HEPATITIS OVERVIEW

Hepatitis
inflammation of the liver

Can have many causes

drugs toxins alcohol viral infections (A, B, C, D, E) other infections (parasites, bacteria) physical damage

Hepatitis Terms

Acute Hepatitis: Short-term hepatitis.

Bodys immune system clears the virus from the body within 6 months Infection lasts longer than 6 months because the bodys immune system cannot clear the virus from the body

Chronic Hepatitis: Long-term hepatitis.

WHAT IS HEPATITIS ?

HEPATITIS IS THE INFLAMATION OF THE LIVER AND CAN RESULT IN LIVER CELL DAMAGE AND DESTRUCTION

Healthy Liver

Cirrhosis Liver

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 AUTOIMMUNE LIVER DISEASES CHRONIC VIRAL HEPATITIS (B,C,D )

HEPATITIS A
SPREAD BY FECAL-ORAL CONTACT, OR FECAL-INFECTED FOOD AND WATER, BLOOD-BORNE INFECTION (WHICH IS RARE ) THE VACCINE HAS BEEN DEVELOPED AND IS NOW AVALIABLE, AND IS NOT RECOMMENDED FOR CHILDREN UNDER 2 YEARS OF AGE

HEPATITIS A VIRUS

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.

Hepatitis A

Symptoms
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 VACCINES 1st dose at time 0

2nd dose 6-12 months afterwards

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

Hepatitis B Virus

HEPATITIS B

HAS A WIDE RANGE OF CLINICAL PRESENTATION ( CAN BE MILD / WITHOUT SYMPTOMS, OR CHRONIC HEPATITIS CHRONIC LIVER DISEASE AND LIVER FAILURE ) TRANSMISIONS OCCURS THROUGH BLOOD AND BODY FLUID EXPOSURE SUCH AS BLOOD, SEMEN, VAGINAL SECRETIONS,OR SALIVA. AND INFANT WHO ARE BORN TO A MOTHER WHO HAS THE VIRUS.

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

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

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 or casual contact

Acute Hepatitis B Virus Infection with Typical Recovery Serologic Course

Symptoms HBeAg anti-HBe

Total anti-HBc

Titer
HBsAg IgM anti-HBc anti-HBs

12 16 20 24 28 32 36

52

100

Weeks after

Outcome of Hepatitis B Virus Infection by Age at Infection 100 100

80
80

60

Chronic Infection

60

40

40

20

20

Symptomatic Infection
0 Birth 1-6 months 7-12 months 1-4 years 0 Older Children and Adults

Age at Infection

Symptomatic Infection (%)

Chronic Infection (%)

HEPATITIS B
10%

Chronically infected Clear the infection

90%

Hepatitis C

What is it?
Hep C is a liver infection caused by a virus Also known as non A, non B hepatitis

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

Hepatitis C

Incubation period
6-7 weeks on average (range 2-6months) infectious one or more weeks before getting ill chronic carriers remain infectious

Hepatitis C

Symptoms
Nausea Loss of appetite Vomiting Fatigue Fever

Dark urine Pale stool Jaundice Stomach pain Side pain

3 out of 4 persons have no symptoms and can infect others without knowing it

Hepatitis C

How do you get it?

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 (<5%) 10-20% of infections have no identifiable risk

HEPATITIS C
15%

Chronically infected Clear the infection

85%

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

Hepatitis D (Delta) Virus

d antigen HBsAg

RNA

Hepatitis D Virus Modes of Transmission

Percutanous exposures injecting drug use Permucosal exposures sex contact

HEPATITIS E
THE FORM OF HEPATITIS IS SIMILAR TO HEPATITIS A TRANSMISION : FECAL-ORAL CONT. IS MOST COMMON IN POORLY DEVELOPED COUNTRIES NO VACCINE

Hepatitis E Virus

Hepatitis E - Clinical Features

Incubation period:
Case-fatality rate: 15%-25% Illness severity: Chronic sequelae: Increased with age None identified

Average 40 days Range 15-60 days Overall, 1%-3% Pregnant women,

HEPATITIS G
THE NEWEST STRAIN OF HEPATITIS, AND VERY LITTLE IS KOWN ABOUT IT TRANSMISSION : THROUGH BLOOD, AND SEEN IN IV DRUG USERS, HEMOPHILIA, HEMODIALYS PATIENT OFTEN HEP. G SHOWS NO CLINICAL SYMPTOMS

WHAT THE SYMPTOMS OF HEPATITIS ?

FLU-LIKE SYMPTOM FEVER NAUSEA AND / OR VOMITING DECREASED APPETITE NOT FILLING WELL ALL OVER

ABDOMINAL PAIN OR DISCOMFORT DIARRHEA JOINT PAIN SORE MUSCLE ITCHY RED HIVES ON SKIN DARK COLORED URINE & JAUNDICE

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

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

PREVENTING THE SPREAD OF VIRAL HEPATITIS

VACCINATION ( HEPATITIS A & B ) BLOOD TRANSFUSION ( SCREENED FOR HEP.B AND C ) ANTIBODY PREPARATION IMUNOGLOBULIN : TO HELP PROTECT