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hepatitis

Ghossoun Badran 4 th year medical student Supervised by: Dr. Samar Musmar. hepatitis. Hepatitis. Hepatitis is an injury to liver characterised by presence of inflammatory cells in the liver tissue. It can be self limiting,or It can progress to scarring of the liver.

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hepatitis

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  1. GhossounBadran 4th year medical student Supervised by: Dr. Samar Musmar hepatitis

  2. Hepatitis • Hepatitis is an injury to liver characterised by presence of inflammatory cells in the liver tissue. • It can be self limiting,or It can progress to scarring of the liver. • Hepatitis viruses cause most cases of liver damage worldwide

  3. Types of Hepatitis viruses A B C D E Source of feces blood/ blood/ blood/ feces virus blood-derived blood-derived blood-derived body fluids body fluids body fluids Route of fecal-oral percutaneous percutaneous percutaneous fecal-oral transmission permucosal permucosal permucosal Chronic no yes yes yes no infection Prevention pre/post- pre/post- blood donor pre/post- ensure safe exposure exposure screening; exposure drinking immunization immunization risk behavior immunization; water modification risk behavior modification

  4. Hepatitis B

  5. Hepatitis B HBs Antigen HBV DNA The Capsid HBc & HBe antigens 5

  6. TRANSMISSION • BLOOD (PARENTERAL / SUBCUTANEOUS) • SEXUAL CONTACT • CONTACT WITH BODY FLUIDS • VERTICAL TRANSMISSION • UNKNOWN SOURCE • NOT TRANSMITTED BY CONTAMINATED FOOD , WATER, INSECTS

  7. 100% 90% 60%-65% <1% 20%-25% 5%-10% 4% 67%-90% 10%-33% 20%-50% 10% Subclinical disease Recovery Acute Hepatitis Fulminant Hepatitis Death Acute Infection “Healthy Carrier” Recovery Persistent Infection Chronic Hepatitis Cirrhosis Death Hepatocellular carcinoma

  8. CHRONICITY HEPATITIS B • Chronic infection occurs in: • 90% of infants infected at birth • 30% of children infected at age 1–5 years  • 6% of persons infected after age 5 years 

  9. Worldwide epidemiology of hepatitis B • Hepatitis B virus (HBV) infection is a serious global health problem • 2 billion people infected world wide • 350 million suffering from chronic HBV infection. • The 10th leading cause of death

  10. Seroepidemiology of hepatitis B virus in northern part of Palestine, 1996 • The prevalence rate of HBsAg in healthy blood doners was 3.4% • greater than that in Israel (0.9-1.3%) • lower than that of Jordan (4.4%) and Saudi Arabia (7.4%). Al.Rifa’i Ammar W. S. Seroepidemiology of hepatitis B virus in the population of northern part of Palestine, 1996

  11. Cont. • The prevalence rate in pregnant women was 3.9%..... higher than that in Israel (2.2%). • Among the staff & students of An-Najah University the prevalence rate was 4.9%.

  12. Annual reported incidence rate of hepatitis B cases and carrier in the Palestine,2000-2005, (per 100,000) http://www.moh.gov.ps/pdffiles/communicable%20diseases-2005.pd)

  13. Prevalence rate of HBV antigens among high risk groups: • 421 sera samples collected during 1995 to 1997 • kidney transplants(n=109), • hemodialyzed patients (n=76), • non-vaccinated healthcare workers (n=52) • blood transfusion dependent patients (n=80). • include 60 thalassemic, 6 hemophilic and 14 sickle cell anemia patients. Medical Journal of Islamic World Academy of Sciences 15:4, 157-160, 2005

  14. Prevalence rate of HBV antigens among high risk groups: Medical Journal of Islamic World Academy of Sciences 15:4, 157-160, 2005

  15. Hepatitis B vaccinationGlobally • Safe and effective vaccines against HBV infection have been available since 1982 • The typical regimen is a 3 doses • should be taken intramuscularly at intervals of 0, 1 and 6 months

  16. Hepatitis B vaccinationGlobally / cont • Recombinant vaccines have been investigated in many clinical studies • (WHO) spends on all immunization programmes about 85 million dollars per year. • Universal vaccination strategies they prove to be cost effective

  17. Hepatitis B vaccination in palestine • Universal hepatitis B immunization was introduced in Palestine in1993 • high coverage rate of 99%. • it is given free of charge to all children at 0,1 and 6 months of age. http://www.moh.gov.ps/pdffiles/communicable%20diseases-2005.pdf

  18. Hepatitisc

  19. HCV .. THE MOST COMPLEXOf Hep. Viruses

  20. The TARGET and COMPLICATIONSof HCV • The LIVER is the main target.. • Recently -- found in bone marrow.. kidney.. monocytes/ macrophages (CD14) .. B lymphocyte CD 19 and granulocytes CD 15 .. • Jaundice occurs in only 20-30 % • Complications-- may develop after about 20-40 years of infection…

  21. Hepatitis C/CHRONICITY • Chronic infection: 55%-85% of infected persons • Chronic liver disease: 70% of chronically infected persons • Deaths from chronic liver disease: 1%-5%

  22. Hepatitis C in Palestine • Surveillance of hepatitis C in Palestine started in 1994 • the incidence rate of hepatitis C cases &carriers per 100,000 was ranging between • “3-9” in the period 1996-1999. • “4.2-8” in the period 2000-2004. http://www.moh.gov.ps/pdffiles/communicable%20diseases-2005.pdf

  23. Hepatitis C in Palestine(cont.) • Screening is performed for blood donors, multiple blood transfusion, hemodialysis patients & contacts of a case. • Hepatitis C virus infection is found in 0.5%-8.0% of blood donors world wide. • Palestine enjoys a very low prevalence rate of 0.2% among blood donors

  24. Virological Features of HCV .. In HD patients >>> PALESTINE • MS thesis /public health program /An-Najah University • FekriSamarah—nurse in HD unit • Al-WATANI hOSPITAL • Study population : • Chronic Renal Failure Patient. 95(64 M, 31 F.. mean age 44.6 ..14-70) • Kidney transplant Patient. 112(74 M, 38 F , mean age 38.9.. 9 -72 )..

  25. The results of the study

  26. Such findings clearly indicates a NOSOCOMIAL INFECTION within the unit.. • Males showed higher rate 63.64% than females 36.36% of HCV infection.. WHYYY !!!... They found that higher rate ofdiabetic males compared with females..

  27. Depending on these results we have separated machines for HCV, HBV positive patints To decrease contamination

  28. REFERENCES • Ministry of Health PALESTINE Website • WHO website.. • A research from AL NAJAH Univ. • EMRO website • Hepatitis Centre Website..

  29. YOU THANK

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