Hepatitis is an inflamation of the liver. This inflammation may be caused by viruses,toxins or chemicals. There are several types of hepatitis such as viral,toxic,chronic and alcoholic.
It is the most common blood-borne infection. The most common of type of hepatitis are: Hepatitis A virus [HAV] Hepatitis B virus [HBV] Hepatitis C virus [HCV] Hepatitis D virus [Delta agent] Hepatitis E virus
Other agents which may cause hepatitis; Rubella virus,varicella virus,retro viruses,yellow fever virus,adeno viruses and marbug virus. Epstein-barr virus,cytomegalo virus,herpes simplex are other possible causes of viral hepatitis.
Anti HAV-IgM Positive in acute hepatitis IgG positive after infection
Hygiene Immune globulin(possive) Inactivated hepatitis A vaccine-havrix & vaqta(active) Adult1st dose 1ml IM 2nd dose 1ml IM after 6 to 12 months.
Hepatocytes undergo pathologic changes induced by the body’s immune response to the virus. Inflammation of the liver with areas of necrosis occurs,and the resultant damage leads to impairment of function. The degree of functional impairment depends on the amount of hepatocellular damage.
The endoplamic reticulamis the first cellular organelle to undergo change and liver functions thats depends on these processes are alters. Kuffer cells increase In both size and number. Vascular and ductular tissues undergo inflammatory changes.
OCCURRENCE:World-wide,especiallyin drug addicts,homosexuals,people exposed to blood and blood product.Occurs all year.
Hygiene Avoidance of risks HBIG(Passive) Recombinant hepatitis B vaccine(active) Hepatitis B vaccine(passive) 3 IM injection(deltoid) 0,1,6 months
The HBV is a DNA virus that has an inner core and a surface envelope. The body forms antibodies to the viral antigens HBsAg. The presence of resolving infection blood denotes:1. A previous or resolving infection with hepatitisB2. A Continuing,chronic infection,3. Immunization with immunoglobulin or HBV vaccine.
IV drug use accounts for 60% of HCV transmission. The risk ralated to injecting drug use is that shared drug paraphenalia used to prepare or inject the drug may have contaminated with HCV infection. Tattooing and body piercing tools contaminated with small amount of blood may also contribute to HCV infection. The tattoo artist or piercer must use good health practices such as hand-washing,sterized or disposable tattoing needles,disposable gloves.
OCCURRENCE: Post-transfusion Those working around blood and blood products. IV drug users Occurs all yearINCUBATION PERIOD: 6-7 weeks
Similar to that for hepatitis B IV drug use Intranasal cocaine use Body piercing Multiple sex partners
TRANSMISSION SEVERITY Contact with Canlead to blood and body chronic fluids. hepatitis. Source of infection uncertain in many clients. Carrier state.
Anti-HCV interferon alfa-2b in combinationHygiene with ribavirin(Rebetol)
Itis also known as delta hepatitis. Hepatitis D is transmitted only through blood contact and thus seen most commonly in clients exposed to blood and blood products,such as IV drug users and people with hemophilia.
Hepatitis D virus requires the helper function of HBV for its replication and expression. Hepatitis D virus can either infect a person stimultaneously with HBV(co-infection) or infect a person already infected with HBV(superinfection)
OCCURRENCE INCUBATION Hepatitis D virus PERIOD AND causes hepatitis RISK only in FACTORS/HIGH association with RISK GROUPS hepatitis B virus Same as for and only in presence of hepatitis B HBsAg
Co infect with hepatitis B Close personal contact Carrier state
Similar to hepatitis B More severe if occurs with chronic hepatitis B Increased risk of hepatocellular carcinoma.
This form of hepatitis primarily affect young adults. It has a short incubation and there is no evidence that it becomes chronic. The hepatitis E virus alters hepatocellular function in almost the other types of hepatitis viruses. It causes necrosis and liver cell damage.
OCCURRENCE INCUBATION Parts of PERIOD Asia,Africa,India, 14-60 Maxico,Philipines days;mean 40 where there is days poor sanitation.
RISK TRANSMISSION FACTORS/HIG Fecal-oral route,food-or H RISK water-borne. GROUPS No carrier state Travelling or living in areas where incidence is high.
Illness self- limiting Mortality rate in pregnant women 10%- 20%
DIAGNOSTIC PROPHYLAXIS TESTS AND ACTIVE Anti-HEV OR PASSIVE IMMUNITY Hygiene Sanitation No immunity
Hepatits f seems to be similar to hepatitis A and E in its mode of transmission. There is no serologic test for hepatitis F, and diagnosis is by electron microscopic identification of the virus.
Hepatitis G is spread through contact with blood,blood product, and body fluids. Most clients are asymptomatic, and chronic infection develops in 90% to 100% of infected individuals. Hepatitis G virus, like HCV,is a blood borne RNA virus. Current data indicate that a large portion of client infected with hepatitis G are also infected with HCV.
Hepatitis G virus does not alter the severity of hepatitis C, nor is it associated with acute or chronic liver injury,although the latter finding requires continused study.
Associated with chronic viremia lasting 10 years. Rarely causes frank hepatitis.
Health care workers in hemodialysis. IV drug users. Hemodialysis clients. Chronic hepatitis B or C clients.
TRANSMISSION Percutaneous SEVERITY Does not appear to cause liver disease. DIAGNOSTIC TESTS Anti-HGV PROPHYLAXIS Hygiene
Lethargy Irritability Myalgia Arthralgia Nausea Vomitting Diarrhea or constipation Fever Flu like manifestation Fatigue Malaise pruritis
Darker urine(the color of tea or mahogany) Clay-colored stool drowsiness
REDUCE FATIGUE: Rest Maintain nutritional and fluid balance: High calorie,low-fat,high-carbohydrate diet more easily digested & more palatable Reduce effects of hepatitis: Antiviral Antiemetics Parenteral vit K Antihistamines
Glucocorticoids: It may reduce serum aminotransferase & bilirubin level. Bile acid sequestentrants: Questran Colestid Vaccines: HAV HBV HVC Medication to avoid: Chlorpromazian, aspirin, acetaminophane
Bed rest High calorie, low fat, high carbohydrate diet. Avoid alcohol Vit. K supplements Relieve nausea & vomitting Psychological support Client teaching Administer medications Promote rest