Hepatitis A, called “infectious hepatitis,” is easily spread by the fecal/oral route. The hepatitis
A virus (HAV) causes a short-lived, acute hepatitis that is not followed by chronic liver
disease. Immunoglobulin G (IgG) antibodies to HAV remain positive for life. To determine
whether the hepatitis is acute, one must look for IgM antibodies in the serum.
Hepatitis Bcalled “serum hepatitis,” is contracted by contact with blood or other bodily secretions from an infected individual, usually through a break in the skin, sexual contact,
perinatal transmission, use of a contaminated needle in IV drug users, or accidental
needlestick in health-care workers. Transmission through blood transfusions is less common
when blood donors are volunteers and are screened for hepatitis B surface antigen (HBsAg).
Unlike HAV, the (HBV) may cause chronic disease and cirrhosis AND predisposes to HCC (hepatoma). A carrier state occurs when infected patients demonstrate persistent HBsAg
without clinically evident disease and are able to transmit the disease.
- How is HCV transmitted? What are the possible courses of the disease?
Blood transfusions, shared and/or contaminated needles among IV drug abusers, intranasal
drugs, high-risk sexual behavior, tattoos, and vertical transmission from infected mothers to
unborn children (accounts for 3–6%). Nearly 30% of persons infected with HCV have no
known risk exposure. Detection of HCV-RNA by polymerase chain reaction is the definitive
test for active HCV. Chronic infection developed in at least 55–85% of affected persons.
Five to 20% of persons infected will develop cirrhosis over a period of 20–25 years, and they
are at risk for the development of HCC.
How can HCV transmission be prevented? How is HCV infection treated?
Risk modification to minimize exposure is the only means of prevention. No vaccine is
available for HCV. The standard treatment regimen for patients with HCV infection consists
of pegylated interferon given weekly in combination with oral ribavirin for 24–48 months.
Patients with genotype 2 or 3 have higher sustained virologic response rate of 80%, whereas
patients with type 1 or 4 have lower sustained virologic response r
Hepatitis C is the form of hepatitis most commonly contracted from blood transfusion.
HCV infection is the most common viral cause of chronic liver disease and increases the
patient’s risk for developing hepatoma (HCC).
Who should receive the HAV vaccine?
& All children 1 year of age (12–23 months old)
& Travellers to endemic areas
& Military personnel and others with occupational exposure
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