitis is defined as “the persistence of clinical manifestation and the liver inflammation after acute
hepatitis B, hepatitis C, hepatitis D. Liver function test remain abnormal for longer than 6 months, and hepatitis B
surface antigen (HbsAg) persists” (Heuther & McCance, 2008, pp. 996).
 Hepatitis B is one of the most common infectious diseases globally. It has been estimated that
there are 350 million chronic hepatitis B virus (HBV) carriers worldwide. The prevalence of chronic HBV
infection varies geographically, from high (>8%), intermediate (2-7%) to low (<2%) prevalence. HBeAg-
negative chronic hepatitis B (e-CHB) and occult HBV infection are two special clinical entities, and the
prevalence and clinical implications remain to be explored. The predominant routes of transmission vary
according to the endemicity of the HBV infection. In areas with high HBV endemicity, perinatal
transmission is the main route of transmission, whereas in areas with low HBV endemicity, sexual contact
amongst high-risk adults is the predominant route. HBV has been classified into 7 genotypes, i.e. A to G,
based on the divergence of entire genome sequence and HBV genotypes have distinct geographical
distributions. Three main strategies have been approved to be effective in preventing HBV infection. They
are behavior modification, passive immunoprophylaxis, and active immunization. The implement of mass
HBV immunization program is recommended by the WHO since 1991, and has dramatically decreased the
prevalence of HBV infection and HCC in many countries.
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