Hepatitis By Peggy Brungardt

1. HepatitisBy Peggy Brungardt

2. What is HEPATITIS? • Hepatitis is inflammation of the liver, which causes damage to the individual liver cells. • Most often caused by viral infection. • Also caused by alcohol, certain drugs, chemicals and poisons, or other diseases. • Can be acute or chronic • Advanced scaring of liver is cirrhosis.

3. A Look at the Liver • Largest internal organ • Adult human liver weighs approx. 1500 g (3.5 lbs.) • Performs greatest number of diverse functions. • Located in the upper right quadrant of the abdomen. • Composed of two major lobes.

4. Liver cont. • Two lobes, large right and small left. • Each composed of 50,000 to 100,000 hepatic lobules (functional units of the liver) • Portal vein brings 75% of the blood supply • Hepatic artery the remaining 25% • 1450 mL of mixed arteriovenous blood each minute. Empties into inferior vena cava.

5. Liver cont. • Plays vital role in: • Digestion • Absorption • Metabolism • Storage of nutrients

6. Deficiencies • When deficiencies occur (manifestations): • Jaundice • Portal hypertension • Clotting disorders • Hepatic encephalopathy • Nutritional deficiencies

7. Common Disorders • Infectious and inflammatory conditions • Hepatitis • Liver abscess • Structural abnormalities • Trauma • Neoplasms

8. Characteristics • Differ: • Incubation period • Route of transmission • Antigenic properties • Progression to chronicity • All Produce inflammatory response in the liver

9. Characteristics cont. • All inflammation and cell regeneration • Disruption of hepatocytes by process of disease and cellular damage. • Bile flow is impaired • Damage occurs is spotty, piecemeal manner.

12. Hepatitis A • HAV found worldwide • Spread by the fecal oral route • Sporadically from close person to person contact • Epidemically by ingestion of contaminated water • By poor food preparation • Lack of toilet training in preschool settings

13. Hepatitis B • HBV found worldwide • Increase seen because of intravenous drug use • Sexual activity with multiple partners • Parenteral route major route of transmission • High risk groups; IV drug users, and people who come into contact with blood and blood products

14. Where HBV is Found • Sweat • Tears • Vaginal secretions • Semen • Saliva • And of course blood

15. Persons at risk • Spouses or sexual contacts of those with active hepatitis B • Family members of chronically infected patients • Residents and staff of institutions for the developmentally delayed.

16. Perinatal • Perinatal transmission rare in U S. But common in Far East and developing countries. • Infants born to healthy carrier mothers or mothers with acute hepatitis B in third trimester of pregnancy. Not clear if infection occurs in utero or at time of delivery. But not related to breast feeding.

17. Hepatitis D • HDV (delta agent) occurs only in people infected with HBV. Transmitted the percutaneous route. • HBV antigen must be present for HDV to replicate. • Common worldwide (is endemic in Mediterranean countries

18. Hepatitis D cont. • Those infected: • Drug users • Hemodialysis patients • Multiple transfusion recipients

19. Hepatitis C • Differs from A and B • Those with A or B develop acute infection, recover completely, and develop antibodies that protect them. • HCV is a “quick change artist” changes in the body to evade the immune system. • Patients do develop antibodies but they are not affective in protecting the body- the virus is never or most never completely killed. Most people develop chronic hepatitis.

20. Hepatitis C • Current estimates are 3.5 million Americans carry the virus, and 150,000 become infected each year. • Test developed in 1980’s to detect HCV therefore our blood supply is generally considered safe > 1%

21. Hepatitis C • Liver cells involved with Hepatitis C

22. Hepatitis C • Chronic hepatitis C is one of the most common indications for liver transplantation in adults

23. Liver fully involved Cirrhosis and Hepatitis C

24. Pie Chart

25. Hepatitis G • HGV transmitted by needle sticks and blood transfusions. • Found worldwide and as a coinfection with HCV patients. • After transmission HGV appears to persist for at least 12 months- some recover uncomplicated and others chronic hepatitis is present. (No test as yet)

26. Hepatitis E • HEV formerly enterically transmitted non-A non-B hepatitis. • Transmitted via enteric route similar to HAV • Leading cause of acute viral hepatitis in young an middle ages adults in developing countries (Asia, Africa, and Central America) • Mortality rate among pregnant women near 20% • Diagnosis dependent on exclusion of other forms. • No serologic test / No evidence of chronic form.

27. Drug Treatment of Choice

28. Mortality Rate

29. Works cited http://www.giare.com/pated/ecdlv42.htm http://www.allabouthepatitisc.com/readyto http://www.cdc.gov/ncidod/diseases/hepatitis/ Monahan, Frances and Marianne Neighbors, Medical-Surgical Nursing Foundations for Clinical Practice 2nd Ed., W. B. Saunders Co. Chapters 25 & 26.1994. S D Ryder, I J Beckingham, Acute hepatitis. (ABC of Diseases of Liver, Pancreas, and Biliary System), Jan. 20, 2001.