Hepatitis - viral
Description
| A | B | C | D | E | |
|---|---|---|---|---|---|
| Genome | ssRNA picornavirus | Partially dsDNA hepadnavirus | ssRNA flavivirus | Defective circular ssRNA | ssRNA hepevirus |
| Route | Faeco-oral | Blood, sexual, perinatal | Blood (PWID) | As HBV | Faeco-oral, zoonotic |
| Incubation | 15-50 d | 60-180 d | 14-160 d | As HBV | 15-60 d |
| Chronic? | Never | Yes (age-dependent) | Yes, ~70% | Yes | Only if immunosuppressed |
| ALF risk | Low (higher if >50 or chronic liver disease) | ~1% | Lowest | Highest | ~20% in 3rd-trimester pregnancy |
| Vaccine | Yes | Yes | No | Via HBV vaccine | Yes (China only) |
| Treatment | Supportive | NA, indefinite | DAA, curative | Bulevirtide | Ribavirin if chronic |
- Mnemonic: the vowels (A and E) go through the bowels; B, C and D are blood-borne
- HCV: least likely to cause acute liver failure, most likely to become chronic
- **A defective virus: HDV needs HBsAg for its envelope - it cannot replicate or cause disease without HBV**
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