Hepatitis d virus(HDV HDV(Delta hepatitis virus) is a kind of defective virus HDV genome is a circular single strand RNa and 1.7kb long HDV has at least eight genotypes genotype i is the most prevalent hdv worldwide The replication of hdv depends on hbv or other hepadnavirus, coated by HBsag HDV has one antigen-antibody system No free hDAg is detected in blood anti-HDV can be detected in serum 16
Hepatitis D virus (HDV) • HDV (Delta hepatitis virus) is a kind of defective virus • HDV genome is a circular single strand RNA and 1.7kb long • HDV has at least eight genotypes, Genotype I is the most prevalent HDV worldwide • The replication of HDV depends on HBV or other hepadnavirus, coated by HBsAg • HDV has one antigen-antibody system No free HDAg is detected in blood, anti-HDV can be detected in serum 16
VIRUSES RESPONSIBLE FOR ACUTE VIRAL HEPATITIS AND LIKELIHOOD OF CHRONIC EVOLUTION VIRUS EVOLUTION TO CHRONIC VIRAL HEPATITIS Hepatitis a ever Hepatitis B >90%(perinatal acquisition) to <1% dult infection Hepatitis C 50-80% Hepatitis d or delta 2%(coinfection) to 90%(superinfection) Hepatitis e Occasionally in immunosuppressed patients Other viruses May establish chronic infection, not associated Human cytomegalovirus with chronic hepatitis Epstein-Barr He erpes simplex Human herpesvirus 6 Parvovirus b19 17
VIRUSES RESPONSIBLE FOR ACUTE VIRAL HEPATITIS AND LIKELIHOOD OF CHRONIC EVOLUTION 17
Epidemiology
Epidemiology 18
Source of infection Hepatitis a patients with Hepatitis a and person with subclinical infection Hepatitis e patients with Hepatitis a and person with subclinical infection; pigs Hepatitis b, c and d patients with acute, chronic hepatitis B, C, and D and carriers 19
Source of infection • Hepatitis A : patients with Hepatitis A and person with subclinical infection • Hepatitis E: patients with Hepatitis A and person with subclinical infection; pigs • Hepatitis B, C and D: patients with acute, chronic hepatitis B, C, and D and carriers 19
Route of transmission Hepatitis b, c, and d: (1) sexual transmission (2)perinatal mother-to-infant transmission very high(>90%)rate of chronic infection (3 horizontal transmission through nonsexual interindividual contact, 15%evolution to chronicity (4) percutaneous transmission by blood and blood products unsafe medical or surgical materials, or injection drug use Hepatitis a and E: fecal-oral route 20
Route of transmission • Hepatitis B, C, and D: (1) sexual transmission; (2) perinatal mother-to-infant transmission, very high (>90%) rate of chronic infection (3) horizontal transmission through nonsexual interindividual contact, 15% evolution to chronicity (4) percutaneous transmission by blood and blood products, unsafe medical or surgical materials, or injection drug use. • Hepatitis A and E: fecal-oral route 20