Abstract

Five distinct human viruses are commonly associated with viral hepatitis in man. Two agents, hepatitis A virus (HAV) and hepatitis E virus (HEV) cause only acute hepatitis and are predominantly transmitted by the fecaloral route. The others, hepatitis B virus (HBV) , hepatitis D virus (HDV) , and hepatitis C virus (HCV) , are transmitted by parenteral and sexual exposure, and in the case of HBV and HCV are also transmitted to infants born of infected mothers. All have a worldwide distribution, although the prevalence of each varies significantly among different populations. The viruses belong to very different virus families and have in common only a tropism for the liver. Each has a distinctive structure and replication strategy. Infection with three of these agents (HBV, HCV and HDV) often leads to chronic hepatitis and possibly cirrhosis, while two of these viruses (HBV and HCV) have been associated with development of liver cancer. Effective vaccines offer hope for control of HAV, HBV, and HDV (through immunization against HBV) , while recent advances in our understanding of HCV and HEV suggest that vaccines may soon be available for these agents as well.

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