Hepatitis

The Pathogenicity and Treatment

and Prevention
Introduction

Viral Hepatitis
An inflammation of the liver
caused by a virus or hepatotoxins
Types of Hepatitis

Hepatitis A(HAV), Infectious Hepatitis

Hepatitis B(HBV), Serum Hepatitis
Hepatitis C(HCV), Post-transfusion
Hepatitis D(HDV), Delta-agent Hepatitis
Hepatitis E(HEV), Enterically Transmitted
Stages of Viral Hepatitis
Preicteric Stage
First stage of hepatitis preceding the
appearance of jaundice.
Icteric Stage
Second stage, Appearance of
jaundice.
Post-icteric Stage
The convalescent stage.
Hepatitis A

Infectious Hepatitis or Short-incubation

Hepatitis.
Caused by Hepatitis A virus.
Increased Risk Individuals

 Commonly seen in young children

 Individuals in institutionalized settings
 Health care personnel
Mode of Transmission

 Fecal-oral route
 Contaminated foods, vegetables
 Contaminated water or milk
 Poorly washed utensils
 Person-to-person contact
Signs and Symptoms
 Fever
 Fatigue
 Loss of appetite
 Nausea
 Vomiting
 Abdominal pain
 Dark urine
 Clay-colored bowel movements
 Jaundice
Incubation Period
2-6 weeks

Infectious Period is 2-3 weeks prior to,

and one week after, developing jaundice
Period of Communicability

It is contagious a week before and a week

after the appearance of symptoms.
Pathogenesis

Hepatophilic virus enters and infects the

liver
Liver cell damage

Hepatic cell dropout

Destruction of liver parenchyma

Complications

 Progressive encelopathy
 GIT bleeding
 Clonus and hyperflexia
 Edema and ascitis
 Aplastic Anemia
Diagnostic Procedure

 HAV and HBV- Complement fixation rate

 Liver function test
 Bile examination in stool and urine
Treatment Modalities

 NO specific treatment, although bed rest

is essential
 High in carbohydrate, low in fat, and low
in protein diet.
 Vitamin Supplement
 IV therapy
 Isoprinosine
 Anti-emetics
Prevention and Control

 Hand washing
 Food handlers should carefully be
screened.
 Safe preparations and serving of food
must be practiced
Vaccines

 The hepatitis A vaccine is a shot of

inactive hepatitis A virus that stimulates
the body's natural immune system
Hepatitis B

The disease is caused by Hepatitis B

virus. This is considered to be more
serious than Hepatitis A.
Hepatitis B virus

 HBV infects the liver and possibly the

pancreas
Incubation Period

 50-189 days or 2-5 months with a mean

equal to 90 days.
Period of Communicability

 during the latter part of the incubation

period and during the acute phase.
Mode of Transmission

 Person-to-person contact via infected

body fluids
 Contaminated needles and syringes
 Infected blood or body fluids introduced
at birth.
 Sexual contact
HBV CANNOT be
transmitted by:
 Fecal- oral Route
 Food-borne or water-borne transmission
 Arthropod transmission
Pathogenesis
 Causes Acute or Chronic infection
 Production of virus and high level of HBsAg.
 Virus is delivered into the liver and established
an infection.
 Replication of virus and large amounts of
HBsAg.
 Liver Damage
 Degenerative changes of the liver parenchyma.
Clinical Manifestations

Prodromal Period
1. Fever, Malaise, and anorexia
2. Nausea and vomiting
3. Jaundice
Fulminant Hepatitis may be fatal and
manifested by severe symptoms like
ascitis and bleeding.
Diagnostic Procedures

 Complement fixation test

 Liver function test
 Bile examination in blood and urine
 Blood count
 Serum transaminase
 HBsAg
Prevention

 Screening of blood donors

 Caution during giving care to patients.
 Wash hands
 Disposable needles be used only once
 Avoid sharing of personal things
 Observe safe sex
Vaccination

 The hepatitis B vaccine series is a

sequence of shots that stimulate a
person’s natural immune system to
protect against HBV.
Hepatitis C

transmitted through blood transfusion

slowly progressing infection that is primarily
spread by intravenous drug users.
Increased Risk Individuals

 Parenteral drug users

 Clients receiving frequent transfusion
 Health care personnel
Mode of transmission

Same as HBV; primarily through blood and

during tattooing.
Incubation Period

5-10 weeks
Complications

 Chronic liver disease

 Cirrhosis
 Primary hepatocellular carcinoma
Prevention

 Strict handwashing
 Needle precautions
 Screening of blood donors
Hepatitis D
 Is found in patients with an acute or
chronic episodes of hepatitis B and
requires presence of HBsAg
Diagnosis

 Should be considered in individuals who

are HBsAg positive or who have
evidence of recent HBV infection.
Incubation

 7-8 weeks
Transmission

 Same as HBV
High Risk Individual

 Drug users
 Clients receiving hemodialysis
 Frequent blood transfusions
Outcomes

 The outcome of disease depends on

whether HDV is contracted as a co-
infection or a superinfection.
Co-infection

Infection occurs when both HDV and HBV

are contracted simultaneously.
Superinfection

Occurs when chronic HBV carriers are

infected with HDV.
Prevention

 Precautions that help prevent Hepa B are

also useful in preventing delta hepatitis
Treatment

 There is no specific treatment for HDV

infections.
Hepatitis E

 A water-borne virus
 Prevalent areas where sewage disposal
is inadequate
 Risk of infection is the same as HAV
Mode of Transmission

 Fecal-oral route
 Contaminated water
Incubation Period

 2-9 weeks
Prevention

 Strict handwasing
 Treatment of water supplies
 Sanitation measures
Treatment

 No specific treatment is available for

hepatitis E. Treatment is supportive .
Liver Cirrhosis
Hepatitis B Virus
Jaundice
Hepatitis D Virus