Treatment:

1. Hepatitis A:
There is no specific treatment for hepatitis A. Recovery from symptoms following
infection may be slow and may take several weeks or months. Most important is the avoidance
of unnecessary medications. Acetaminophen / Paracetamol and medication against vomiting
should not be given.
Hepatitis A treatment usually focuses on keeping comfortable and controlling signs and
symptoms. You may need to:
 Rest: Many people with hepatitis A infection feel tired and sick and have less
energy.
 Manage nausea: Nausea can make it difficult to eat. Try snacking throughout the
day rather than eating full meals. To get enough calories, eat more high-calorie
foods. For instance, drink fruit juice or milk rather than water. Drinking plenty of
fluids is important to prevent dehydration if vomiting occurs.
 Avoid alcohol and use medications with care: Your liver may have difficulty
processing medications and alcohol. If you have hepatitis, don't drink alcohol. It
can cause more liver damage. Talk to your doctor about all the medications you
take, including over-the-counter drugs.

https://www.mayoclinic.org/diseases-conditions/hepatitis-a/diagnosis-treatment/drc-20367055

2. Hepatitis B:
a. Treatment for acute hepatitis B infection:
If your doctor determines your hepatitis B infection is acute — meaning
it is short-lived and will go away on its own — you may not need treatment.
Instead, your doctor might recommend rest, proper nutrition and plenty of
fluids while your body fights the infection. In severe cases, antiviral drugs or a
hospital stay is needed to prevent complications.

b. Treatment for chronic hepatitis B infection:

Most people diagnosed with chronic hepatitis B infection need

treatment for the rest of their lives. Treatment helps reduce the risk of liver
disease and prevents you from passing the infection to others. Treatment for
chronic hepatitis B may include:

 Antiviral medications. Several antiviral medications — including

entecavir (Baraclude), tenofovir (Viread), lamivudine (Epivir), adefovir
(Hepsera) and telbivudine (Tyzeka) — can help fight the virus and slow
its ability to damage your liver. These drugs are taken by mouth. Talk to
your doctor about which medication might be right for you.
 Interferon injections. Interferon alfa-2b (Intron A) is a man-made
version of a substance produced by the body to fight infection. It's used
mainly for young people with hepatitis B who wish to avoid long-term
 treatment or women who might want to get pregnant within a few
years, after completing a finite course of therapy. Interferon should not
be used during pregnancy. Side effects may include nausea, vomiting,
difficulty breathing and depression.
 Liver transplant. If your liver has been severely damaged, a liver
transplant may be an option. During a liver transplant, the surgeon
removes your damaged liver and replaces it with a healthy liver. Most
transplanted livers come from deceased donors, though a small number
come from living donors who donate a portion of their livers.

https://www.mayoclinic.org/diseases-conditions/hepatitis-b/diagnosis-treatment/drc-20366821

3. Hepatitis C:
Hepatitis C is treated using direct acting antiviral (DAA) tablets. DAA tablets are the safest
and most effective medicines for treating hepatitis C. They're highly effective at clearing the
infection in more than 90% of people. The tablets are taken for 8 to 12 weeks.

 Antiviral medications
Hepatitis C infection is treated with antiviral medications intended to
clear the virus from your body. The goal of treatment is to have no hepatitis C
virus detected in your body at least 12 weeks after you complete treatment.
Researchers have recently made significant advances in treatment for
hepatitis C using new, "direct-acting" antiviral medications, sometimes in
combination with existing ones. As a result, people experience better outcomes,
fewer side effects and shorter treatment times — some as short as eight weeks.
The choice of medications and length of treatment depend on the hepatitis C
genotype, presence of existing liver damage, other medical conditions and prior
treatments.
Due to the pace of research, recommendations for medications and
treatment regimens are changing rapidly. It is therefore best to discuss your
treatment options with a specialist.
Throughout treatment your care team will monitor your response to
medications.

 Liver transplantation
If you have developed serious complications from chronic hepatitis C
infection, liver transplantation may be an option. During liver transplantation,
the surgeon removes your damaged liver and replaces it with a healthy liver.
Most transplanted livers come from deceased donors, though a small number
come from living donors who donate a portion of their livers.
In most cases, a liver transplant alone doesn't cure hepatitis C. The
infection is likely to return, requiring treatment with antiviral medication to
prevent damage to the transplanted liver. Several studies have demonstrated
that new, direct-acting antiviral medication regimens are effective at curing
post-transplant hepatitis C. At the same time, treatment with direct-acting
 antivirals can be achieved in appropriately selected patients before liver
transplantation.

 Vaccinations
Although there is no vaccine for hepatitis C, your doctor will likely
recommend that you receive vaccines against the hepatitis A and B viruses.
These are separate viruses that also can cause liver damage and complicate the
course of chronic hepatitis C.

4. Hepatitis D:
There is currently no cure for hepatitis D, but treatment can help people manage the
condition. For people with chronic hepatitis D, a doctor will often prescribe a medicine called
pegylated interferon-alpha, which reduces the risk of the condition worsening. People will
usually take this for at least 48 weeks

5. Hepatitis E:
There is no specific treatment capable of altering the course of acute hepatitis E. As the
disease is usually self-limiting, hospitalization is generally not required. Most important is the
avoidance of unnecessary medications. Acetaminophen/Paracetamol and medication against
vomiting should not be given.

Nursing Care Plans:

Nursing care planning and management for patients with hepatitis includes:

 reducing the demands of the liver while promoting physical well-being

 preventing complications of hepatitis
 enhance self-concept
 acceptance of situation
 providing information about the disease process, prognosis, and treatment

Primary Nursing Diagnosis:

 Altered nutrition: Less than body requirements related to decreased oral intake, nausea,
vomiting, and anorexia

Pharmacologic Intervention:

 Vitamin K injected subcutaneously (S.C.) if prothrombin time is prolonged.

 I.V. fluid and electrolyte replacements as indicated.
 Antiemetic for nausea.
 Long-term interferon therapy in combination with oral ribavirin may produce remission inHCV
patients. Peginterferon alfa-2b is a long-acting preparation given S.C., once per week, and
ribavirin is taken twice daily.
  Antiviral treatment is being investigated for HBV.

Nursing Intervention:

1. Monitor hydration through intake and output.

2. Monitor prothrombin time and for signs of bleeding.
3. Encourage the patient to eat meals in a sitting position to reduce pressure on the liver.
4. Encourage pleasing meals in an environment with minimal noxious stimuli (odors, noise, and
interruptions).
5. Teach self-administration of antiemetics as prescribed.
6. Encourage rest during symptomatic phase, according to level of fatigue.
7. Encourage diversional activities when recovery and convalescence are prolonged.
8. Encourage gradual resumption of activities and mild exercise during convalescent period.
9. Stress importance of proper public and home sanitation and proper preparation and
dispensation of foods.
10. Encourage specific protection for close contacts.
11. Explain precautions about transmission and prevention of transmission to others to the patient
and family.
12. Warn the patient to avoid trauma that may cause bruising.
13. Stress the need to follow precautions with blood and secretions until the patient is deemed free
of HBsAg.
14. Emphasize that most hepatitis is self-limiting, but follow up is needed for liver function tests.

Evaluation:

 Initiate behaviors, lifestyle changes to regain/maintain appropriate weight.

 Demonstrate progressive weight gain toward goal with normalization of laboratory values and
no signs of malnutrition.