Hepatitis D, C, G Virus

Disease: Hepatitis D
HDV causes hepatitis D.
Properties:

1. It is a defective virus.
2. It cannot replicate by itself because it does not have envelope protein.
   3.Depends on HBV because HDV uses the surface antigen of HBV,
3. It is an enveloped virus.
4. Single stranded RNA genome.
5. Negative polarity.
   7.Its internal core protein is called delta antigen.
6. It has no virion polymerase.
7. It replicates in the nucleus (specifically complex)
8. There is no animal reservoir.
   Transmission:
   Same as HBV.
   Mostly intravenous drug abusers.
   “pathogenesis:
   Same as HBV.
   here is some evidence that delta antigen is cytopathic for hepatocytes.
   clinical findings:
   V infection (hepatitis delta) can occur only in a person infected with HBV.
9. Coinfection:
   Infected with both HDV & HBV at the same time. Severe than HBV alone
10. Superinfection:
    Previously infected with HBV and at present infected with HDV. More se
    coinfection.

Laboratory diagnosis:
Either –
Delta antigen
► Early acute HDV infection.
Or,
IgM antibody to delta antigen

Present or past infection with HDV.
Treatment and prevention:

1. Alpha interferon can be used
2. No vaccine against but immunized against HBV will not be inf
   Disease: Hepatitis C virus
   HCV causes hepatitis C
   Properties:
3. it’s a member of the flavivirus family.
4. Single-stranded RNA genome,
5. Positive polarity,
6. It is an enveloped virus.
7. It has no virion polymerase,
   Transmission:
8. Human is the reservoir.
9. It is transmitted primarily via blood.
10. Intravenous drug abusers,
11. Commercially prepared immune globulin preparations.
12. It is only an infectious disease transmitted by immune globulins.

Pathogenesis:
HCV infects hepatocytes
Immune attack by cytotoxic T cell
Death of hepatocyte
No cytopathic effect
Chronic carrier
Chronic hepatitis
Cirrhosis
Hepatocellular carcinoma
Laboratory diagnosis:

1. Detection of HCV RNA:
   ➤ By PCR.
2. Serological procedure
   Anti-HCV is detected by ELISA.
   Confirmed by RIBA (Recombinant Immunoblot Assay)
   Abnormal liver function test.
   Chronic infection:
   Characterized by elevated transaminase levels –

A positive RIBA &
Detectable viral RNA
Treatment & prevention:

1. Combination of alpha interferon and ribavirin.
2. No vaccine and no immunoglobulin, because of antigenic variation of glycoprotein.
3. Advice to reduce or eliminate alcohol consumption to reduce the risk of hepatocellular carcinoma and cirrhosis.
   Patients coinfected with HCV & HIV should be prescribed HAART (Highly active antiretroviral therapy)
   Hepatitis G virus:
   Properties:
4. HGV is a member of the flavivirus family.
5. Transmitted via sexual intercourse and blood.
6. Chronic hepatitis disease.
7. Identified by detection of the nucleic acid by RT-PCR
   Conclusion:
   I am trying to discusses this article, which is a complex disease and requires an interprofessional approach from healthcare providers to tackle it. The article discusses strategies to prevent hepatitis through patient education and vaccination and the importance of closer monitoring for disease progression and complications. These strategies require significant interprofessional communication and care coordination by physicians, including primary care physicians and specialists, nurses, pharmacists, and other health professionals, to enhance patient-centred care. Nursing needs to work closely with the patient to ensure they understand their disease, are compliant with medications and vaccines, and note progress or lack thereof. Pharmacists are crucial to ensuring the proper medications at the correct dose are in the therapy regimen, and that there are no interactions. These measures can help improve the outcomes and aid patient safety and can also help enhance team performance.