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Acute Viral Hepatitis Presentation

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ACUTE VIRAL HEPATITIS OUTLINE • • • • • • • • Introduction Virology and Etiology Pathogenesis Clinical features Investigations Complications and sequelae Treatment Prophylaxis INTRODUCTION • Acute viral hepatitis is a systemic infection affecting the liver predominantly. • Almost all cases of acute viral hepatitis are caused by one of five viral agents: hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis C virus (HCV), the HBV-associated delta agent or hepatitis D virus (HDV), and hepatitis E virus (HEV). Virology and Etiology Hepatitis A • HAV is a nonenveloped 27-nm, heat-, acid-, and ether resistant RNA virus in the Hepatovirus genus of the picorna virus family • Hepatitis A has an incubation period of about 4 weeks. • Its replication is limited to the liver, but the virus is present in the liver, bile, stools, and blood during the late incubation period and acute preicteric/presymptomatic phase of illness • Antibodies to HAV (anti-HAV) can be detected during acute illness • This early antibody response is predominantly of the IgM class and persists for several (~3) months, rarely for 6–12 months. • Therefore, the diagnosis of hepatitis A is made during acute illness by demonstrating antiHAV of the IgM class Hepatitis B • HBV is a DNA virus with a remarkably compact genomic structure • Once thought to be unique among viruses, HBV is now recognized as one of a family of animal viruses, hepadnaviruses (hepatotropic DNA ...
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