HEPATITIS

Ridha Wahyutomo
Departemen Mikrobiologi
Klinik
FK UNISSULA

What Is Hepatitis?
The word "hepatitis" means inflammation
of the liver. Toxins, certain drugs, some
diseases, heavy alcohol use, bacterial and
viral infections can all cause hepatitis.
Hepatitis is also the name of a family of
viral infections that affect the liver; the
most common types in the United States
are hepatitis A, hepatitis B, and hepatitis C.

Viral Hepatitis
A group of viruses known as the hepatitis
viruses cause most cases of liver damage
worldwide. Hepatitis can also be due to
toxins (notably alcohol), other infections.
Common viruses cause hepatitis include
A,B,C,D,E. G
Acute hepatitis
Viral Hepatitis: Hepatitis A through E (more
than 95% of viral cause), Herpes simplex,
Cytomegalovirus, Epstein-Barr,
yellow fever virus, adenoviruses.

Viral Hepatitis - Historical Perspectives

Infectious
Viral
hepatitis
Serum

Enterically
E
transmitted

NANB
Parenteral
B D
C y
transmitte
F, G, TTV
d
? other

Hepatitis A

EPIDEMIOLOGY

Zuckerman AJ, Thomas HC. Viral Hepatitis 1993

Edition Churchill livingstone.

At A Glance
First characterized in 1973
RNA virus (member of enterovirus group)
Present in large quantity in stool of
infected individuals
Lesser quantities in serum and saliva
Can be grown in vitro

Clinical Features
Often asymptomatic in childhood
<10% icteric under 6 years of age
70-80% icteric in
adolescence/adulthood
Fulminant hepatitis is rare
<0.5% mortality in children
No known chronic sequelae or carrier
state

Prevention
Food, Sex, Hand, Oral, Anal
Specific Ig 80-90% efficacy

Vaccine
94-100% efficacy
Recommended for high-risk individuals,
such as travelers to endemic areas,
homosexual or bisexual men, drug users,
chronic liver disease, children in locales
with high endemic rates

SEROLOGY

Hepatitis B

EPIDEMIOLOGY

Zuckerman AJ, Thomas HC. Viral Hepatitis 1993

Edition Churchill livingstone.

At A Glance
Member of hepadnavirus family with partly
single-stranded DNA
Dane particle is probably complete virion and
contains HBsAg
Incomplete forms (spherical and filamentous
particles) also contain HBsAg
Virion cores (HBcAg) are contained within the
incomplete forms
HBeAg exists in serum and on hepatocytes

At A Glance

At A Glance

Clinical Features
Incubation 60-90 days (range 45-180)
Jaundice relatively uncommon in children
- <10% in under 5 years old - 30-50% over 5
years of age
Acute mortality 0.5-1%
Chronic infection common, age-related
- Complications include chronic persistent and
chronic active hepatitis, hepatocellular
carcinoma, extrahepatic syndromes

Prevention

PREVENTION

SEROLOGY

HBsAg

AHBsAg

HBeAg

AHBe

AHBc

Acute HBV

IgM

Chronic
HBV high
infectivity

IgG

Chronic
HBV low
infectivity

IgG

Recovery

IgG

Immunized

TREATMENT
Interferon- : 5 to 6 million units
3 times/week subcutaneously for
4 to 6 months.

Hepatitis C

EPIDEMIOLOGY

Zuckerman AJ, Thomas HC. Viral Hepatitis 1993

Edition Churchill livingstone.

At A Glance
Incubation 6-7 weeks (range 2-26)
Jaundice 20-40%, less age dependent
Persistent infection in most
70% develop chronic hepatitis

SEROLOGY

HBsAg

AHBsAg

HBeAg

AHBe

AHBc

Acute HBV

IgM

Chronic
HBV high
infectivity

IgG

Chronic
HBV low
infectivity

IgG

Recovery

IgG

Immunized

TREATMENT

FIXING THE BROKEN

HEART