HEPATITIS A VIRUS. 012345678910111213 Week Response Clinical illness ALT IgM IgG HAV in stool Infection Viremia EVENTS IN HEPATITIS A VIRUS INFECTION.

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Presentation transcript:

HEPATITIS A VIRUS

Week Response Clinical illness ALT IgM IgG HAV in stool Infection Viremia EVENTS IN HEPATITIS A VIRUS INFECTION

CONCENTRATION OF HEPATITIS A VIRUS IN VARIOUS BODY FLUIDS Source:Viral Hepatitis and Liver Disease 1984;9-22 J Infect Dis 1989;160: Feces Serum Saliva Urine Body Fluids Infectious Doses per mL

HEPATITIS A INCIDENCE UNITED STATES AND NATIVE AMERICANS Source: NNDSS, CDC Vaccine Licensed ACIP Recommendation Native American United States

GEOGRAPHIC DISTRIBUTION OF HEPATITIS A VIRUS INFECTION

Hepatitis B Virus

Acute Hepatitis B Virus Infection with Recovery Typical Serologic Course Weeks after Exposure Titer Symptoms HBeAg anti-HBe Total anti-HBc IgM anti-HBc anti-HBs HBsAg

Progression to Chronic Hepatitis B Virus Infection Typical Serologic Course Weeks after Exposure Titer IgM anti-HBc Total anti- HBc HBsAg Acute (6 months) HBeAg Chronic (Years) anti-HBe Years

Geographic Distribution of Chronic HBV Infection HBsAg Prevalence  8% - High 2-7% - Intermediate <2% - Low

Estimated Incidence of Acute Hepatitis B United States, Estimated Incidence of Acute Hepatitis B United States, Vaccine licensed HBsAg screening of pregnant women recommended Infant immunizatio n recommend ed OSHA Rule enacted Adolescent immunizatio n recommend ed * Decline among homosexual men & HCWs Decline among injecting drug users Year Cases per 100,000 Population * Provisional date

Serologic Pattern of Acute HCV Infection with Recovery Symptoms +/- Time after Exposure Titer anti- HCV ALT Normal Years Months HCV RNA

Serologic Pattern of Acute HCV Infection with Progression to Chronic Infection Symptoms +/- Time after Exposure Titer anti- HCV ALT Normal Years Months HCV RNA

Posttransfusion Hepatitis C All volunteer donors HBsAg Donor Screening for HIV Risk Factors Anti-HIV ALT/Anti-HBc Anti-HCV Improved HCV Tests Adapted from HJ Alter and Tobler and Busch, Clin Chem 1997