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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
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