Hepatotropic Viruses

Hepatitis A Viral (HAV) infection

1. This can be detected in the following samples:
   1. Feces
   2. Liver
   3. All body fluids (serum, other body fluids).
   4. These samples can be stored at 4 °C, and tissues may be stored at -20 °C.
2. Diagnostic tests are:
   1. Anti-HAV IgM.
   2. Anti-HAV IgG.

Hepatitis B viral (HBV) infection

1. This virus can be detected in the following samples:
   1. Serum
   2. Whole blood
   3. Liver
   4. Body fluids
   5. Store serum and body fluids at 4 °C and store tissue at -20 °C.
2. Diagnostic tests are:
   1. HB surface antigen.
   2. HB surface- antibody
   3. HBe antigen.
   4. HBe antibody.
   5. HBc-IgM antibody.
   6. HBc-antibody total (HBc-IgM and IgG).

Hepatitis C viral (HCV) infection

1. The virus can be detected in the following samples:
   1. Whole blood
   2. Serum
   3. liver tissue
   4. Body fluids
2. Diagnostic tests are:
   1. Anti-HCV antibody.
   2. PCR for HCV antigen.
   3. Serum, blood, and body fluids can be stored at 4 °C and liver tissue at -20 °C.

Hepatitis Delta Virus (HDV) infection

1. The Hepatitis D virus is also called delta hepatitis. It was discovered in 1977.
2. A partially defective virus must enter the HBV to penetrate the hepatocytes.
3. So HBV will be present before the patient develops Hepatitis D infection.
4. HBV is needed as a helper to start the infection.
5. The Hepatitis D virus can be detected in the following samples:
   1. Whole blood
   2. Serum
   3. Liver tissue
6. Diagnostic tests are:
   1. Anti-D IgM.
   2. Anti-D IgG.

• The whole blood and serum can be stored at 4 °C and liver tissues at -20 °C.

Hepatitis E virus (HEV)

1. It is the NANB virus with incubation time, clinical signs and symptoms, and epidemiology, which is like HAV infection.
2. HEV is thought to be a calicivirus.
3. HEV is a nonenveloped, single-stranded RNA virus.
4. Till 1994, no serological tests for HEV were available.
5. HEV diagnostic tests are:
   1. HEV antigen identified in hepatocytes.
   2. HEV can be identified in the stool by immunoelectron microscopy.
   3. Serum is positive for anti-HEV antibodies IgM, which is short-lived.
   4. Anti-HEV IgG was also found to appear immediately after IgM.

Other Viruses

Herpes Simplex (HSV) infection

1. Most cases are caused by HSV type 2, and there are significant numbers of HSV type 1.
2. This can be diagnosed by:
   1. Skin biopsy lesion
   2. Vitreous humor
   3. Cerebrospinal fluid (CSF)
   4. Serum
3. Diagnostic tests are:
   1. Cultural is the gold standard,
   2. HSV antigen 1.
   3. HSV antigen 2.

• Stored body fluids at 4 °C and tissue at -20 °C.

Cytomegalovirus (CMV) infection

1. CMV is a part of the herpesvirus group.
2. CMV infection is widespread, as serological evidence of infection varies from 30% to >90% of the population.
3. There is a lower incidence in the USA and Western Europe.
4. CMV infection is seen in:
   1. Fetal and early childhood.
   2. Young adults and late adolescents.
5. This can be diagnosed from:
   1. Whole blood
   2. Serum
   3. Urine
   4. Tissues
6. Diagnostic tests:
   1. Culture is the most sensitive method.
   2. CMV-IgM indicates the most recent infection.
   3. CMV-IgG indicates past infection.

• Store all fluids at 4 °C and tissues at -20 °C.

Epstein-Barr Virus (EBV) infection

1. EBV is a member of the herpes virus.
2. This can be diagnosed with the following samples:
3. Whole blood
4. Tissue
5. saliva
6. Diagnostic tests are:
   1. Monospot heterophilic agglutination test.
   2. Viral capsid antigen-antibody test for IgM and IgG.
   3. EBV nuclear antigen (EBNA).
      1. EBNA-IgG
      2. EA-D

• Store the fluid at 4 °C and the tissue at -20 °C.

Human Immunodeficiency Virus (HIV-1)

1. This can be diagnosed by:
   1. Whole blood
   2. urine
   3. Body fluids
2. Diagnostic tests are:
   1. HIV antibody test by ELIZA.
   2. Western blot test.
   3. p24 antigen capture assay. This will detect before the seroconversion and also assesses the progression of AIDS.
   4. Oral fluids for the detection of HIV antibodies, kits by the name of Orasure, Orapette, and Omni sal are available.
   5. Urine for the HIV antibody test.

• Store fluids at 4 °C and tissue at -20 °C.

Human papillomavirus (HPV)

1. This can be diagnosed from:
   1. Cervical smears
   2. Biopsy or scrapings
   3. Tissue from anogenital area
2. Diagnostic tests are:
   1. Colposcopy and Vinegar acetic acid will give white color to the affected area.
   2. PAP smear will give abnormalities of the cells and see the virus-infected cells.
   3. Biopsy.
   4. HPV cervical test.
   5. DNA test (PCR, southern blot hybridization).

• Store the tissue at -20 °C.

Rotavirus Infection

1. This can be diagnosed from:
   1. Feces (isolate the nucleic acid)
   2. This can be stored at 4 °C.
2. Diagnostic tests are:
   1. 1. Stool for rotavirus antigen.
      2. ELIZA

Varicella-Zoster Virus

1. This can be diagnosed from:
   1. Whole blood
   2. Skin Lesions
   3. Diagnostic tests are:
      1. Usually, this is diagnosed by the clinician as a typical skin lesion, a vesicular dermal lesion.
      2. Culture of the virus.
      3. PCR from the lesion.

• Store fluids at 4 °C and tissues at -20 °C.

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