HEPATITIS

Presented by/ Hams Hamed

outline
Definition of hepatitis
Causes of hepatitis
Types of hepatitis viruses
Hepatitis B virus
Hepatitis C virus

Definition of hepatitis:
Hepatitis is an inflammation of
the liver,
the condition can be self-limiting
or can progress to fibrosis
(scarring), cirrhosis or liver
cancer.

CAUSES
OF
HEPATITI
S
NONVIRAL
Giant
cell
hepati
tis

Ischemi
c
hepatit
is

Nonalcoholi
c fatty
liver
hepatiti
s

Autoimm
une
hepatitis

VIRAL
Toxic
and
drug
induce
d
hepatit
is

Alcohol
ic
hepatit
is

A, B, C,
D, E

HEPATITIS B & C
VIRUSES

ROUTE OF TRANSMISSION

RISK OF TRANSMISSION:
Risk of transmission mainly depend on:
Environmental
Viability
(ability to
survive
outside the
human body)

Viral load
Number of
viruses in
patients
blood

Frequency of
the disease
occurring in
population

OW DENTISTS GET THE INFECTIO

DIRECT INFECTION
through a cut on the skin
(percutaneous), as a result
of:
An accidental bite by the
patient during a dental
procedure.
Needle wound during an
anesthetic procedure.
Cut with a sharp object
such as a scalpel blade.

INDIRECT INFECTION
Aerosols of saliva.
Gingival fluid.
Natural organic particles (dental caries tissue) mixed
with air and water.

e.g. blood splash to the

eye.

SIGNS AND SYMPTOMS

HBV

HEPATITIS B
VIRUS

HEPATITIS B
VIRUS
Prevalence:
The world can be divided into three
areas where the prevalence of chronic
HBV infection is:
High (>8%), Intermediate (2-8%), and
Low (<2%).
Egypt is of intermediate endemicity (2

HEPATITIS B
VIRUS
Incubation period:
Symptoms begin an average of 90 days
(range: 60150 days) after exposure to HBV.
Diagnosis: (serology)
Detection ofhepatitis Bvirus infection involveserum
orblood teststhat detect either viral antigens
(proteins produced by the virus)
orantibodiesproduced by the host.

HEPATITIS B
VIRUS
Diagnosis: (serology)

(HBsAg)
(antiHBs)
(HbeAg
)

indicating infectious person.

Used to make hepatitis B
vaccine.
Indicating recovery and
immunity.
In successfully vaccinated
person.
Indicating replicating virus.
Person has high level of HBV.

HEPATITIS B
VIRUS

Treatment:
Acutehepatitis Binfection does not usually require
treatment as most adults clear the infection
spontaneously.
Treatment of chronic infection may be necessary to
reduce the risk ofcirrhosisand liver cancer.
Treatment lasts six months to year depending on
medication and genotype.
Antiviral drugs lamivudine(Epivir),adefovir(Hepsera).

HEPATITIS B
VIRUS
Vaccination:
Vaccine by 3 injections : 1st dose at base line,
2nd dose after one month, 3rd dose after 6
months from 1st and post vaccination (antiHBs) antibody level one month later if:
>100 IU/l ---Responder
(85%-90% of
individual)
10-100--- poor responder (need booster)
<10 ---non responder

(repeat

HCV

HEPATITIS C
VIRUS

Source of infection for persons

of hepatitis C

HEPATITIS C
VIRUS
Prevalence:
About 170million people
are living with HCV
infection.
the prevalence is reported
to be the highest
(approximately 10%) in

HEPATITIS C
VIRUS
Incubation period:
The incubation period for
hepatitis C virus is (2 weeks to 6
months).
The average time period from
exposure to symptom onset is 4
12 weeks

HEPATITIS C
VIRUS
Diagnosis:
Several blood tests are performed to test for HCV infection,
including:
Screening tests for antibody to HCV (anti-HCV)
Qualitative tests to detect presence or absence of virus
(HCV RNA polymerase chain reaction [PCR])
Quantitative tests to detect amount (titer) of virus (HCV
RNA PCR)

HEPATITIS C
VIRUS
Treatment:
Therapy based on interferon and ribavirin, which
required weekly injections for 48 weeks, cured
approximately half of treated patients, but caused
frequent and sometimes life-threatening adverse
reactions.
Recently, new antiviral drugs have been developed.
These medicines, called direct antiviral agents (DAA)
are much more effective, safer and better-tolerated
than the older therapies.

HEPATITIS C
VIRUS
vaccination:
There is novaccineagainst HCV.
There are major challenges to the future
development of a hepatitis C vaccine.

Refrences:
http://www.cdc.gov/hepatitis/hcv/index.htm
https://en.wikipedia.org/wiki/Hepatitis
http://www.healthline.com/health/hepatitis#Diagnosis5
http://
www.dentalcare.com/media/en-US/education/ce307/ce3
07.pdf
http://
www.ejgd.org/article.asp?issn=2278-9626;year=2013;
volume=2;issue=1;spage=13;epage=19;aulast=Setia