Prepared By: Mojica, Mark Louie Perlado, Karen Tec, Emicar Uwineza, Agnes

Hepatitis B Virus

 Transmitted through BLOOD; percutaneous and permucosal routes Has found in blood, saliva, semen and vaginal secretions Can be transmitted through membranes and breaks in the skin Transferred from carriers mothers to their babies Major cause of cirrhosis and hepatocellular carcinoma Incubation period, 1-6 months

 Frequent exposure to blood, blood products, or other body fluids Health care workers: hemodialysis staff, oncology and chemotherapy nurses, personnel at risk for needlesticks, operating room staff, respiratory therapies, surgeons, dentists Hemodialysis Male homosexual and bisexual activity IV/injection drug use Close contact with carrier of HBV Travel to or residence in area with uncertain sanitary conditions Multiple sexual partners Recent history of sexually transmited disease Receipt of blood or blood products

Either insidious or variable Fever and respiratory sx; rare Loss of appetite Dyspepsia Abdominal pain Generalized aching Malaise Weakness Jaundice; may be or not evident, if it does usually accompanies with light-colored stools and dark urine

Antigenic particles: HBcAg- hepatitis B core antigen HBsAg- hepatitis B surface antigen HBeAg- an independent protein circulating in the blood HBxAg- gene product of X gene og HBV?DNA
HBsAg- 80-90% in infected patients 1-10 weeks after exposure to HBV, 2-8 weeks before the onset of sx

Screening of blood donors Disposable syringes, needles Good personal hygiene Usage of gloves Health teaching to clients

Active Immunization For individuals at high risks for hepatitis B Client with hepa C and other chronic liver disease Administered in 3 doses, IM Produces active immunity to HBV in 90% of healthy people

Passive Immunization Indicate for people exposed to HBV who have never had hepatitis b and have never received hepa B vaccine Inadvertent exposure to HBAg-positive blood through percutaneous or transmucosal Sexual contact with people positive for HBAg Perinatal exposure

 Elderly patients who contracts hepa B has a serious risk of severe liver cell necrosis or fulminant hepatic failure The patient seriously ill and the prognosis is poor, so efforts should be undertaken to eliminate other factors (meds, alcohol) that may affect liver function

 Goals:
minimize infectivity Normalize liver inflammation Decrease symptoms

Usage Antiviral agents:

Lamivudine [Epivir} Adefovir [Hepseral]

 With complete symptoms, the patient requires a 3-4 months of recovery or longer. Identify psychological concerns and issues Advise to void sexual contact

Promoting Home Community-Based Care

Teaching Patients Self-Care Continuing Care- follow check ups, home visits