Hepatitis D y E

Hepatitis D and E Overview

Introduction to Hepatitis D

• The discussion begins with an overview of Hepatitis D, concluding the exploration of hepatitis viruses, while briefly mentioning Hepatitis E.

• Hepatitis D is classified under the family of deltaviruses, characterized as a small virus (35-37 nanometers) with a spherical structure and enveloped nature.

Characteristics of Hepatitis D Virus

• The virus is described as defective, stemming from a mutation in another hepatitis virus. Its genome consists of approximately 1700 bases.

• Notably, Hepatitis D requires the presence of Hepatitis B for replication; thus, co-infection is essential for its lifecycle.

Infection Dynamics

• A superinfection occurs when an acute infection of Hepatitis D arises in a chronic carrier of Hepatitis B.

• Approximately 80% of patients with acute Hepatitis B develop chronic conditions; only 15% progress to cirrhosis within two years.

Clinical Implications

• Chronic patients typically die from liver disease within 10 to 15 years; however, deaths are primarily due to cirrhosis or hepatocellular carcinoma rather than directly from Hepatitis D.

• In Mexico, there are no substantial data on the prevalence of Hepatitis D. Comparatively few cases have been reported in the U.S., while higher rates exist in certain regions like South America and Africa.

Transmission and Symptoms

• Similar transmission routes to those seen in Hepatitis B include bloodborne and sexual contact. The incubation period varies between 4 to 20 days for co-infections.

• Some authors suggest that asymptomatic infections may occur without co-infection with Hepatitis B, complicating diagnosis.

Risk Factors and Treatment Options

• High-risk groups include drug users, healthcare workers, and individuals undergoing frequent transfusions or hemodialysis. Vertical transmission from infected mothers can also occur.

• Treatment options may involve interferon over three months; however, severe cases may necessitate liver transplantation due to rapid progression.

Prevention Strategies

• Vaccination against Hepatitis B is crucial for preventing coinfection with Hepatitis D. Limited knowledge exists regarding asymptomatic cases related to this virus.

Insights on Hepatitis E

Overview of Hepatitis E Virus

• Briefly mentioned as belonging to the picornavirus family alongside hepatitis A; it has been recognized relatively recently.

Transmission and Symptoms

• It is transmitted via fecal oral routes similar to hepatitis A but remains underdiagnosed due to insufficient laboratory testing.

Clinical Presentation

• Symptoms resemble those seen in hepatitis A—diarrhea and right upper quadrant pain—but some reports indicate it could be less severe except in pregnant women or elderly patients who may experience more serious complications.

Hepatitis E Treatment Considerations

Contextual Factors in Hepatitis E Management

• The discussion raises questions about whether the patient's geriatric context influences treatment decisions or if it is primarily due to the hepatitis E virus itself.

• It is noted that there is no specific treatment available for hepatitis E, emphasizing the need for supportive care.

• Supportive care includes hydration and symptomatic management as necessary for patient comfort.

• The speaker concludes with a brief remark, indicating that this is all the information available at this time.