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
chronic carriers remain infectious
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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
chronic carriers remain infectious
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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