Hepatitis By Peggy Brungardt. 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
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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.
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.
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.
Liver cont. • Plays vital role in: • Digestion • Absorption • Metabolism • Storage of nutrients
Deficiencies • When deficiencies occur (manifestations): • Jaundice • Portal hypertension • Clotting disorders • Hepatic encephalopathy • Nutritional deficiencies
Common Disorders • Infectious and inflammatory conditions • Hepatitis • Liver abscess • Structural abnormalities • Trauma • Neoplasms
Characteristics • Differ: • Incubation period • Route of transmission • Antigenic properties • Progression to chronicity • All Produce inflammatory response in the liver
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.
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
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
Where HBV is Found • Sweat • Tears • Vaginal secretions • Semen • Saliva • And of course blood
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.
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.
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
Hepatitis D cont. • Those infected: • Drug users • Hemodialysis patients • Multiple transfusion recipients
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.
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%
Hepatitis C • Liver cells involved with Hepatitis C
Hepatitis C • Chronic hepatitis C is one of the most common indications for liver transplantation in adults
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)
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.
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.