1. Viral hepatitis

2. Viral hepatitis is liver inflammation due to a viral infection. It may present in acute (recent infection, relatively rapid onset) or chronic forms. The most common causes of viral hepatitis are the five unrelated hepatotropic viruses: Hepatitis A, Hepatitis B, Hepatitis C, Hepatitis D, and Hepatitis E.

3. Viral hepatitis Hepatitis viruses HAVHBVHCVHDVHEV Transmissionfecal-oralBlood fecal-oral Incubation period 15–45 days45–160 days15–150 days30–60 days15–60 days Severity /Chronicity mild; acuteoccasionally severe; 5-10% chronic subclinical; 70% chronic exacerbates symptoms of HBV; chronic w/ HBV Normal mild; pregnant women, severe; acute Vaccine10 year protection 3 injections, lifetime protection none

4. Viral hepatitis symptoms include: dark urine light-colored stools fever jaundice most common are flu- like symptoms including: loss of appetite, nausea, vomiting, fever, weakness, tiredness, aching in the abdomen symptoms acute hepatitis – lasting less than six months (caused by hepatitis A, hepatitis B, hepatitis C, hepatitis D and hepatitis E) chronic hepatitis – lasting longer than six months. (caused by hepatitis B, hepatitis C and hepatitis D)

5. Viral hepatitis Liver enzymes AST or SGOT (5 to 40 units) ALT or SGPT (7 to 56 units) Viral antibodies Hepatitis AHepatitis BHepatitis CHepatitis DHepatitis E HAV IgM(D-6M) (infecting) HBsAg(2-20W) ( infecting ) Anti-HCV IgM (infecting) HDAg(-21D) (infecting) HEV IgM(-3M) (infecting) HAV IgG(M-Y) (infecting or infected ) HBeAg&Anti- HBsAg(W-Y) (infecting, infected, after Vaccine) Anti-HCV IgG (infecting or infected ) Anti-HDV IgM (infecting) HEV IgG(M-Y) (infecting)

6. Viral hepatitis Acute hepatitis A,B and E are self-limited. most recover in 3 months A, die rate 0.01%. B 60-90% recover 10-40% Change to Chronic C easy to change to Chronic D&HBV 70% change to Chronic E die rate 1%-5%, pregnant women 10%- 40% Chronic hepatitis 80% will develop with hepatocirrhosis, less develop to lever Cancer.