Hepatitis

Hepatitis A

Definition Hepatitis A is a highly contagious liver infection caused by the hepatitis A virus. The hepatitis A virus is one of several types of hepatitis viruses that cause inflammation that affects your liver's ability to function. Hepatitis A was clearly recognized as an entity separate from other types of hepatitis during World War II, but only later did studies provide convincing evidence of the prevalence and transmission of hepatitis A virus (HAV).

Structure The Hepatitis virus (HAV) is a Picornavirus; is the causative agent of infectious hepatitis. Non-enveloped contains a single-stranded RNA packaged in a protein shell "capsid" . There is only one serotype of the virus, but multiple genotypes exist. At the 5’ end of the RNA strand is a viral protein called VPg.

Symptoms Hepatitis A signs and symptoms typically don't appear until you've had the virus for a few weeks. Signs and symptoms of hepatitis A include: Fatigue Nausea and vomiting Abdominal pain or discomfort. Loss of appetite Low-grade fever Dark urine Muscle pain Yellowing of the skin and eyes (jaundice) Acute liver failure In rare cases, hepatitis A can cause acute liver failure, which is a loss of liver function that occurs suddenly.

Causes Hepatitis A is caused by infection .   Hepatitis A is caused by infection . Hepatitis A virus can be transmitted several ways, such as: The hepatitis virus is usually spread when a person ingests tiny amounts of contaminated fecal matter. When someone with the virus handles the food you eat without first carefully washing his or her hands after using the toilet Drinking contaminated water Being in close contact with a person who's infected — even if that person has no signs or symptoms

Risk factors You're at increased risk of hepatitis A if you: Travel or work in regions with high rates of hepatitis A Are HIV positive Use injected or noninjected illicit drugs Live with another person who has hepatitis A Children in preschools and day-care centers

Diagnosis Although HAV is excreted in the feces towards the end of the incubation period, specific diagnosis is made by the detection of HAV in the blood. During the acute stage of the infection, the liver enzyme alanine transferase (ALT) is present in the blood at levels much higher than is normal. The enzyme comes from the liver cells that have been damaged by the virus.

Treatments No specific treatment exists for hepatitis A. Your body will clear the hepatitis A virus on its own. In most cases of hepatitis A, the liver heals completely in a month or two with no lasting damage. However, there are some things you can do that might help you feel better: Get enough calories. Get plenty of rest. Drink plenty of fluids. Avoid medicines that can harm the liver Avoid alcohol. Exercise regularly.

Prevention Consider the hepatitis A vaccine Practice good hygiene including washing your hands often — is one of the best ways to protect against hepatitis A. Follow safety precautions when traveling peeling and washing all your fresh fruits and vegetables yourself and by avoiding raw or undercooked meat and fish. Drink bottled water and. If bottled water isn't available, boil tap water before drinking it.

Hepatitis B

Definition Hepatitis B is a serious disease caused by a virus that attacks the liver and can cause both acute and chronic disease. The virus, which is called hepatitis B virus (HBV), can cause lifelong infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and death . Hepatitis B is a potentially life-threatening liver infection caused by the hepatitis B virus. It is a major global health problem and the most serious type of viral hepatitis. It can cause chronic liver disease and puts people at high risk of death from cirrhosis of the liver and liver cancer. Worldwide, an estimated two billion people have been infected with the hepatitis B virus (HBV), and more than 350 million have chronic (long-term) liver infections.

Structure HBV is a 42nm, double-shelled deoxyribonucleic acid (DNA) virus of the class Hepadnaviridae. The outer surface membrane contains hepatitis B surface antigen (HBsAg), which also circulates in blood as 22-nm spherical and tubular particles The inner core of the virus contains hepatitis B core antigen (HBcAg), hepatitis B e antigen (HBeAg), a single molecule of partially double-stranded DNA, and DNA-dependent DNA polymerase.

Symptoms Hepatitis B virus can cause an acute illness with symptoms that last several weeks, including yellowing of the skin and eyes (jaundice), dark urine, extreme fatigue, nausea, vomiting and abdominal pain. People can take several months to a year to recover from the symptoms. HBV can also cause a chronic liver infection that can later develop into cirrhosis of the liver or liver cancer.

Diagnosis Infection with hepatitis B is suspected when the medical history and the physical examination reveal risk factors for the infection or symptoms and signs that are suggestive of hepatitis B. Abnormalities in the liver tests (blood tests) also can raise suspicion; however, abnormal liver tests can result from many conditions that affect the liver. The diagnosis of hepatitis B can be made only with specific hepatitis B virus blood tests. These tests are known as hepatitis 'markers' or 'serology.'

Transmission Hepatitis B virus is transmitted between people by contact with the blood or other body fluids (i.e. semen and vaginal fluid) of an infected person. Modes of transmission are the same for the human immunodeficiency virus (HIV), but HBV is 50 to 100 times more infectious Unlike HIV, HBV can survive outside the body for at least 7 days. During that time, the virus can still cause infection if it enters the body of a person who is not infected. HBV is not spread by contaminated food or water, and cannot be spread casually in the workplace

Treatment There is no specific treatment for acute hepatitis B. Care is aimed at maintaining comfort and adequate nutritional balance, including replacement of fluids that are lost from vomiting and diarrhoea. Chronic hepatitis B can be treated with drugs, including interferon and anti-viral agents, which can help some patients. Treatment can cost thousands of dollars per year and is not available to most patients in developing countries

Prevention All infants should receive the hepatitis B vaccine: this is the mainstay of hepatitis B prevention. The vaccine can be given as either three or four separate doses, as part of existing routine immunization schedules. In areas where mother-to-infant spread of HBV is common, the first dose of vaccine should be given as soon as possible after birth (i.e. within 24 hours). The complete vaccine series induces protective antibody levels in more than 95% of infants, children and young adults. After age 40, protection following the primary vaccination series drops below 90%. At 60 years old, protective antibody levels are achieved in only 65 to 75% of those vaccinated. Protection lasts at least 20 years and should be lifelong. All children and adolescents younger than 18 years old and not previously vaccinated should receive the vaccine.

Hepatitis C

Definition Hepatitis C is a liver disease caused by the hepatitis C virus (HCV). Hepatitis C is a contagious liver disease that results from infection with hepatitis C virus (HCV). It can range in severity from a mild illness lasting a few weeks to a serious, lifelong illness. HCV is usually spread when blood from a person infected with HCV enters the body of someone who is not infected. HCV is among the most common viruses that infect the liver About 130–170 million people are chronically infected with hepatitis C virus, and more than 350 000 people die from hepatitis C-related liver diseases each year.

Structure Hepatitis C virus (HCV) is a hepacivirus of the family Flaviviridae, according to the Viral Hepatitis Prevention Board (VHPB). It is an RNA virus with an envelope. Proteins on its surface help an HCV virus particle (called a virion) to bind to and infect host cells; once it is brought within a host cell, it replicates (creates more copies of itself).

Symptoms Following initial infection, approximately 80% of people do not exhibit any symptoms. Those people who are acutely symptomatic may exhibit fever, fatigue, decreased appetite, nausea, vomiting, abdominal pain, dark urine, grey-coloured faeces, joint pain, and jaundice (yellowing of skin and the whites of the eyes). When a chronically-infected person develops symptoms, it may indicate advanced liver disease. Statistically, 60–70% of chronically-infected persons develop chronic liver disease, 5-20% develop cirrhosis, and 1–5% die from cirrhosis or liver cancer.

Diagnosis Diagnosis of acute infection is often missed because the infected person has no symtoms. Common methods of antibody detection cannot differentiate between acute and chronic infection. The presence of antibodies against HCV (anti-HCV) indicates that a person is or has been infected. HCV recombinant immunoblot assay (RIBA) and HCV RNA testing are used to confirm the diagnosis of HCV infection. Diagnosis of chronic infection diagnosis is made when anti-HCV is present for more than 6 months. Similar to acute infections, diagnosis should be confirmed with an additional test. Specialized tests are often used to evaluate patients for liver disease including cirrhosis and liver cancer.

Transmission The virus is most commonly transmitted through exposure to infectious blood such as through: receipt of contaminated blood transfusions, blood products, and organ transplants; injections given with contaminated syringes, needle-stick injuries in health-care settings; injection drug use; being born to an HCV-infected mother. It is less commonly transmitted through sex with an infected person and sharing of personal items contaminated with infectious blood. Hepatitis C is not spread through breastmilk, food or water or by casual contact such as hugging, kissing and sharing food or drinks with an infected person.

Treatment Treatment outcomes depend on many factors, including whether a patient is being treated for acute or chronic disease. Acute HCV infection is uncommonly diagnosed, because it often manifests with nonspecific flulike symptoms. Available evidence suggests that interferon-based therapy given early in the course of infection decreases the risk of progression to chronic disease. 5 Health care workers, for example, who are accidentally exposed to HCV-infected blood via a needle stick injury, should be followed carefully for evidence of ongoing infection and, if unable to clear the infection spontaneously, be treated early.

Prevention Primary prevention No vaccine exists to prevent HCV infection, unlike those for hepatitis A and B virus. The risk of infection can be reduced by avoiding: unnecessary and unsafe injections unsafe blood products unsafe sharps waste collection and disposal use of illicit drugs and sharing of injection equipment unprotected sex with HCV-infected persons sharing of sharp personal items that may be contaminated with infected blood tattoos, piercings and acupuncture performed with contaminated equipment. Secondary and tertiary prevention If a person is infected with HCV, they should: receive education and counselling on options for care and treatement be immunized with hepatitis A and B vaccine, to prevent co-infection from these hepatitis viruses, to protect their liver get early and appropriate medical management including antiviral therapy if appropriate and get regular monitoring for early diagnosis of liver disease.

Hepatitis D

History In 1977, Dr. Mario Rizzetto and associates discovered in Italy, in patients affected by Hepatitis B a new antigen different than surface, core and e systems that they called "delta antigen". This antigen was detected by immunofluorescence in the nuclei of liver cells in patients infected with hepatitis B and looked similar to hepatitis B core antigen. , tenaciously postulated by Dr. Rizzetto, was confirmed some years later by experimentally infecting chimpanzees and obtaining a new viral particle which was given the name of Hepatitis D Virus (HDV).

Structure Hepatitis D or Delta Hepatitis D is called Delta virus, is characterized by the inability to reproduce, reproduction and lonely, and needs the presence of another liver virus for reproduction, it is often with hepatitis C (b) Hepatitis B o should be possible Additional virus infection (d) when any patient with hepatitis C virus (b) chronic o concurrent infection co-infection: When a patient is infected with the virus (d) and virus (b) at the same time o superinfection super-infection.: When a patient is infected with the virus (d) and the patient infected with hepatitis C (b) previously Structure Hepatitis D or Delta

Symptoms: * jaundice (yellowing of the skin and eyes) * shift to color the urine dark tea color * turning to the light color stool * symptoms as symptoms (influenza), loss of appetite, general weakness and fatigue, nausea and vomiting * fever, headache or pain in the joints * skin rash or itching

Modes of transmission *the transfer of blood or blood products * sexual intercourse with an infected * Drug abuse by injection common * dialysis *o Acupuncture, tattooing, ear or nose piercing, circumcision, non-sterile instruments * Working in the field when it is under to deal with blood or other *body fluids

Diagnosis: Diagnosis is made by testing to detect the presence of antibodies to the virus (d)

Treatment: o Do not no cure for the condition o uses the drug interferon alpha interferon-alpha for the treatment of patients with hepatitis (b) and (d)

Methods of prevention: To date there is no vaccination against this virus, but since it required the presence of the virus (b) to be infected with HIV (d) Valttaam against the virus, (b) provides protection against viruses, albeit indirectly, for the virus (d). Patients infected with HIV (b) understanding vulnerable to HIV infection (d), and therefore must take the protective measures necessary to avoid injury

Hepatitis E

Viral hepatitis is liver inflammation caused by a virus Hepatitis E is most often seen in young-to-middle-aged adults (15 years to 40 years old). Major waterborne epidemics of hepatitis E have occurred in Asia and North and East Africa. To date, no U.S. outbreaks have been reported

  Causes : The disease occurs through infection with the hepatitis E virus, which commonly happens through "fecal-oral transmission." This type of transmission can occur when a person eats or drinks something that has been contaminated with the stool of someone infected with the hepatitis E virus. It can also result from placing a utensil or other infected object into the mouth.

transmission: Transmitted by contaminated water Person-to-person transmission is uncommon. There is no evidence for sexual transmission or for transmission by transfusion When a person becomes infected with the hepatitis E virus, it begins to multiply within the liver. Fourteen to 60 days later, a person may develop hepatitis E symptoms. This period between transmission of the virus and the start of symptoms is called the "hepatitis E incubation period

Symptoms Excessive tiredness A lack of appetite Nausea Diarrhea A low-grade fever Muscle pain Joint pain A sore throat Dark urine Pale-colored stool Stomach pain (or abdominal pain) on the right side. Jaundice (yellowing of the skin or the whites of the eyes)

Diagnosing When diagnosing hepatitis E, your healthcare provider will begin by asking questions about your medical history, including questions about: Symptoms Current medical conditions Current medications Family history of medical conditions Any recent travel Alcohol and/or drug use Sexual history Tests Used for Diagnosing Hepatitis E Since cases of hepatitis E are not clinically distinguishable from other types of acute viral hepatitis, diagnosis is made by blood tests which detect elevated antibody levels of specific antibodies to hepatitis E in the body

Treatment : Hepatitis E is a viral disease, antibiotics are of no value in the treatment of the infection. No available therapy is capable of altering the course of acute infection Specific Hepatitis E Treatment Suggestions: Get enough calories Get plenty of rest Drink plenty of fluids Avoid medicines that can harm the liver Avoid alcohol Exercise regularly

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