1 / 20

Serologic diagnosis of HBVinfection

Serologic diagnosis of HBVinfection. Clinical outcomes of HBV infection. Subclinical disease Acute hepatitis, Fulminant hepatitis Asymptomatic carrier Chronic hepatitis >6 months necrosis and inflammation of the liver , actively replicating virus—source of infection Cirrhosis, HCC.

keith-schultz
Télécharger la présentation

Serologic diagnosis of HBVinfection

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Serologic diagnosis of HBVinfection

  2. Clinical outcomes of HBV infection • Subclinical disease • Acute hepatitis, Fulminant hepatitis • Asymptomatic carrier • Chronic hepatitis >6 months necrosis and inflammation of the liver , actively replicating virus—source of infection • Cirrhosis, HCC

  3. Outcome of hepatitis B infection

  4. Chronic hepatitis • Inflammation of the liver >6 mo (not alcoholic) • Mild-(chronic persistent hepatitis) • Inflammation confined to portal tract • Limiting plate preserved • Severe (chronic active hepatitis) • Inflammation spills into periportal liver • Interface hepatitis • Bridging necrosis Fatty change, lymphocytes (C) Periportal fibrosis Ground glass (B)

  5. Chronic hepatitis

  6. Hepatitis B infection

  7. Carrier state • Presence of HBsAg in serum >6 months • May be symptomatic /asymptomatic • More common following vertical transmission & immunocompromised

  8. Biochemical abnormalities in chronic hepatitis • Elevation of AST,ALT • S. Bilirubin elevated at times

  9. HCV • Hepacivirus • Enveloped single stranded RNA virus • Unstable virus with multiple genotypes and subtypes. (no vaccine) • Anti HCV IgG does not confer effective immunity • High risk of chronicity (80%),cirrhosis &HCC (10%)

  10. Pathogenesis of HCV infection • Cytotoxic T cells response to virally infected hepatocytes • Not directly cytopathic • Defects in HCV specific cellular immunity

  11. Clinical features of HCVdisease • Mild disease • Fulminant disease rare • Chronic disease is common (80% ) • 20% develop cirrhosis • 5% of cirrhosis develop HCC • Extrahepatic manifestation-membranoproliferative glomerulonephritis,prophyria cutanea tarda, sicca syndrome

  12. Serologic diagnosis of HCVinfection

  13. HDV • RNA virus • Conifection HBV and HDV simultaneously • Superinfection: HBV followed by HDV • Serologic diagnosis: anti HDV IgM.

  14. Clinical outcomes of HDV infection

  15. HEV • Oro-fecal transmission • Asia,india,subsaharan africa, mexico • High mortality in pregnant women • Self limiting • No chronic phase,no viremia.

  16. Comparison of hepatitis viruses

  17. Clinical manifestations of hepatitis • Preicteric or palindromic phase • Precedes jaundice • 1-21 days • Phase of maximum infectivity in HAV infection • Nausea, fever, anorexia, malaise • Serum sickness-like syndrome (B)

  18. Hepatitis-clinical manifestations... Icteric phase Jaundice • Pruritis • Pale coloured stool,dark urine • Tender hepatomegaly

  19. Clinical features of Chronic hepatitis • Variable • Not predictive of outcome • Fatigue,malaise .mild haundice’spider angiomas,mild tender hepatomegaly, • Occasionly, immune complex mediated disease (C&D)

  20. Summary • Definition of hepatitis • Hepatitis viruses, serologic diagnosis • Clinical manifestations • Acute hepatitis,fulminant hepatitis,chronic hepatitis, carrier state. • Cirrhosis, HCC ……

More Related