The Changing Face of Viral Hepatitis

The Changing Face of Viral Hepatitis
Presentation by:D. Robert Dufour, MD, FACB, FCAP
Consultant Pathologist
Attending, Liver Clinic
VAMC, Washington DC
Emeritus Professor of Pathology


SIGNIFICANCE
HEPATITIS A
HEPATITIS E
HEV DIAGNOSIS
HEPATITIS B
HBV BIOLOGY
HBV Replication
Circulating HBV
Infection
Reservoir
Replication
HBV
mRNA
Reverse
Transcriptase
RNA-DNA Hybrid
Partially ds-DNA
Pre-S
Free HBsAg
DNA Polymerase
Partially ds-DNA
HBV BIOLOGY
OUTCOME
Loss of HBsAg
HBV SEROLOGIC TESTS
HBsAg
ISOLATED ANTI-HBc
HBeAg
ANTI-HBe
HBV DNA
HBV OUTCOMES & SEROLOGY
Immune control
Immune active
Immune tolerance
Acute hepatitis
HBV REACTIVATION
Anti-HBc pos
HBsAg neg
HEPATITIS C
HCV BIOLOGY
ANTI-HCV
RIBA for anti-HCV
Screening test for Anti-HCV
HCV RIBA
TREATMENT OF CHRONIC HBV AND HCV
ACUTE HEPATITIS
CHRONIC HEPATITIS B
TREATMENT INDICATIONS
TREATMENT BENEFITS
MONITORING Rx

* In HBeAg + with loss HBV DNA, serial monitoring of HBeAg status prognostic; if HBeAg lost (and anti-HBe develops), treatment can be D/C after 6-12 mo with 80% success
* In HBeAg – (or HBeAg + who do not convert), D/C treatment leads to rapid reactivation of HBV replication; treatment usually long-term in these patients

CHRONIC HEPATITIS C
RECENT ARTICLES

The Changing Face of Viral Hepatitis.ppt