1. By: DR.Abeer Omran
Consultant pediatric infectious disease
Head of infection control departement

2. OBJECTIVES:
Definition
Causes
Types
Sign & Symptoms
Diagnoses
Treatment
Prevention

3. DEFINITION & CAUSES Hepatitis” means inflammation of the liver.
The liver is a vital organ that processes nutrients, filters the blood, and fights infections.
several types of viruses including A, B, C, D, E, and possibly G are the causes of hepatitis.
Types A, B, and C are the most common.
All hepatitis viruses can cause acute hepatitis.
Viral hepatitis types B and C can cause chronic hepatitis.
All hepatitis viruses are RNA except HBV is a DNA virus

4. hepatitis D virus (HDV), also known as the delta virus or agent
hepatitis D virus (HDV), also known as the delta virus or agent. It is a small virus that requires concomitant infection with HBV to survive. HDV cannot survive on its own because it requires a protein that the HBV makes (the envelope protein, also called surface antigen) to enable it to infect liver cells. The ways in which HDV spread are by shared needles among drug abusers, contaminated blood, and by sexual contact; essentially the same way as HBV

5. Individuals who already have chronic HBV infection can acquire HDV infection at the same time as they acquire the HBV infection, or at a later time. Those with chronic hepatitis due to HBV and HDV develop cirrhosis (severe liver scarring) rapidly. Moreover, the combination of HDV and HBV virus infection is very difficult to treat.

6. Hepatitis E virus (HEV) is similar to HAV in terms of disease, and mainly occurs in Asia where it is transmitted by contaminated water.
virus (HGV, also termed GBV-C) was recently discovered and resembles HCV, the virus and its effects are under investigation, and its role in causing disease in humans is unclear. 

7. SIGN & SYMPTOMS
Many people with hepatitis do not have symptoms and do not know they are infected. If symptoms occur with an acute infection, they can appear anytime from 2 weeks to 6 months after exposure. Symptoms of chronic viral hepatitis can take decades to develop.
Symptoms of hepatitis can include:  fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, grey-colored stools, joint pain, and jaundice.

8. How is it spread?
Hepatitis A is spread when a person ingests fecal matter—even in microscopic amounts—from contact with objects, food, or drinks contaminated by feces or stool from an infected person.
Hepatitis B is primarily spread when blood, semen, or certain other body fluids from a person infected with the Hepatitis B virus - even in microscopic amounts - enters the body of someone who is not infected.
The Hepatitis B virus can also be transmitted from:
Birth to an infected mother
Sex with an infected person
Sharing equipment that has been contaminated with blood from an infected person, such as needles, syringes, and even medical equipment, such as glucose monitors
Sharing personal items such as toothbrushes or razors
Poor infection control has resulted in outbreaks in health care facilities

9. Hepatitis C is spread when blood from a person infected with the Hepatitis C virus - even in microscopic amounts - enters the body of someone who is not infected.
This can happen through multiple ways including:
Sharing equipment that has been contaminated with blood from an infected person, such as needles and syringes
Receiving a blood transfusion or organ transplant before 1992 (when widespread screening virtually eliminated Hepatitis C from the blood supply)
Poor infection control has resulted in outbreaks in health care facilities.

11. DIAGNOSIS
There are three types of blood tests for evaluating patients with hepatitis:
liver enzymes
antibodies to the hepatitis viruses
viral proteins or genetic material (viral DNA or RNA).

12. Liver enzymes: Among the most sensitive and widely used blood tests for evaluating patients with hepatitis are the liver enzymes, called aminotransferases. They include aspartate aminotransferase (AST or SGOT) and alanine aminotransferase

13. Viral antibodies: Antibodies are proteins produced by white blood cells that attack invaders such as bacteria and viruses. Antibodies against the hepatitis A, B, and C viruses usually can be detected in the blood within weeks of infection, and the antibodies remain detectable in the blood for decades thereafter. Blood tests for the antibodies can be helpful in diagnosing both acute and chronic viral hepatitis.
PCR

14. TREATMENT Hepatitis A : Supportive treatment for symptoms
Hepatitis B :
Acute: No medication available; best addressed through supportive care
Chronic: Regular monitoring for signs of liver disease progression; some patients are treated with antiviral drugs.
Hepatitis C:
Acute: Antivirals and supportive care
Chronic: Regular monitoring for signs of liver disease progression; Some patients are treated with antiviral drugs including new medications that can cure Hepatitis C and offer shorter length of treatment and increased effectiveness.

15. Proper infection control
PREVENTION
Vaccination
Proper infection control

16. Hepatitis A:
All children at age 1
Travelers to region where Hepatitis A is common.
Family and caregivers of recent adoptees from countries where Hepatitis A is common
People with certain medical conditions including chronic liver disease, clotting-factor disorders

17. Hepatitis B:
All infants at birth
Uninfected household members and sexual partners with Hepatitis B
Persons seeking evaluation or treatment for an STD
People who inject drugs
People with certain medical conditions, including HIV, chronic liver disease
Travelers to region where Hepatitis B is common.
Hepatitis C:
No vaccine is available.