Dhanya VJ,Assistant Professor, Child health nursing,SUM Nursing College

1. HEPATITIS
DHANYA VJ
ASSISTANT PROFESSOR
SUM NURSING COLLEGE

2. DEFINITION
• Hepatitis’ means
inflammation of the liver.
TYPES OF HEPATITIS
• Hepatitis A, B, C, D& E .

3. CAUSES
• ACUTE CAUSES:
• Viral hepatitis
• Non-viral infection
• Alcohol
• Toxins
• Drugs
• Ischemic hepatits
• Autoimmune
• Metabolic diseases

4. CAUSES
• CHRONIC CAUSES:
• Viral hepatitis
• Alcohol
• Drugs
• Non-alcoholic
steatohepatitis
• Autoimmune
• Heredity

5. CAUSES
• Hepatitis viruses.
• Cytomegalovirus
• Epstein-Barr virus
• Herpes simplex virus
• Varicella zoster virus
• Enteroviruses.
• Rubella.
• Adenovirus
• Parvovirus.

6. PATHOPHYSIOLOGY
• Virus invades the parenchymal cells
• Local degeneration and necrosis
• Subsequent infiltration of parenchyma
by lymphocytes, macrophages, plasma
cells, eosinophils, neutrophils
• Inflammation
Biliary obstruction

7. PATHOPHYSIOLOGY
Structural changes in parenchymal
cells
Altered liver function
Impaired bile excretion causes a
built up of bile in the blood urine
and skin.
Elevated ALT, SGPT and ALP.
Decreased albumin synthesis

8. TYPES OF
HEPATITIS

9. HEPATITIS A

10. Hepatitis A
Mode of Transmission
• Close personal contact
(e.g., household contact, sex
contact, child day care centers)
• Contaminated food, water
(e.g., infected food handlers,
raw shellfish)
• Blood exposure (rare)
(e.g., injecting drug use,
transfusion)

11. CLINICAL FEATURES
Incubation or preclinical period:
• ranging from 10-50 days, patient
remains asymptomatic.
pre-icteric phase
• ranging from several days to more
than a week. symptoms like
• loss of appetite,
• fatigue,
• abdominal pain,

12. CLINICAL FEATURES
• Nausea and vomiting
• fever
• Diarrhea
• dark urine and pale stools.
• Icteric phase:
• jaundice develops at total bilirubin
levels exceeding 2-4 mg/dl.

13. CLINICAL FEATURES
• The icteric phase generally begins
within 10 days of the initial symptoms.
• Fever
Convalescent period:
• Disease is slow, but patient recovery
uneventful and complete.
• Necrosis of the liver -first 6-8 weeks
• high fever, abdominal pain, vomiting,
jaundice
• Hepatic encephalopathy

14. DIAGNOSIS
• IgM in the serum of patients
• Detection of IgG
• Liver function test

15. PREVENTION
• Shot of immune globulin
up to 2 weeks after
exposure
• Good hand washing
• Cook food well
• Good diaper hygiene
• Only drink clean water
• Vaccine

16. TREATMENT
• No medicine or treatment
to make it go away
• Rest, fluids, treatment of
symptoms
• Most people recover
completely and become
immune to reinfection

17. HEPATITIS B

18. MODES OF TRANSMISSION
• Unprotected sexual contact with an
infected individual
• Sharing needles
• Mother to child during birth
• Blood to blood contact
• Sharing razors or toothbrushes
with an infected person

19. CLINICAL FEATURES
Incubation period : 2-6 months
• Fever
• Fatigue
• Loss of appetite
• Nausea
• Vomiting
• Abdominal Pain
• Dark Urine
• Clay-colored stool
• Jaundice

20. PREVENTION
• Vaccination
- Highly effective recombinant vaccines
• Hepatitis B Immunoglobulin (HBIG)
-Exposed within 48 hours of the
incident/ neonates whose mothers are
HBsAg and HBeAg positive.
• Other measures
-Screening of blood donors, blood and
body fluid precautions.

21. TREATMENT
• 2 approved therapies :-
interferone
Lamivudine.
• Interferones are naturally
occurring agents with antiviral,
antineoplastic and
immunomodulatory properties.
• Other drugs are adefovir,
entecavir

22. HEPATITIS C
• Hep. C is a liver infection caused by
a virus
• Also known as non A, non B
hepatitis

23. MODE OF TRANSMISSION
• Injection Drug Use-sharing needles
• Receiving blood or blood products
• Infected mother to child transmission
• Unprotected sex with an infected
person

24. CLINICAL PRESENTATION
• Incubation period: 2-26 weeks
• Fatigue
• Malaise
• Jaundice
• Joint pain
• Nausea
• Itching
• Poor apetite

25. TREATMENT
Interferon/Ribavirin
(suggest 40%
“cure” rate)

26. PREVENTION:
• There is NO VACCINATION for
Hepatitis C
• Do not share needles or rinse water
• Wear protective equipment when
handling blood or blood products
• Do not engage in unprotected sexual
contact with an infected person

27. HEPATITIS D
Hepatitis D
(Delta) Virus

28. Modes of Transmission
 Percutaneous exposures
 injecting drug use
 Per mucosal exposures
 sex contact

29. Clinical Features
Coinfection
 severe acute disease.
 low risk of chronic infection.
Superinfection
usually develop chronic
HDV infection.
high risk of severe chronic
liver disease.
may present as an acute
hepatitis

30. Prevention
 HBV-HDV Coinfection
Pre or post exposure
prophylaxis to prevent HBV
infection.
 HBV-HDV Superinfection
Education to reduce risk
behaviors among persons
with chronic HBV infection

31. HEPATITIS E

32. MODE OF TRANSMISSION
• person-to-person via
fecal-oral route
• contaminated drinking
water

33. CLINICAL PRESENTATION
• Incubation period -ranges
from 3-6 weeks, with a
mean of 40 days.

34. PREVENTION
• There are no vaccines at
present.
• Good personal hygiene, high
quality standards for public
water supplies and proper
disposal of waste have resulted
in lower prevalence of HEV.

35. Clinical features
• Flu-like symptoms
• Jaundice (yellow color in the skin
and/or eyes)
• Fever
• Nausea and/or vomiting
• Decreased appetite
• Not feeling well all over
• Abdominal pain or discomfort

36. Clinical features
• Diarrhea
• Joint pain
• Sore muscles
• Itchy red hives on skin
• Clay-colored stools
• Dark urine

37. Diagnostic measures
• History collection
• Physical examination
• Blood test
• CT scan
• MRI
• Liver biopsy

38. TREATMENT
• Supportive care
• Medications
• Maintaining adequate growth and
development
• Avoiding alcohol and drugs
• Preventing the spread of the disease
• Interferon drug therapy
• Frequent blood testing
• Hospitalization
• Liver transplantation

39. NURSING MANAGEMENT
• Early detection
• Recognition of chronic liver
disease
• Support and monitoring
• Preventing spread of infection
• Maintain adequate nutrition
• Promote rest and comfort
• Provide diversional activities