IMMUNOLOGY and SEROLOGY: HEPATITIS

brainrotgaIore || October 2023

HEPATITIS A B C D E
“NON-A, NON-B HEPATITIS” “WATER-BORNE NON-A, NON-B
“INFECTIOUS HEPATITIS” “SERUM HEPATITIS”
KNOWN AS “BLOOD-BORNE HEPATITIS” “DELTA HEPATITIS” HEPATITIS”
“SHORT-INCUBATION HEPATITIS” “LONG INCUBATION HEPATITIS
“POST-TRANSFUSION HEPATITIS” “ENTERIC HEPATITIS”
Hepatitis A virus (HAV) or Hepatitis B virus (HBV) or Hepatitis C virus (HCV) Hepatitis D virus (HDV) or
Hepatitis E virus (HEV)
Enterovirus 72 Dane Particle Delta Virus
✓ RNA virus:
PATHOGEN ✓ RNA virus: Hepevridae
✓ RNA virus: Picornaviridae ✓ DNA virus: Hepadnaviridae Flaviviridae (Family) ✓ RNA virus: Deltaviridae
(Old: Caliciviridae)
✓ Non-enveloped, Icosahedral, ✓ Enveloped, circular, partial Hepacovirus (Genus) ✓ Enveloped (contains HBsAg),
✓ Non-eneveloped, ssRNA
ssRNA genome dsDNA genome ✓ Enveloped, ssRNA ssRNA, circular RNA genome
Acute, self-limiting infection Majority are asymptomatic but 70%
May be acute, chronic, fulminant, or Self-limiting disease with recovery by
CLINICAL COURSE (symptoms resolve within 2 months)
asymptomatic carrier state
develop chronic infection and half Acute infection or Chronic infection
4-6 weeks
with no chronic state develop cirrhosis
INCUBATION 15-50 days (28 days) 30-180 days (8-13 weeks) 7 weeks (2-30 weeks) 2-6 weeks
MODE OF TRANSMISSION Fecal-Oral route Parenteral Blood transfusion Parenteral Fecal-Oral route

SEROLOGIC MARKERS INTERPRETATION OF HEPATITIS C PANEL

ANTIGEN ANTIBODY TESTS RESULTS INTERPRETATION
Active infection HCV Antibody - No HCV Antibody detected. There was no previous nor active infection
HBsAg Anti-Hbs Recovery and Immunity
(acute or chronic) HCV Antibody + Presumptive HCV infection. (Requires confirmatory test).
NOT detected Window Period (IgM) HCV Antibody +
HBcAg Anti-HBc No current HCV infection. (Patient may have previous HCV infection)
(not a serologic marker; stays in the liver) IgG: lifelong marker of Hepa B HCV RNA -
HBeAg Active Replication (Infectious) Anti-HBe Recovery (Convalescence) HCV Antibody (+) +
Active, or current HCV infection.
HCV RNA (+) +
INTERPRETATION OF HEPATITIS B PANEL
TESTS RESULTS INTERPRETATION
HEPATITIS D
HBsAg -
No HBV infection CO-INFECTION SUPERINFECTION
Anti-HBc -
Susceptive to HBV infection; patient does not have antibodies against HBV Both HDV and HBV HBV infection exposed to HDV; more severe
Anti-HBs - Hepatitis D simultaneously infects cells Hepatitis D infects cells on top of the active infection with Hepatitis B.
HBsAg - along with Hepatitis B This usually occurs among chronic HBV carriers
Past infection; patient does not have active infection – HBsAg (-)
Anti-HBc +
Immune due to natural infection; Anti-HBc indicates previous infection
Anti-HBs + HEPATITIS G
HBsAg -
Immune due to Hepatitis B vaccination
Anti-HBc -
Anti-HBc (-) because there is no previous hepatitis infection • Caused by Hepatitis G virus (HGV) and GB virus type C (GBV-C)
Anti-HBs + o RNA virus: Flaviviridae
Interpretation unclear; o Enveloped
HBsAg -
(1) Recovering from acute HBV infection (most common) • Blood borne agent: Transfusion recipients and IV drug users are at risk of infection
Anti-HBc + (2) False (+) Anti-HBc: no HBV infection • Commonly occurs as co-infection with HCV
(3) Low level of chronic infection • HGV is common worldwide but is believed to be non-pathogenic
Anti-HBs - (4) Resolving acute infection
(5) Patient is at window period of infection TRANSFUSION-TRANSMITTED VIRUS (TTV)
HBsAg +
Anti-HBc + • Named after the initials of the first patient (TT) from whom the virus was isolated
Acute HBV infection; presence of IgM antibody indicates Acute Infection
IgM Anti-HBc + • Non-enveloped, ssDNA virus with 3739 nucleotides
Anti-HBs - • Recent addition to infectious hepatitis family
HBsAg + • Most remarkable feature is the extraordinary high prevalence of chronic viremia in apparently healthy people
Anti-HBc + • Pathogenicity has not been proven
Chronic infection; presence of IgG antibody indicates Chronic Infection
IgM Anti-HBc -
Anti-HBs -

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