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Acute Viral Hepatitis Viral Hepatitis • Infectious: Hepatitis A • Serum : Hepatitis B, D • NANB : Hepatitis C Hepatitis E Viral Hepatitis Over View Virus Source Transmission Chronicity Prevention A Stool Feco-oral No Immunoglobulin Vaccination B Parentral Percutanous per mucosal Yes Immunoglobulin Vaccination Immunoglobulin Vaccination C Parentral Percutanous per mucosal Yes Blood donor screening Risk behavior modification D Parentral Percutanous per mucosal Yes HBV Prevention E Stool Feco-oral No Safe water cleaning Clinical Features • Sub clinical • Clinical o Non specific (fever, myalgea, arthralgia, fatigue..) o gastrointestinal (jaundice, itching, anorexia, pain..) Hepatitis A • Incubation Period: 15-50 days • Clinical Hepatitis -<6y : <10% -6-14y : 40-50% -14y : 70-80% Hepatitis B • Incubation Period: 45-180 days • Clinical Hepatitis • -<5y : <10% ->5y : 30-50% Chronic Infection: -<5y : 30-90% ->5y : 2-10% Hepatitis C • Incubation Period: 2-26 Weeks • Clinical Hepatitis: 20% • Chronic Infection: 80% Hepatitis D • HBV Co infection -Severe acute hepatitis -Low risk of chronic infection • HBV Super infection -High risk of chronic liver disease Hepatitis E • Incubation Period: 15-60 days • Case fatality: 20% in pregnancy • Illness severity: Increase with age Diagnosis • Biochemical tests o Serum aminotransferases o Serum billirubin o albumin • Serology o Serum antigens / antibody o Nucleic acid detection (PCR) Diagnosis • Serology o HAV-Ab IgM o HBsAg, HBeAg, HBcAb IgM o HCV Ab o HDV Ab IgM o HEV Ab IgM Treatment • Supportive management • Prevent infection spread • Specific antiviral therapy (may be considered for HBV & HCV) • Liver transplant for Fulminant hepatitis