Acute Viral Hepatitis Viral Hepatitis Infectious Hepatitis A

Acute Viral Hepatitis

Viral Hepatitis • Infectious: Hepatitis A • Serum : Hepatitis B, D • NANB : Hepatitis C Hepatitis E

Viral Hepatitis Over View Virus Source Transmission Chronicity Prevention A Stool Feco-oral No Immunoglobulin Vaccination B Parentral Percutanous per mucosal Yes Immunoglobulin Vaccination C Parentral Percutanous per mucosal Yes Blood donor screening Risk behavior modification D Parentral Percutanous per mucosal Yes HBV Prevention E Stool Feco-oral No Safe water cleaning

Clinical Features • Sub clinical • Clinical o Non specific (fever, myalgea, arthralgia, fatigue. . ) o gastrointestinal (jaundice, itching, anorexia, pain. . )

Hepatitis A • Incubation Period: 15 -50 days • Clinical Hepatitis -<6 y : <10% -6 -14 y : 40 -50% -14 y : 70 -80%

Hepatitis B • Incubation Period: 45 -180 days • Clinical Hepatitis • -<5 y : <10% ->5 y : 30 -50% Chronic Infection: -<5 y : 30 -90% ->5 y : 2 -10%

Hepatitis C • Incubation Period: 2 -26 Weeks • Clinical Hepatitis: 20% • Chronic Infection: 80%

Hepatitis D • HBV Co infection -Severe acute hepatitis -Low risk of chronic infection • HBV Super infection -High risk of chronic liver disease

Hepatitis E • Incubation Period: 15 -60 days • Case fatality: 20% in pregnancy • Illness severity: Increase with age

Diagnosis • Biochemical tests o Serum aminotransferases o Serum billirubin o albumin • Serology o Serum antigens / antibody o Nucleic acid detection (PCR)

Diagnosis • Serology o HAV-Ab Ig. M o HBs. Ag, HBe. Ag, HBc. Ab Ig. M o HCV Ab o HDV Ab Ig. M o HEV Ab Ig. M

Treatment • Supportive management • Prevent infection spread • Specific antiviral therapy (may be considered for HBV & HCV) • Liver transplant for Fulminant hepatitis