Hepatitis A,B,C,D,E

DOLLEE BELICAN

 Hepatitis is an inflammation of the liver, most commonly caused by a viral infection. There are five main hepatitis viruses, referred to as types A, B, C, D and E. These five types are of greatest concern because of the burden of illness and death they cause and the potential for outbreaks and epidemic spread. In particular, types B and C lead to chronic disease ,the most common cause of liver cirrhosis and cancer.

Hepatitis

 Hepatitis A and E are typically caused by ingestion of contaminated food or water. Hepatitis B, C and D usually occur as a result of parenteral contact with infected body fluids. Common modes of transmission for these viruses include receipt of contaminated blood or blood products, invasive medical procedures using contaminated equipment and for hepatitis B transmission from mother to baby at birth, from family member to child, and also by sexual contact.

Hepatietis A (HAV) *common in young children and young adult, lack of toilet training *mood of transmission: fecal-oral route, poor sanitation, person-toperson, waterborne, foodborne, oral-anal contact during se
Anti-HAV IgM

Hepatitis B (HBV) *common in health care workers, hemodialysis, IV/injection drug use, close contact with person, multiple sex partner, blood products *mood of transmission: Parenteral: blood,, exposed blood through equipments and drugs, saliva, semen, vaginal secretions HBsaG, Anti-HBs, HBeAG, anti-Hbe, HBcAg, ant-HBc

Hepatitis C (HCV) *common in IV/injection drug users, multiple partner, frequent transfusions, blood transfusion, health care personnel *mood of transmission: blood transfusion, sharing in contaminated needles by IV/injection, sexual contact
Anti-HCV

Hepatitis D (HDV) Common in hepatitis B pts, requires hepa B surface antigen for replication, IV/injection drug users, hemodialysis pts, multiple blood transfusion, *mood of transmission: sexual contact with hepa B pt.

Hepatitis E (HEV) *common in areas with poor sanitation, resembles hepatitis A *mood of transmission: fecal-oral primarily to contaminated water

HDAg, anti-HDV

Anti- HAV IgM/ igG

Incubation period: 15-50 days

Incubation period: 28-160 days

Incubation period: 15-60 days

Incubation period: 21-140 days

Incubation period: 15-65 days

Knowledge deficit r/t course of llness

Susceptible host

serologies and liver chemistry panels

Viral invasion (HAV, HBV, HCV, HDV, HEV)

Virus multiplication/replicate Acute viral hepatitis A,B,C,D,E
antiemetics

anxiety

-interferon Antivirals.

Lysis of infected cell

prodromal period malaise, easy fatigability, nausea, and loss of appetite. Weight loss, lowgrade fever, headaches, muscle aches and pains, vomiting, and diarrhea, right upper quadrant abdominal pain a jaundice phase, 5 to 10 days. jaundice,Severe pruritus and liver tenderness

Imbalance nutrition: less than body requirement r/t anorexia, nausea and reduce metabolism of nutrients

Hepatitis panel Liver profile aspartate transaminase (AST, SGOT), alanine transaminase (ALT, SGPT), alkaline phosphatase (alk phos), gammaglutamyltransferase (GGT), and bilirubin. Hyperthermia r/t presence of endogenous pyrogens

Activity intolerance r/t fatigue and weakness

immune responses against viral antigens Cell become inflammation and necrosis

Regeneration of liver cells Return to normal function after recovery

Readiness for enhanced wellness

convalescent phase is increased sense of well-being, return of appetite, and disappearance of jaundice.

direct cellular injury

viral antigens persist

Risk for injury: Bleeding

chronic or carrier state

For HBV: Nuvleoside Analogs: Lamivudine, adefoivr, telbivudine

Signs and Symptoms

Pre-icteric phase: anorexia, nausea, vomiting, diarrhea, constipation, RQ discomfort, malaise, fatigue, fever, weight loss, arthralgia's, urticarial, hepatomegaly, splenomegaly

Icteric phase pruritus, dark urine, bilirubinuria, clay-colored stool, fatigue, weight loss, hepatomegaly, RUQ tenderness, jaundice(most common)

Post-ecteric phase malaise, early fatigability, symptoms subsiding when jaundice abates

Prevent viral Hepatitis

Hepatitis A -Receive Hepatitis virus A (HAV) vaccine, -Observe Standard Precautions. Wear gloves if hands come into contact with body fluids; wear gown and face shields if body fluids may be splashed. Hepatitis B -Receive Hepatitis B virus (HBV) vaccine -Obtain hepatitis B immune globulin (HBIG) -Observe Standard Precautions -Do not recap, bending or break needles. -Dispose of needles and other sharp objects in a puncture resistant container. -Do not share razors, fingernail tools, toothbrushes or any personal care item that may come into contact with blood or body fluids. -Good hygiene practices such as hand washing and use of gloves when expecting in contact with blood -Use condom in sexual intercourse -Household members of a patient with hepatitis B should be vaccinated -Rest is extremely important. Hepatitis C -no vaccine Primary measure is to prevent HCV transmission - Use infection control precaution - Use gloves when expecting contact with blood - Razors, toothbrushes and other personal items should not be shared

Hepatitis D, E -infection precaution and infection control

-Perform conscientious hand washing, even after removing gloves, after bowel movement and before eating
-Avoid placing fingers and handheld objects in mouth.

-Do not share eating utensils , or beverage containers.

-Avoid eating raw seafood or seafood harvested from possibly polluted water. -Personal and environmental hygiene and health education to promote good sanitation. -Infection control precaution -A private room in necessary.

fine