1. Acute Viral Hepatitis

2. Viral Hepatitis Infectious: Hepatitis A Infectious: Hepatitis A Serum : Hepatitis B, D Serum : Hepatitis B, D NANB : Hepatitis C NANB : Hepatitis C Hepatitis E Hepatitis E

3. Viral Hepatitis Over View VirusSourceTransmissionChronicityPrevention AStoolFeco-oralNoImmunoglobulinVaccination BParentralPercutanous per mucosal YesImmunoglobulin Vaccination Immunoglobulin Vaccination CParentralPercutanous per mucosal Yes Blood donor screening Risk behavior modification DParentralPercutanous per mucosal Yes HBV Prevention EStoolFeco-oralNo Safe water cleaning

4. Clinical Features Sub clinical Sub clinical Clinical Clinical o Non specific ( fever, myalgea, arthralgia, fatigue..) o gastrointestinal ( jaundice, itching, anorexia, pain.. )

5. Hepatitis A Incubation Period: 15-50 days Incubation Period: 15-50 days Clinical Hepatitis Clinical Hepatitis -<6y : <10% -<6y : <10% -6-14y : 40-50% -6-14y : 40-50% -14y : 70-80% -14y : 70-80%

6. Hepatitis B Incubation Period: 45-180 days Incubation Period: 45-180 days Clinical Hepatitis Clinical Hepatitis -<5y : <10% -<5y : <10% ->5y : 30-50% ->5y : 30-50% Chronic Infection: Chronic Infection: -<5y : 30-90% -<5y : 30-90% ->5y : 2-10% ->5y : 2-10%

7. Hepatitis C Incubation Period: 2-26 Weeks Incubation Period: 2-26 Weeks Clinical Hepatitis: 20% Clinical Hepatitis: 20% Chronic Infection: 80% Chronic Infection: 80%

8. Hepatitis D HBV Co infection HBV Co infection -Severe acute hepatitis -Severe acute hepatitis -Low risk of chronic infection -Low risk of chronic infection HBV Super infection HBV Super infection -High risk of chronic liver disease -High risk of chronic liver disease

9. Hepatitis E Incubation Period: 15-60 days Incubation Period: 15-60 days Case fatality: 20% in pregnancy Case fatality: 20% in pregnancy Illness severity: Increase with age Illness severity: Increase with age

10. Diagnosis Biochemical tests Biochemical tests o Serum aminotransferases o Serum billirubin o albumin Serology Serology o Serum antigens / antibody o Nucleic acid detection (PCR)

11. Diagnosis Serology Serology o HAV-Ab IgM o HBsAg, HBeAg, HBcAb IgM o HCV Ab o HDV Ab IgM o HEV Ab IgM

12. Treatment Supportive management Supportive management Prevent infection spread Prevent infection spread Specific antiviral therapy ( may be considered for HBV & HCV) Specific antiviral therapy ( may be considered for HBV & HCV) Liver transplant for Fulminant hepatitis Liver transplant for Fulminant hepatitis