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Feature
HAV
HBV
HCV
HDV
HEV
15160, mean 50
Onset
Acute
Insidious or acute
Insidious
Insidious or acute
Acute
Age preference
Children,
young adults
Young adults
(2040 years)
Fecal-oral
+++
+++
Percutaneous
Unusual
+++
+++
+++
Perinatal
+++
Transmission
Feature
HAV
HBV
HCV
HDV
HEV
Sexual
++
++
Severity
Mild
Occasionally severe
Moderate
Occasionally severe
Mild
Fulminant
0.1%
0.11%
0.1%
520%b
12%e
Progression to
chronicity
None
Commond
None
Carrier
None
0.130%c
Variablef
None
Cancer
None
+(Neonatal infection)
None
Prognosis
Excellent
Clinical
1.53.2%
+
Moderate
Feature
HAV
HBV
HCV
HDV
HEV
poor
Prophylaxis
None
Vaccine
Therapy
None
Interferon
None
Interferon
Lamivudine
Adefovir
Pegylated interferon
Entecavir
Telbivudine
Tenofovir
Table 304-6 Simplified Diagnostic Approach in Patients Presenting with Acute Hepatitis
HBsAg
IgM Anti-HAV
IgM Anti-HBc
Anti-HCV
Diagnostic Interpretation
Acute hepatitis B
Chronic hepatitis B
Acute hepatitis A
Acute hepatitis C
Hepatitis Virus
Morphology
Type
Particle,
nm
Genome*
HAV
7.5-kb
Hepatovirus
RNA,
linear, ss, +
27
Icosahedral
nonenveloped
Classification
HAV
HBV
42
Double-shelled
3.2-kb
virion (surface and DNA,
core) spherical
circular,
ss/ds
Hepadnavirus
HBsAg
Anti-HBs
HBcAg
Anti-HBc
HBeAg
Anti-HBe
Chronic diagnosis: IgG anti-HBc,
Hepatitis Virus
Morphology
Type
Particle,
nm
Genome*
Classification
HBsAg
Markers of replication: HBeAg,
HBV DNA
Liver, lymphocytes, other organs
27
22
Nucleocapsid core
Spherical and
filamentous;
represents excess
virus coat material
HBcAg
Anti-HBc
HBeAg
Anti-HBe
HBsAg
Anti-HBs
Hepatitis Virus
Morphology
Type
Particle,
nm
Genome*
HCV
9.4-kb
Hepacivirus
RNA,
linear, ss, +
Approx.
4060
Enveloped
Classification
HCV
C100-3
Acute diagnosis: anti-HCV (C33c,
C22-3, NS5), HCV RNA
C33c
C22-3
NS5
HDV
3537
Enveloped hybrid
particle with
HBsAg coat and
HDV core
1.7-kb
Resembles
HBsAg
RNA,
viroids and plant
circular, ss, satellite viruses HDV
antigen
Anti-HBs
Hepatitis Virus
Morphology
Type
Particle,
nm
Genome*
HEV
7.6-kb
Hepevirus
RNA,
linear, ss, +
3234
Nonenveloped
icosahedral
Classification
HEV
antigen
Harrison's
PRINCIPLES OF INTERNAL MEDICINE
Eighteenth Edition