Viral Hepatitis: A, B, C, D and E—Infection
Saul Krugman MD1
1 Professor of Pediatrics, NYU Medical Center, 550 First Avenue, New York, NY 10016
Viral hepatitis is caused by at least five etiologically and immunologically distinct viruses: hepatitis A (HAV), hepatitis B (HBV), hepatitis C (HCV), hepatitis D (HDV), and hepatitis E (HEV). The clinical, epidemiologic, and immunologic features of these five forms of viral hepatitis may be similar or different. Hepatitis also may occur during the course of disease caused by cytomegalovirus, Epstein-Barr virus, herpes simplex virus, varicella-zoster virus, adenoviruses, enteroviruses, rubella virus, arboviruses, and other agents.
Hepatitis A is synonymous with "infectious hepatitis," an ancient disease described by Hippocrates and formerly known as epidemic jaundice, acute catarrhal jaundice, and other designations. The fulminant form of the disease was called acute yellow atrophy of the liver.
Hepatitis B is synonymous with "serum hepatitis," a disease with a more recent history. The first known outbreak occurred during 1883 among a group of shipyard workers who were vaccinated against smallpox with glycerinated lymph of human origin. Later, an increased incidence of the disease was observed among patients attending venereal disease clinics, diabetes clinics, and other facilities where multiple injections were given with inadequately sterilized syringes and needles contaminated with the blood of a viral carrier. The most extensive outbreak occured in 1942, when yellow fever vaccine containing human serum caused 28 585 cases of hepatitis B infection with jaundice among United Stated military personnel.
