HEPATITIS

• Hepatitis refers to the inflammation of the liver.

• Inflammation can be caused by various factors including viral infections, toxins, autoimmune diseases & metabolic diseases.

• Viral hepatitis is a significant contributor to liver inflammation & is categorized by different types of hepatitis viruses.

Types of hepatitis

• Types of viral hepatitis:

  A. Hepatitis A (HAV):

  • Transmitted through the consumption of contaminated food or water.

  • Generally an acute, short-term infection.

  • Symptoms can range from mild to severe but do not typically lead to chronic infection.

  B. Hepatitis B (HBV):

  • Transmitted through contact with infected blood or body fluids (e.g., sexual contact, sharing of needles).

  • Can lead to acute or chronic infections.

  • Chronic HBV infection can result in severe liver damage, cirrhosis, and an increased risk of liver cancer.

  C. Hepatitis C (HCV):

  • Primarily transmitted through contact with infected blood (e.g., sharing needles, healthcare exposures).

  • Often progresses to chronic infection, potentially leading to liver damage and complications.

  • A leading cause of liver cirrhosis and liver cancer.

  D. Hepatitis D (HDV):

  • Requires the presence of HBV for replication.

  • Co-infection with HBV or superinfection in individuals with chronic HBV can result in severe liver disease.

  E. Hepatitis E (HEV):

  • Commonly transmitted through contaminated water.

  • Similar to HAV, often causing acute, self-limiting infections.

  • Can be more severe in pregnant women, leading to increased mortality.

HEPATITIS A VIRUS

MORPHOLOGY

• Size – 27 – 32 nm

• Shape – spherical shape

• Symmetry – Icosahedral symmetry

• Envelop – non-envelop

• Contain single standard RNA

PATHOGENESIS

• Also called infectious hepatitis

• Mainly occur in children & adult

• Asymptomatic

• Human is only natural host

• There is no chronic state seen

  • Source of infection: contaminated food & water

  • Mode of infection: ingestion

  • Route of entry: through oral route

  • Incubation period: 2-6 week

• Hepatitis A occur in two stages-

• 1. Preicteric: ingestion contaminated food & water, virus entre into body & multiply in intestine.

• 2. Icteric: In this phase virus entre into liver & affect the liver.

Symptoms:

• The common symptoms associated with Hepatitis A virus (HAV) infection:

  • Vomiting

  • Malasia

  • Anxiety

  • Nausea

  • Jaundice

  • Dark urine

  • Enlarged of liver & spleen

LABORATORY DIAGNOSIS

• The laboratory diagnosis of Hepatitis A virus (HAV) involves various tests to detect the presence of the virus or its markers in the blood. Common laboratory tests for HAV include:

• a. Demonstration of virus -

  • Immunoelectron microscopy (IEM)

  • Enzyme-linked immunosorbent assay (ELISA)

  • Isolation

• b. Molecular method -

  • Reverse transcriptase polymerase chain reaction (RT-PCR)

• c. Biochemical test –

  • Liver function test such as -

  • Serum glutamic pyruvic transaminase (SGPT/ALT)

  • Serum bilirubin

TREATMENT

• No specific antiviral therapy is available, treatment is symptomatic.

PROPHYLAXIS

• Hepatitis A generally transmitted through faeco-oral route so the steps for preventive measures should be attempted to improve hygiene such as:

  • Hand wash

  • Purification of drinking water

  • Vaccination with hepatitis A vaccine

COMPLICATION

• Hepatic encephalopathy

• Hypoglycemia

• Coagulopathy

• Pancreatitis

• Thrombocytopenia