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Hepatitis 2


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~Hepatitis A~ RNA virus, Facal-oral Transmission, Incubation period 15-50 days, replicates in liver, jaundice, fatigue, abdominal pain,enlarged tender liver, anorexia, nausea, vomiting, diarrhea, drak urine, light stools, joint pain. Adults more than kids. Once infected, immuned for life.
Hepatitis B. DNA virus. Blood/Body fluid transmission, sexual contract, IV drug use. Attacks liver/can life-long infection, cirrhosis, liver cancer, liver failure, even death. Symptoms same as HAV. Get HBV vaccine
HBV test interpretations:
*hepatitis B virus:pt.has an active infection.
*hepatitis B surface immunity against HBV or a current infection. also: anti-HBC-IgM
* immuned/or had be vaccinated.
*anti-HBc:pt.has a past or current infection.
IgM-anti-HBc:pt.infected w/HBV past 4-6 mos.
HBeAg:pt.has active replication and highy infectious.
HBeAG:pt has active/chronic infection.
Pt with HBeAG
Treatment last b/t 4-12 mos.
Receive a combo of interferon alfa, and antiviral agents: lamivudine(Epivir) and adefovir dipivoxil(Hepsera)
Adverse effects of interferon alfa:
fever, chills, anorexia, nausea, myagias, fatigue, alopecia, and infection.
Also watch bone marrow suppression and thyroid dysfunction.
Also can cause depression, avoid if severly depressed.
Hepatitis C, RNA virus
Transmitted the same as HBV
Mutates rapidly, 75%-85% ppl infected experience chronic infection and 70% having chronic live disease. Leading indication for live transplants. Hard to diagnose of symptoms alone, 80% infected have no symptoms. NEED BLOOD TEST.
HCV Blood Tests Diagnosis
Anti-HCV antigen-indicates infections
4 -12 mos. to show up in blood.
1-2 wks after infection.
Treatment for HCV
two options:
Interferon alfa2(Intron A) and ribaviron (Rebetol)
Peginterferon alfa2 (Pegasys)and ribavirin (Copegua) depending in the HCV genotype.
Combo therapy eradicates the virus more often than monotheraphy
Liver Transplantion also a possibility.
Hepatitis D
The dangerous duo
Needs HBV to replicate
Coinfection/superinfection leads to acute or fulminant hepatitis.Mode of transmission same as HBV.
Diagnosis made from the presence of intrehepatic anti-delta antibodied (HbAg).
Hepatitis E
Don't Drink the Water.
single-strand RNA virus.
Transmission from drinking contaminated water.
Incubation 40 days.
Young to middle aged adults.
Symptoms as others, but also pruritis and urticarial rash.
Hepatitis G
Recently identifed.
one or two single-strand enveloped RNA viruses similar to but distinct from HCV.
Transmission-tainted injectable drugs, tainted blood, organs, tissues are received.
Hemodialysis, unsafe tattooning and body piercing.
Transfusion Transmissible Virus
Single-standed encapsulated DNA virus
Spread by transfusion or from infected Mother to child.
Not yet determined pathogenic effects.
Function of Liver Test
Serum AST and ALT levels increase in the prodromal stage of viral hepatitis.
Serum ALP level may increase Serum Billrubin will be elvated.
PT will elavte as liver damage increases. PT of 3 seconds or more indicated severe liver damage.
WBC counts reveal transient neutropenia and lymphopenia, followed by lymphocytosis.
Serum Aspartate aminotransferase
Serum Alanine aminotransferase
Serum Alkaline Phosphatase
Patients Teachings
HAV-two-dose vaccine,Hand washing after restroom,diaper,changing,Proper food prepatration.
HBV-three-dose vaccine, safe sex, no needle sharing, safe handling of needles.
HCV-Avoid any practices or behaviors that put them at risk.
HEV-educated pt about drinking water or beverages with ice in areas of uncertain water quulity. Refrain from eating raw shellfish and raw products unless they are prepared with purified water.

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