Hepatitis C
Of all the viral hepatitis types, hepatitis C has the poorest diagnosis. The virus is mainly transmitted parenterally, for example, through contaminated needles, and rarer sexually or perinatally.
However, in more than half of all cases, untreated hepatitis C leads to chronic infection, with a comparatively high risk of developing liver cirrhosis or hepatocellular carcinoma. On a global scale, approximately 350,000 individuals die from HCV-related complications each year.
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| Hepatitis C |
During infection, extrahepatic manifestations can occur.
Hepatitis C virus, HCV for quick, is an unmarried-stranded RNA virus belonging to the Flaviviridae own family. Like other hepatitis viruses, there are numerous genotypes. treatment regimens are based in elements on the viral genotype gift in the affected person. consequently, unlike other viral hepatitis kinds, the viral genotype of HCV is simply decided through PCR.
After recovery from infection, reinfection with another HCV genotype remains possible. The incubation period of the hepatitis C virus ranges from two weeks to six months. Like HBV, HCV is also only detectable in serum. In suspected cases, serological testing for anti-HCV antibodies is performed.
However, these antibodies are found in both acute and chronic infections and remain detectable long after the infection has resolved. Therefore, it is often useful to perform PCR to detect viral RNA in serum for confirmation. This is especially important for immunocompromised individuals, as their anti-HCV screening test may be falsely negative. Viral load levels provide information about infection. Other laboratory parameters, such as transaminases, are also elevated. In chronic infections, they are detectable episodically. Currently, there is no vaccination available against HCV.
Is hepatitis C more dangerous than hepatitis A or hepatitis B?
Certainly, hepatitis C is more dangerous than hepatitis B, and hepatitis A is not meant to be a serious infection and is often overlooked. Vaccination against hepatitis B infection (Hep-B2) can be given 6 weeks later. 6 months (Hep-B3). There are also vaccines against hepatitis A infection at 12 months (Hep-A1) and 18 months (Hep-A 2). There is currently no vaccination against hepatitis C infection. Hepatitis B and C cause similar clinical symptoms, however, hepatitis B is less pathogenic than hepatitis C.
Hepatitis D
Hepatitis D is caused by a virusoid. Virusoids are circular, single-stranded RNA molecules that depend on other viruses for reproduction.
For example, the hepatitis D virusoid, in short HDV, requires the HBs antigen. With its help, it enters hepatocytes through the same bile acid transporter as HBV. Therefore, hepatitis D can only occur in combination with hepatitis B. There are two types of infection: One type is coinfection with acute hepatitis B infection. This leads to a more severe acute hepatitis, with usually a 90% rate of recovery. The other is superinfection, which can occur in individuals with acute or chronic hepatitis B or healthy carriers.
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| Hepatitis D |
In this case, chronification occurs in more than half of the cases, increasing the risk of liver cirrhosis or hepatocellular carcinoma. HDV is transmitted sexually, parenterally, or congenitally. The incubation period for HDV is about four to 12 weeks. In general, viricides do not produce any proteins. HDV is an exception, as it produces HD antigen. This schematic diagram shows the serological work-up of an individual who was simultaneously infected with HBV and HDV. As a diagnostic marker, HD antibodies to either HD antigen or RNA are measured. Typically, these antibodies are only detected relatively late in infection, and often only for a short time in acute HDV infection.
IgG and IgM antibodies usually disappear within a few months after infection, and IgG antibodies can be detected up to 2 years after the infection has resolved. Eventually, in the case of co-infection, an HBV-infected character also develops its own HDV. This can be inferred from the data that markers of HBV infection are present early, while markers of HDV appear to be the easiest past due to contamination. Otherwise, the serological picture is very comparable.
If superinfection leads to chronic HBV/HDV infection, high levels of HD-IgM and -IgG antibodies are persistently detectable. In addition, serum transaminases are usually always elevated. There is no vaccine available for hepatitis D, although vaccination with the HBV vaccine provides indirect protection.
Hepatitis E
Finally, let’s take a look at hepatitis E. As previously mentioned, hepatitis A and E can be easily confused.
In fact, hepatitis E infection wasn’t even considered a disease of its own until the At that time, the development of sensitive methods enabled the specific detection of HAV.
Like HAV, HEV is a single-stranded RNA virus. Currently, it’s the only member of the herpes virus family. There are four different genotypes that exist. Genotypes 1 and 2 are primarily transmitted via the fecal-oral route and occur mainly in endemic areas in Asia, the Middle East, Africa, and Central America, where they are transmitted through contaminated drinking water or food. That's why in high-income countries, hepatitis E was previously considered to be a disease
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| Hepatitis E |
However, genotypes three and four are very not unusual place international as they may be similarly transmitted via the usage of infected animals, particularly pigs and undercooked crimson meat. The path of hepatitis E infection is largely self-proscribing and can be asymptomatic. but, the contamination becomes fulminant in about 3% of instances, a notably higher rate in comparison to hepatitis A infection. A vital hazard institution for developing fulminant hepatitis E is pregnant ladies. Liver failure is common, especially in past due to being pregnant, and has a mortality price of up to 20%.
Usually, hepatitis E does not develop into a chronic infection. However, it cannot be ruled out in immunocompromised individuals. The incubation period is similar to that of hepatitis A and is relatively short, two to ten weeks. Serology is also the method of choice used to diagnose hepatitis E infection. IgM antibodies can usually be detected one to four weeks after symptoms appear. The single presence of anti-HEV IgG antibodies indicates past infection. Transaminase levels are also elevated in acute hepatitis E. Additionally, HEV can be detected by PCR in serum or stool samples. Currently, there is no vaccine available to protect against hepatitis E in the United States.
OK, so these were the most important facts on the various types of viral hepatitis. Were you able to remember all the relevant aspects? Let’s see if you did with the quiz on the next slide.
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