Serum Hepatitis B, C, D

water borne A and E

Transmission

BCD: Blood, Body fluids, Baby (childhood), Birth/Perinatal

Horizontal and vertical

AE: Feco-oral, hygiene, Endemic, Epidemics, Equatorial

Pathogenesis

virus infects hepatocyte, replicate, produce viral antigen coating hepatocyte surface and released into blood. T lymphocyte attraction and response results in immune attack and apoptosis of hepatocytes. macrophages engulf and clear necrotic cells.

causes inflammation: fever, jaundice, loss of function

elevated liver enzymes AST, ALP, ALT, GGT

Clinical Presentation

• Silent Carrier
• Acute asymptomatic infection
• Acute hepatitis with recovery
• Acute liver failure