HEPATITIS A & B

BIOLOGY

HEPATITIS
Hepatitis is the condition of inflammations of the liver. The condition
can be self-limiting or may develop to fibrosis (scarring), cirrhosis or
liver cancer. Hepatitis virus is the main cause of hepatitis, toxic
substances (e.g. alcohol, certain drugs, etc), and autoimmune
diseases.

Types of Hepatitis:
Hepatitis A,B,C,D and E.
Types B and C are the most common one and may lead to cirrhosis
or liver cancer.
Types A and E are mainly caused by ingestion of contaminated
water or food.
Hepatitis B,C and D are mostly a result of parenteral contact with
infected body fluid. This may receipt of contaminated blood,
unhygienic medical procedures with contaminated equipment,
genetically (for hepatitis B) and sexual contact.

HEPATITIS
A

Causative
Agent
Hepatitis A is caused by the Hepatitis A virus (HAV), a hepatovirus from the
Picornaviridae family

Transmissi
on
The virus
is mainly spread when an uninfected or unvaccinated person

ingest food or water is contaminated by the feces of an infected person.

Unsafe water, unhygienic sanitation and poor personal hygiene.
Physical contact with infected person, but casual contact does not
spread virus.

Symptom
sThe incubation period of hepatitis A is usually 24-28 days

Symptoms of hepatitis A may range from mild to severe, but the case of
hepatitis A becoming a chronic disease is very rare compared to other
types of hepatitis.
Nausea
Abdominal Discomfort
Dark colored urine
Jaundice

Fever
Malaise
Lost of appetite
Diarrhoea

Treatment
There us no specific treatment for hepatitis A, but there are certain
procedures that can help to maintain the replacement of fluid in the body
that are lost from vomiting and diarrhoea.

Preventio
n
Safe drinking water (chlorination of water)

Safe drinking water (chlorination of water)

Proper sewage disposal
Maintain personal hygiene
Vaccination
1. Havrix
2. Vaqta
3. Twinrix
Boiling or cooking food for at least one minute to
85C

Vaccination in adult last for 25 years and 14-20 years in children.

Hepatitis A vaccination is recommended for all children at the age of
one.
Natural Immunity
People who have hepatitis A infection become immune to HAV for
the rest of their lives once they recover. They cannot get hepatitis A
twice.
The blood test for immunity to hepatitis A is called the "Hepatitis A
Total Antibody test." People who have had hepatitis A and those who
have received hepatitis A vaccine show positive antibodies to hepatitis
A on this test for the rest of their life.

Geographical Distribution
Hepatitis A happened epidemically worldwide.
Hepatitis A is one of the most causes of food borne infection.
In developing countries where the level of spread is high, hepatitis A is
very frequent because of the lacking of hygiene and sanitary conditions.
Most children (almost 90%) have been infected by hepatitis A before the
age of ten. Epidemics are uncommon because adult are usually immune.
In developing countries where the level of spread is intermediate,
hepatitis A rarely infects children and are more common in adults. This
causes a higher percentage of epidemical outbreaks because the both
children and adults are not immune to this.
In developed countries where the level of spread is very low, infection of
hepatitis A rarely happen because of the good sanitary and hygiene
condition. Infection only occur to a group of people who uses injected
drugs, sexual contact with infected person and usually after traveling
abroad.

HEPATITIS B

Causative Agent
Hepatitis B is caused by the Hepatitis B virus (HBV).
HBV virus can survive outside the body for about 7 days

Transmission
Child birth from infected mother (perinatal transmission)
Exposure to infected blood (horizontal transmission)
Exposure to various body fluids such as saliva, menstrual, vaginal and
seminal fluid through sexual contacts.
Reuse of needles for drugs or unhygienic medical procedures

Symptoms
The incubation period of the hepatitis B virus is 75 days, but can vary from
30-180 days.
The virus may be detected within 30-60 days of infection.
Hepatitis B may lead to chronic liver disease and often leads to death.
Jaundice, dark urine, vomiting, nausea, fatigue and abdominal pain.
Hepatitis B may later cause chronic liver infection that may develop into
cirrhosis or liver cancer.
Acute hepatitis B can develop into liver failure which results in death.

Treatment
There is no specific treatment for acute hepatitis B, but there are some
medical procedures that can help to replace the fluid lost from vomiting
or diarrhoea.
Chronic hepatitis B infection can be treated with drugs or oral antiviral
agents which slows down the progress of liver scarring (cirrhosis) and
improve long term survival.
These treatment does not cure hepatitis B, but rather suppresses the
replication of HBV virus. Therefore people needs to continue with these
procedure for the rest of their lifetime.
Chemotherapy
Interferon injections (4-12 months injection period)

Prevention
Vaccination
Vaccination for children after birth (within 24 hours) will help increase
antibody and immunity towards the disease. Vaccine lasts for about 20
years.

HbV Virus

HbV virion binds to a receptor at the surface of the hepatocyte.

Viral nucleocapsids enter the cell and reach the nucleus where the viral
genome is delivered.
In the nucleus, the second-strand DNA synthesis is completed and they
form a circular supercoiled DNA that serves as a template for
transcription of four viral RNA.
These transcripts are transferred to the cytoplasm where they are
translated into viral nucleocapsid and other proteins.
The envelope proteins insert themselves as integral membrane
proteins into the lipid membrane of the ER.
Then the spanning entire genome and termed pre-genomic RNA is
packaged together with HBV polymerase and protein kinase into core
particles where it serves as a template for reverse transcription of
negative-strand DNA.
The RNA to DNA conversion takes place inside the particles.
The new, mature, viral nucleocapsids can then follow two different
intracellular pathways, one which leads to the formation and secretion
of new virions an the other leads to amplification of the viral genome.

GEOGRAPHICAL DISTRIBUTION
The hepatitis B virus is most viral in the sub-Saharan Africa and East
Asia, where between 5-10% of the adult population is chronically
infected.
High rates of hepatitis B infection are also found in Amazon and the
southern parts of eastern and central Europe.
In the Middle East and the Indian subcontinent, between 2-5% of the
population is chronically infected.
Less than 1% of the population in Western Europe and North America
is chronically infected by hepatitis B.
An estimated 240 million people are chronically infected with hepatitis
B.
More than 780 000 people die of hepatitis B complication including
cirrhosis and liver cancer.

Hepatitis A

Hepatitis B

HAV

UNDER ELECTRON MICROSCOPE

HBV

UNDER ELECTRON MICROSCOPE

Jaundice