3. ETYMOLOGY
• The word ‘hepatitis’
is derived from the
Latin word
‘ hēpatītis ’ and from
the ancient Greek
word ‘hepar’
meaning liver.
• In modern Greek ‘ites’ means inflammation
of.
• Thus the word hepatitis means ‘inflammation of the
liver.’
4. INTRODUCTION
• Hepatitis can be caused due to a number of causes, such as
infections, alcohol abuse, trauma or drug induced toxicity.
• However, in global terms, viral infections are the most important
cause of hepatitis.
• These include infections with herpes simplex virus,
cytomegalovirus and Epstein–Barr virus, but the majority of viral
liver diseases are by hepatitis viruses.
• Hepatitis may occur incidentally during many other viral infections,
such as yellow fever, Lassa fever, Marburg, cytomegalovirus as
mentioned above which is not included in the category of viral
hepatitis.
• Hepatitis viruses are taxonomically unrelated.
6. Greek mythology- Titan
Prometheus stole fire from Zeus
and gave to mankind. Titan was
send to Mount Caucasus.
Heracles – saved Titan
Prometheus.
Hippocrates - 400 BC – jaundice.
5 th century- epidemic of
jaundice.
17 th and 18 th century- Europe.
‘Campaign jaundice’ – armies epidemic.
19 th century- Acute Catarrhal Jaundice.
1923 - Blumer
7.
8. HEPATITIS TYPE A VIRUS
INTRODUCTION: Hepatitis A formerly known as
infectious hepatitis or epidemic jaundice is an acute
infectious disease caused by Hepatitis A Virus
(HAV).
DISCOVERY: 1973, Feinstone and co- workers,
Immunoelectron microscopy (IEM).
MORPHOLOGY: small, 27 nm, non- enveloped RNA virus, Picorna
virus family.
RESISTANCE: inactivation of heat at 60º C for one hour, ether and acid
at pH 3.
SENSITIVE: inactivated at 37º C for 72 hours, and chlorine 1ppm for 30
minutes.
MODE OF TRANSMISSION: fecal oral route, parenteral route, sexual
transmission.
INCUBATION PERIOD: 15- 45 days.
9.
10. DIAGNOSIS:
Demonstration of Virus in feces, blood, bile by IEM.
Detection of Antibody by ELISA.
Biochemical tests includes Alanine aminotransferase
(ALT), Bilirubin, Protein.
Molecular Diagnosis is by RT PCR of feces.
PROPHYLAXIS:
Formalin inactivated, alum conjugated vaccine containing
HAV grown in human diploid cell culture (2 doses
intramuscular injections).
TREATMENT:
This is symptomatic. No specific antiviral drug is
available.
11. HEPATITIS TYPE B VIRUS
INTRODUCTION: Hepatitis B formerly
known as serum hepatitis is an acute
systemic infection with major pathology in
the liver, caused by Hepatitis B Virus (HBV).
DISCOVERY: 1965, Dr. Baruch Blumberg,
Australian antigen
MORPHOLOGY: 42 nm, enveloped DNA
virus, Hepadnavirus family.
RESISTANCE: heat stable virus.
SENSITIVE: inactivated by 2% glutaraldehyde
MODE OF TRANSMISSION: parenteral route, sexual
transmission, perinatal (vertical) transmission.
INCUBATION PERIOD: 1- 6 months.
13. DIAGNOSIS:
Series of blood test is done for screening of HBV
viz.,
• Hepatitis B surface antigen test,
• Hepatitis B core antigen test,
• Hepatitis B surface antibody test and,
• Liver function test.
PROPHYLAXIS:
Hyperimmune Hepatitis B immunoglobulin (HBIG)
TREATMENT:
No specific treatment is available. Interferon α alone
or with combination of lamivudine and famcyclovir.
14. HEPATITIS TYPE C VIRUS
INTRODUCTION: Hepatitis C is
an infectious disease affecting
primarily the liver, caused by the
hepatitis C virus (HCV).
DISCOVERY: 1989, ‘non- A non-
B’ viruses.
MORPHOLOGY: 50-60 nm,
enveloped ss RNA virus,
Flaviviridae family.
MODE OF TRANSMISSION: intravenous, sexual transmission,
vertical transmission, hemodialysis, healthcare exposure.
INCUBATION PERIOD: 15-160 days
15.
16. DIAGNOSIS:
Antibody detection by ELISA, the antigens used
are various structural and non- structural proteins
cloned in Escherichia coli. Confirmation is done by
immunoblot assay.
PROPHYLAXIS:
Blood screening. No specific active or passive
immunisation is available.
TREATMENT:
Prolonged treatment with interferon α alone or with
ribavirin.
17. HEPATITIS TYPE D VIRUS
INTRODUCTION: Hepatitis D is an acute or
chronic infection caused by Hepatitis D
(Delta)Virus (HDV).
DISCOVERY: 1977, Rizzetto and co-
workers, new viral antigen in the liver cells of
infected HBV patients.
MORPHOLOGY: spherical, 35- 37 nm,
defective enveloped ss RNA virus, deltavirus.
MODE OF TRANSMISSION: vertical transmission, homosexual men,
blood transfusion, intravenous drugs.
CLINICAL FEATURES: 2 types of infection- coinfection and
superinfection.
INCUBATION PERIOD: 30- 180 days.
19. DIAGNOSIS:
Immunofluorescence to detect delta antigen
and to detect anti- delta antibodies by ELISA.
PROPHYLAXIS:
No specific prophylaxis exists, but
immunisation with HBV vaccine is effective.
TREATMENT:
No treatment is available for both acute and
chronic type.
20. HEPATITIS TYPE E VIRUS
INTRODUCTION: Hepatitis E, also
known as Enterically transmitted NANB or
Epidemic NANB hepatitis is an acute viral
hepatitis which is a self- limiting infection
caused by Hepatitis E Virus (HEV).
MORPHOLOGY: spherical, 32- 34 nm,
non- enveloped ss RNA virus, Caliciviridae
family.
MODE OF TRANSMISSION: fecal oral route, vertical transmission,
blood transfusions.
INCUBATION PERIOD: 15-60 days.
DIAGNOSIS: ELISA for IgG and IgM antibodies detection and, IEM.
PROPHYLAXIS: no specific prophylaxis available.
26. REFERENCES
• Ananthanarayanan R and CK Jayaram Panicker, 1994,
‘Textbook of Microbiology’ Orient Longman.
• https://bioetymology.blogspot.com/2011/06/hepatitis.html
• Hepatitis-150918092901-Ival-app6891.pdf
• www.Medscape.com
• www.healthline.com
• ‘California Association for Medical Laboratory
Technology’, viral hepatitis 2015: Causes, diagnosis and
treatment- course # DL-004
