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Hepatitis B

Hepatitis B. Name: Kwasi Paul Gambrah Date: July 14, 2014. Outline. Introduction Replication Cycle Transmission Epidemiology Pathogenesis Immunity Clinical Finidings Treatment. Introduction.

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Hepatitis B

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  1. Hepatitis B Name: Kwasi Paul Gambrah Date: July 14, 2014

  2. Outline • Introduction • Replication Cycle • Transmission • Epidemiology • Pathogenesis • Immunity • Clinical Finidings • Treatment

  3. Introduction • A 27-year-old African American female presented to the emergency room with a five day history of malaise, fatigue, low-grade fever and nausea. Yesterday, she noted that her urine was very dark and her stools were very light in color. She also complained of joint pain. Her liver was noted to be enlarged on physical exam and the whites of her eyes were yellow. She had a history of three sex partners in the past few months, denied illegal drug use and otherwise was in good health.

  4. Replication Cycle

  5. Transmission • Blood transmission • Shared/Unsanitized IV • Sexual Fluid • Perinatal transfer from mother to newborn • HBeAg – Transmissible protein, marker of active replication

  6. Epidemiology

  7. Pathogenesis • Inflammation of Hepatocytes. • Result of Cytotoxic Immune Response to Viral core and surface antigens • Excessive amount of HBsAg in circulation • Glomerulonephritis, Arthritis, Vasculitis • Chronic forms of Hepatitis • May be the result of decreased CD4+ cells antigen presentation causing cccDNA amplification

  8. Immunity • Hepatitis B Vaccine • HBsAg produced by yeast. • Given to patients traveling to areas with prevalent HBV. • Neonatal Immunization • Vaccine usually given in 2 doses, six moths apart. • Life Long Immunity after exposure

  9. Clinical Findings • HBV virus has incubation period of 10 – 12 weeks. • Chronic Carriers • 5% of patients • Persistent HBsAg for 6 months • Asymptomatic • Usually in patients who contracted virus as neonates • Chronic Active Hepatitis • Chronic inflammation leads to fibrosis, liver cirrhosis • May progress to hepatocellular carcinoma • Fulminant Hepatitis • 1% of patients • Usually occurs in patients co-infected with Hepatitis D Virus • Results in severe shrinkage of Liver

  10. Clinical Findings • Symptoms Include • Malaise, fatigue, nausea • Ascites • Dark Urine • Light Colored Stool • Jaundice • Internal Bleeding • Arthritis • Glomerolonephritis • Vasculitis • Acute Liver Failure Fulminant Hepatitis Hepatocellular Carcinoma

  11. Liver Cirrosis

  12. Treatment • Alpha interferon - used to treat Chronic Hepatitis B • Lamivudine – Inhibit reverse transcriptase/DNA polymerase Prevention • Recombivax Vaccine

  13. Questions??

  14. Credits • http://usfhepadnaviridaedaniel.wikispaces.com/USFhepadnaviridaedaniel • http://www.plospathogens.org/article/info%3Adoi%2F10.1371%2Fjournal.ppat.1001082 • http://www.meddean.luc.edu/lumen/MedEd/orfpath/images/fig104x.jpg • http://www.olympus-sis.com/standard_images/Image_1_Kopie.gif • Hepatitis Lecture Slides

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