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Viral hepatitis is any type of liver inflammation caused by a viral infection. The three most common viruses now recognized to cause liver disease are hepatitis A, hepatitis B, and hepatitis non-A, non-B (also called hepatitis C). Several other types have been recognized: hepatitis D, hepatitis E, and the recently identified hepatitis G. A seventh type (hepatitis F) is suspected but not yet confirmed.
The different types of viral hepatitis produce similar symptoms, but they differ in terms of transmission, course of treatment, prognosis, and carrier status. When the clinical history of a patient is insufficient for differentiation, hepatitis virus tests are used as an aid in diagnosis and in monitoring the course of the disease. These tests are based primarily on antigen-antibody reactions—an antigen being a protein foreign to the body, and an antibody another type of protein manufactured by lymphocytes (a type of white blood cell) to neutralize the antigen.
There are five major types of viral hepatitis. The diseases, along with the antigen-antibody tests available to aid in diagnosis, are described below.
Commonly called infectious hepatitis, this is caused by the hepatitis A virus (HAV). It is usually a mild disease, most often spread by food and water contamination, but sometimes through sexual contact. Immunologic tests are not commercially available for the HAV antigen, but two types of antibodies to HAV can be detected. IgM antibody (anti-HAV/IgM), appears approximately three to four weeks after exposure and returns to normal within several months. IgG (anti-HAV/IgG) appears approximately two weeks after the IgM begins to increase and remains positive. Acute hepatitis is suspected if IgM is elevated; conversely, if IgG is elevated without IgM, a convalescent stage of HAV is presumed. IgG antibody can remain detectable for decades after infection.
Commonly known as serum hepatitis, this is caused by the hepatitis B virus (HBV). The disease can be mild or severe, and it can be acute (of limited duration) or chronic (ongoing). It is usually spread by sexual contact with another infected person, through contact with infected blood, by intravenous drug use, or from mother to child at birth.
HBV, also called the Dane particle, is composed of an inner protein core surrounded by an outer protein capsule. The outer capsule contains the hepatitis B surface antigen (HBsAg), formerly called the Australia antigen. The inner core contains HBV core antigen (HBcAg), and the hepatitis B e-antigen (HBeAg). Antibodies to these antigens are called anti-HBs, anti-HBc, and anti-HBe. Testing for these antigens and antibodies is as follows:
Author Info: Janis O. Flores, The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Medicine, 2002
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