HEPATITIS

Prepared by: Diar Carlo Revlon M. Cabug

What is Hepatitis?

Inflammation of the liver. May occur with limited or no symptoms but often leads to jaundice, anorexia, and malaise.

Viral Hepatitis

Inflammation of the liver caused by a viral infection.

Types of Viral Hepatitis

Hepatitis A Hepatitis B Hepatitis C Hepatitis D Hepatitis E

Hepatitis A

Formerly known as Infectious Hepatitis Starts within 2 to 6 weeks after contact and lasts no longer than 2 months Antibodies can be created by our immune system after infection for future immunity Etiologic Agent: Hepatitis A Virus (Picornavirus)

Hepatitis A

Incubation Period
15-60

days, or 3-5 weeks, with a mean incubation period of 30 days

Period of communicability
A

week before and after the appearance of symptoms

Hepatitis A

Mode of Transmission:
Fecal-oral

route (poor sanitation) Person-to-person contact Waterborne; foodborne Oral-anal contact during sex

Hepatitis A

Groups at Risk
Children

in Day Care Centers Military troops Homosexuals People that lives in unsanitary conditions

Hepatitis A

Clinical Manifestations
Flu-like

illness with chills and fever Diarrhea, fatigue, and abdominal pain Loss of appetite Nausea Jaundice and dark-colored urine (Pathognomonic sign)

Hepatitis A

Diagnostic Procedure
HAV

Complement fixation test Liver function test to determine the presence and extent of liver damage Urinalysis and Fecalysis to check for presence of bile SGOT-Serum Glutamic Oxaloacetic Transaminase SGPT-Serum Glutamic Pyruvic Transaminase ALT-Serum Alamine Transaminase IgM Level

Hepatitis A

Treatment Modalities
No

specific treatment but bed rest is essential High-carb, Low fat, Low protein Diet Vitamin supplements especially B-Complex Isoprinosine may enhance immunity of the Tlymphocytes Alkalies, belladona, and anti-emetics should be administered to control dyspepsia and malaise Vaccine: 10 year protection

Hepatitis A

Nursing Management
Enteric

Isolation Encourage patient to rest Improve nutritional status Appropriate measures to minimize spread of the disease

Hepatitis B

Formerly known as Serum Hepatitis Considered to be more serious than hepatitis A due to severe complications such as massive damage of the liver and hepatocarcinoma Etiologic Agent: Hepatitis B Virus (Hepadnavirus)

Hepatitis B

Incubation Period
50-189

days, or 2-5 months, with a mean incubation period of 90 days

Period of communicability
Latter

part of the incubation period and during the acute phase. Virus may persist in blood for many years.

Hepatitis B

Mode of Transmission:
Person-to-person

via body fluids Through contaminated needles and syringes Through infected blood or body fluids introduced at birth Sexual contact

Hepatitis B

Clinical Manifestations
Prodromal
Fever,

Period

malaise, and anorexia Nausea, vomiting, and abdominal discomfort Jaundice, dark urine, and pale stools (Pathognomonic sign)
Fulminant
Ascitis

hepatitis (may be fatal)

Bleeding

Hepatitis B

Diagnostic Procedure
HBV

Complement fixation test Liver function test to determine the presence and extent of liver damage Urinalysis and Fecalysis to check for presence of bile SGOT-Serum Glutamic Oxaloacetic Transaminase SGPT-Serum Glutamic Pyruvic Transaminase ALT-Serum Alamine Transaminase Blood count

Hepatitis B

Treatment Modalities
Alpha

Interferon Pegylated Interferon Adefovir Entecavir Telbivudine Iamivudine

Vaccine:

3 injections, lifetime protection

Hepatitis B

Nursing Management
Contact

Precaution Encourage patient to rest Improve nutritional status Appropriate measures to minimize spread of the disease

Hepatitis C

Formerly known as Non-A, Non-B Hepatitis Usually leads to chronic hepatitis Remains asymptomatic for decades Patients with hepatitis C are susceptible to severe hepatitis if they contract either hepatitis A or B. Most common chronic bloodborne infecton in the USA. Etiologic Agent: Hepatitis C Virus (Hepacivirus)

Hepatitis C

Incubation Period
15-150

days

Hepatitis C

Mode of Transmission:
Through

blood transfusion Through placenta during pregnancy

Hepatitis C

Treatment Modalities
Alpha

Interferon Ribavirin Pegylated Interferon Adefovir

Hepatitis C

Nursing Management
Contact

Precaution Avoid alcohol Advise patient to not share needles in IV or drug use

Hepatitis D

Requires hepatitis B surface antigen for its replication, thus, only people with hepatitis B are at risk for hepatitis D Exacerbates symptoms of hepatitis B Incubation period: 30-150 days Etiologic Agent: Hepatitis D Virus (Deltavirus)

Hepatitis E

Believed to be transmitted by the fecal-oral route, principally through contaminated water in areas with poor sanitation Incubation period: 15-65 days Jaundice is always present Chronic forms do note develop Etiologic Agent: Hepatitis E Virus (Hepevirus)