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INTRODUCTION

Many viruses cause hepatitis. Of these, five medically important viruses are commonly described as “hepatitis viruses” because their main site of infection is the liver. These five are hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis D virus (HDV, delta virus), and hepatitis E virus (HEV) (Tables 41–1 and 41–2). Other viruses, such as Epstein–Barr virus (the cause of infectious mononucleosis), cytomegalovirus, and yellow fever virus, infect the liver but also infect other sites in the body and therefore are not exclusively hepatitis viruses. They are discussed elsewhere.

TABLE 41–1Glossary of Hepatitis Viruses and Their Serologic Markers
TABLE 41–212Important Properties of Hepatitis Viruses

Note that these viruses belong to different viral families; some are DNA viruses, whereas others are RNA viruses, and some are enveloped, whereas others are nonenveloped. They are united by their ability to infect hepatocytes because they have proteins on their surface that react with receptors on the surface of hepatocytes.

Note also that they are all noncytotoxic (i.e., they do not kill hepatocytes directly). The death of hepatocytes is mediated by cytotoxic T cells directed against viral antigen displayed on the surface of the hepatocyte in ...

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