m Hepatitis-Liver Inflammation further can advance to liver

cirrhosis, and ultimately to liver failure.

m Can be caused due to viruses, bacteria, toxins (notably alcohol,
certain medications and plants), other infections and
autoimmune diseases.
m Virus is blood borne.
m Five types of viruses-HAV,HBV,HCV,HDV and HEV
m Its history starts from 8th century where infectious hepatitis
was suggested.
m Outbreaks during wars due to improper sanitation.
 
 

 





   
 

6
 
  

 
   

 
m rates of hepatitis A consistently have been higher among males than

among females; during 1996²2002.

m More chances of coinfection with HIV as both are blood borne

viruses.

m Present in similar populations.

m About 35% of population infected with HIV are found infected with

HCV.
m Mouth-Teeth and Salivary Glands

m Esophagus

m Stomach

m Small Intestine

m Large Intestine

m Liver

m Pancreas

m Gall Bladder
m Largest internal organ and largest gland in the human body.

m Wide range of functions, including detoxification, protein

synthesis, and production of biochemicals necessary for digestion.
m Glycogen storage, decomposition of red blood cells, plasma
protein synthesis, hormone production.
m reddish brown organ with four lobes of unequal size and shape.

m Connected to two large blood vessels, one called the hepatic

artery and one called the portal vein.
m Infections from viruses (such as hepatitis A, B, or C), bacteria,

or parasites.

m Liver damage from alcohol or poisonous mushrooms.

m Medications, such as an overdose of acetaminophen, which can

be deadly.

m Immune cells in the body attacking the liver and causing

autoimmune hepatitis.

m Inherited disorders such as cystic fibrosis.

 
m Wilson's disease, a condition that involves having too much

copper in your body.

m Engaging in risky sexual behaviors.

m Eating contaminated foods.

m Traveling to an area where certain diseases are common.

m Being an organ transplant recipient.

m Malaise

m Tiredness and Weakness

m Weight loss and Easy bruising

m Bleeding tendencies

m Occurrence of jaundice

m Scarring of liver (i.e. cirrhosis)

m Peripheral edema (swelling of the legs)

m Hepatorenal syndrome (kidney dysfunction).

m Blood tests:
o ALT(Alanine Aminotransferase)
o AST( Aspartate Aminotransferase)
o Alkaline phosphatase
o Bilirubin
o Ammonia
o Albumin
o Hepatitis A tests
o Hepatitis B tests
o Hepatitis C tests

 
m Imaging tests:

o Ultrasound

o CT scan (computed tomography):

o Liver biopsy

o Liver and spleen scan

m Alcoholic Hepatitis-Due to consumption of alcohol.
m Drug induced Hepatitis- Acetaminophen, Isoniazid.
m Hepatitis due to toxins- Amatoxin, White phosphorus ,
Carbon tetrachloride.
m Metabolic Disorders[Non-alcoholic steatohepatitis (NASH)]
m Obstructive ²Obstruction of bile by gallstones.
m Autoimmune-Exposure of human leukocyte antigen (HLA)
class II on the surface of hepatocytes.
m Non-alcoholic fatty liver disease (NAFLD)
m Ischemic hepatitis-Due to improper circulation.
m ã

 
Alcoholism ,Hepatitis B , Hepatitis C, Aflatoxin,

Cirrhosis, Wilsons disease.

m ¢


: Mostly same as that of Hepatitis infection

m ( 


:Develops when there is a mutation to the cellular

machinery. chronic infections of hepatitis B and/or C can

aid the development of hepatocellular carcinoma by
repeatedly causing the body's own immune system
to attack the liver cells.

m



: CTscan of the abdomen, MrI, rising alpha-fetoprotein and

des-gamma carboxyprothrombin levels

m 6







  
› Immune tolerant
› Immune clearance
› residual - nonreplicative
› reactivation
m 6





  
› Increased levels of CD4+ and CD8+
› Increased levels of T helper cells
› Increased levels of enzyme like perforin-granzyme B and Fas
ligand.
› Increased secretion of tumor necrosis factor alpha and interferon
gamma.
*i
(i6
›Protease Inhibitors
›Drugs
*i

›i

   (kalmegh)
›(  
i (Bhuiamala)
›   
 (Baheda)

 
m 
ã( ã ii
i  i
(
¢

› Lactoferrin

› Thymus extract

m 
i

› Bikram Yoga
m Entecavir (INN) - Trade name Baraclude (BMS)

m ribavirin (brand names: Copegus, rebetol, ribasphere, Vilona

and Virazole)
m Nitazoxanide

m Viramidine

m Taribavirin

m Immunoglobulins

m Adefovir dipivoxil
*Vaccines are available for all viruses.

*recombinant protein vaccines

*Peptide vaccines

*Yeast based protein vaccines

*DNA vaccination

*Virally vectored vaccines

*E.g., Engerix-B, Epivir® (lamivudine)

*Avoid contact with blood or blood products.
*Take precautions if this is part of your work.
*Avoid sexual contact with a person infected with Hepatitis
or unknown health history.
*DO NOT drink alcohol at the same time that you take
acetaminophen
*When traveling to endemic areas, DO NOT eat uncooked
or partially cooked foods.
 
m When traveling to geographical areas where the water supply is

doubtful:
› Avoid drinking the water unless it is sealed bottled water.

› Avoid using local ice.

› Avoid uncooked shellfish.

› Avoid uncooked fruits or vegetables that are not peeled or

prepared by the traveler.