By: Dr. Babar T. Shaikh

Acute Viral Hapatitis refers to infections of the liver caused by Hapatitis A virus (HAV) , Hapatitis B virus (HAB), non A, non B Hapatitis virus and Hapatitis Delta virus (HDV). Other virus like Epstien-Barr virus (EBV), Cytomegalovirus (CMV) and Herpes virus may also present with a hepatic illness.

It is a major health problem in both developed and developing countries. It seldom gives rise to clinical illness. Infections occur readily in conditions of poor sanitations and epidemics are common during wars or following natural disaster. Infections may also follow exposure to contaminated food or water.

It is a common infection worldwide and may give rise to Hepto-cellular cancer. The spread of this virus is through blood route. In addition, inapparent parenteral spread occurs between people in very close contact (e.g, sexual parteners, mother and child, siblings) and probably involves exchange of material through minute abrasions in skin or mucosa or via saliva.

It is a transfusion related (sporadic) type virus. This infection is associated with a carrier state. The illness is typically seen about 6-8 weeks after transfusion of blood or blood products. It is often mild with 50% of patients showing moderate symptoms. Low grade but protracted illness is its feature.

It is caused by Delta virus, a small and incomplete virus which exists only in the presence of Hapatitis B infections. It may either occur simultaneously with HBV or as a superimposed infection. It is fairly common in drug addicts and to a lesser extent in homosexuals.

• Transfusion with blood or blood products
• Intravenous drug abuse

• Promiscuous hetrosexual or homosexual activity

• Tattooing

• A history of travel to areas where hepatitis is common

• Consumption of food or water in countries with poor hygiene

• Direct contact with cases of known hapatitis

Acute viral Hapatitis is usually characterized by loss of appetite, nausea, vomiting and distaste for smoking. These symptoms are followed several days later by jaundice, the passage of dark urine and pale stools. Diarrhea may be initial feature with low grade fever.

• Patients History
• Clinical findings
• Liver function tests

Hepatitis A is diagnosed by testing for IgM-specific anti HAV. Hepatitis B is diagnosed by testing HbsAg.

Hepatitis A can be controlled by keeping a good personal hygiene and proper sewage disposal. Hepatitis B eradication is possible by a combination of hygienic practices, vaccination of at risk individuals and selective use of Hepatitis B vaccine. In hospitals, blood donors must be screened for HbsAg. The dentists must be encouraged to wear gloves. Diposable materials and equipment should be used wherever possible. The vaccines should be offered to high risk groups like:

• Health Care Workers
• High risk patients
• Hospital Staff
• Family members of a carrier
• Homosexuals and prostitutes
• Pregnant women
• New borns with mothers having positive HbsAg