2. hepatitis overview.ppt

8/14/2019 2. hepatitis overview.ppt

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H E P A T I T I S

OVERVIEW


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Hepatitisinflammation of the liver

Can have many causes

drugs

toxins

alcohol

viral infections (A, B, C, D, E)

other infections (parasites, bacteria)

physical damage


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Hepatitis Terms

Acute Hepatitis: Short-term hepatitis.

Bodys immune system clears the virus from

the body within 6 months

Chronic Hepatitis: Long-term hepatitis.

Infection lasts longer than 6 months because

the bodys immune system cannot clear the

virus from the body


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WHAT IS HEPATITIS ?

HEPATITIS IS THE INFLAMATION OF

THE LIVER AND CAN RESULT IN LIVER

CELL DAMAGE AND DESTRUCTION


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Healthy Liver Cirrhosis Liver


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WHAT CAUSES HEPATITIS ?

HEPATITIS IN CHILDREN HAS MANY

DIFFERENT ORIGINS AND CAUSES

HEPATITIS VIRUSES(A, B, C, D, E, G )

CYTOMEGALO V.

EPSTEIN-BARR V. HERPES SIMPLEX V

VARICELLA ZOSTER

ENTEROVIRUSES

ADENOVIRUS

PARVOVIRUS

AUTOIMMUNELIVER DISEASES

CHRONIC VIRAL

HEPATITIS (B,C,D )


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HEPATITIS A

SPREAD BY FECAL-ORAL CONTACT,

OR FECAL-INFECTED FOOD AND WA-

TER, BLOOD-BORNE INFECTION

(WHICH IS RARE )

THE VACCINE HAS BEEN DEVELOPED

AND IS NOW AVALIABLE, AND IS NOT

RECOMMENDED FOR CHILDRENUNDER 2 YEARS OF AGE


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HEPATITIS A VIRUS


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Hepatitis A

Incubation period

30 days on average (range 15-50 days)

infectious latter half of incubation period while

asymptomatic through 1 week after having

jaundice.


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Nausea

Loss of appetite

Vomiting

Fatigue

Fever

Dark urine

Pale stool

Jaundice

Stomach pain

Side pain

A person may have all, some or none of these

Hepatitis A

Symptoms


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HEPATITISA VACCINES

1stdose at time 0

2nddose 6-12 months afterwards


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Hepatitis B

What is it?

Hep B is a serious disease caused by a virus

that infects the liver

Can cause lifelong infection, cirrhosis (liver

scarring), liver cancer, liver failure and death


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Hepatitis B Virus


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HEPATITIS B

HAS A WIDE RANGE OF CLINICAL

PRESENTATION ( CAN BE MILD / WITHOUT

SYMPTOMS, OR CHRONIC HEPATITIS

CHRONIC LIVER DISEASE AND LIVERFAILURE )

TRANSMISIONS OCCURS THROUGH BLOOD

AND BODY FLUID EXPOSURE SUCH AS

BLOOD, SEMEN, VAGINAL SECRETIONS,ORSALIVA. AND INFANT WHO ARE BORN TO A

MOTHER WHO HAS THE VIRUS.


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Hepatitis B

Incubation period

60-90 days on average (range 45-180 days)

infectious weeks before getting ill and for

variable period after acute infection

chronic carriers remain infectious


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Hepatitis B

Incubation period

60-90 days on average (range 45-180 days)

infectious weeks before getting ill and for

variable period after acute infection



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Hepatitis B

How do you get it?

Direct contact with blood or body fluids of an

infected person

sharing injection equipment

sex

baby from infected mother during childbirth

Hepatitis B is not spread by food, water orcasual contact


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Acute Hepatitis B Virus Infection with

RecoveryTypical Serologic Course

Weeks after

Titer

Symptoms

HBeAg anti-HBe

Total anti-HBc

IgM anti-HBc anti-HBsHBsAg

0 4 8 12 16 20 24 28 32 36 52 100


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Outcome of Hepatitis B Virus Infection

by Age at Infection

Symptomatic Infection

Chronic Infection

Age at Infection

ChronicInfection(%)

S

ymptomatic

Infection(%

)

Birth 1-6 months 7-12 months 1-4 years Older Children

and Adults

0

20

40

60

80

100100

80

60

40

20

0


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10%

90%

Chronically infected

Clear the infection

HEPATITIS B


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Hepatitis C

What is it?

Hep C is a liver infection caused by a virus

Also known as non A, non B hepatitis


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HEPATITIS C

THE SYMPTOMS ARE USUALLY MILD

AND GRADUAL.

TRANSMISION: FROM CONTACT WITH

INFECTED BLOOD, SEXUAL, INFECTED

MOTHER TO HER BABY

IT LEADS TO CHRONIC LIVER DISEASE

THERE IS NO VACCINE FOR HEP. C


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Hepatitis C

Incubation period

6-7 weeks on average (range 2-6months)

infectious one or more weeks before getting ill



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Nausea

Loss of appetite

Vomiting

Fatigue

Fever

Dark urine

Pale stool

Jaundice

Stomach pain

Side pain

Hepatitis C

Symptoms

3 out of 4 persons have no symptoms and can

infect others without knowing it


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Hepatitis C

Shared injection equipment (60% of new

infections)

Blood transfusion before May, 1992 (now only 1

in 100,000 chance of transmission)

Blood transfer (HCW, tattoo, piercing )

Sex? (HCV in semen and vf but only 1.5% rate

of transmission for long-term partners)

Mother to child (


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85%

15%

Chronically infected

Clear the infection

HEPATITIS C


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HEPATITIS D

CAN ONLY OCCUR IN PRESENCE OF

HEPATITIS B

CAN PUT THAT HEP.TITIS B INFECTION

PERSON AT RISK FOR LIVER FAILURE

TRANSMISION = HEPATITIS B, EXCEPT

FROM MOTHER TO BABY IS LESS

COMMON


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Hepatitis D (Delta) Virus

HBsAg

RNA

antigen


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Percutanous

exposuresinjecting drug use

Permucosalexposures

sex contact

Hepatitis D Virus

Modes of Transmission


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HEPATITIS E

THE FORM OF HEPATITIS IS SIMILAR

TO HEPATITIS A

TRANSMISION : FECAL-ORAL CONT.

IS MOST COMMON IN POORLY

DEVELOPED COUNTRIES

NO VACCINE


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Hepatitis E Virus


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Hepatitis E - Clinical

Features

Incubation period: Average 40 days

Range 15-60 days

Case-fatality rate: Overall, 1%-3%Pregnant women,

15%-25%

Illness severity: Increased with age

Chronic sequelae: None identified


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HEPATITIS G

THE NEWEST STRAIN OF HEPATITIS,

AND VERY LITTLE IS KOWN ABOUT IT

TRANSMISSION : THROUGH BLOOD,

AND SEEN IN IV DRUG USERS, HEMO-

PHILIA, HEMODIALYS PATIENT

OFTEN HEP. G SHOWS NO CLINICAL

SYMPTOMS


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WHAT THE SYMPTOMS OF

HEPATITIS ?

FLU-LIKE SYMPTOM

FEVER

NAUSEA AND / OR

VOMITING

DECREASED

APPETITE

NOT FILLING WELLALL OVER

ABDOMINAL PAIN

OR DISCOMFORT

DIARRHEA

JOINT PAIN

SORE MUSCLE

ITCHY RED HIVES

ON SKIN DARK COLORED

URINE & JAUNDICE


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HOW IS HEPATITIS

DIAGNOSED?

BLOOD TESTING

LIVER FUNCTION

STUDIES

ANTIBODY STUDIES

CELLULAR BLOOD

COUNTS

BLEEDING TIMES

ELECTROLYTES

OTHER CHEMICALS

IN THE BODY

USG

LIVER BIOPSY


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TREATMENT FOR HEPATITIS

DEPENDING ON THE UNDERLYING CAUSES

SUPPORTIVE CARE

MEDICATIONS

MAINTAINING ADEQUATE GROWTH & DEV.

AVOIDING ALCOHOL AND DRUG PREVENTING THE SPREAD OF THE DIS.

INTERFERON DRUG THERAPY

FREQUENT BLOOD TESTING

HOSPITALIZATION

LIVER TRANSPLANTATION


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PREVENTING THE SPREAD OF

VIRAL HEPATITIS

VACCINATION ( HEPATITIS A & B )

BLOOD TRANSFUSION ( SCREENED

FOR HEP.B AND C )

ANTIBODY PREPARATION

IMUNOGLOBULIN : TO HELP PROTECT

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