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OUTLINE
General Concepts
Hepatitis = 'inflammation of the liver'.
Etiology:
1. Viral: hepatotropic, non- hepatotropic
2. Toxin
3. Autoimmune
4. Drugs
5. Systemic
Enterically
E
transmitted
A
NANB
B D
Parenterally
C transmitted
F, G, TTV
? other
caSe
14y/o male, presented with
General malaise, poor appetite and abd.
discomfort
Icteric sclera, tea-color urine, ascites,
Past history
Operation, transfusion or systemic disease
Symptom of hepatitis infection
Family history:
Mother (48y/o): HBsAg+,brother: HBsAg+
FOCUS:
HEPATITIS B VIRUS
EPIDEMIOLOGY
VERTICAL TRANSMISSION
HBV : OUTCOME OF INFECTION
caSe
14y/o male, presented with
General malaise, poor appetite and abd.
discomfort
Icteric sclera, tea-color urine, ascites,
Past history
Operation, transfusion or systemic disease
Symptom of hepatitis infection
Family history:
Mother (48y/o): HBsAg+,brother: HBsAg+
HBV STRUCTURE
HBV : Structure
HBV REPLICATION
HBsAg
HBV CLEARANCE
Mechanisms of HBV
clearance
Destruction of virus- infected cells: 1.
immune- mediated cell injury, 2. direct
cytotoxicity
Cytotoxic T- lymphocytes: directly inhibit
HBV replication and inactivate HBV without
killing the infected heaptocyte
Expression of a product of HBV genome to
cause cell death
Genetic differences in the host immune
response also may be a factor
OUTCOME OF INFECTION
80
60
40
Chronic Infection
100
80
60
40
20
20
Chronic Infection
(%)
100
Symptomatic Infection
0
Birth
1-6 months
7-12 months
Age at Infection
1-4 years
0
Older Children
and Adults
Immuntolerance????
PHASES
CONCLUSION
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