HEPATITIS. WHAT IS HEPATITIS? Hepatitis is the inflammation of the liver caused by viruses, bacterial infections, or continuous exposure to alcohol, drugs, or toxic chemicals, such as those found in aerosol sprays and paint thinners.

OTHER FACTS ABOUT HEPATITIS A. Hepatitis can also result from an autoimmune disorder, in which the body mistakenly sends disease-fighting cells to attack its own healthy tissue, in this case the liver. No matter what its cause, hepatitis reduces the liver’s ability to perform life-preserving functions, including filtering harmful infectious agents from the blood, storing blood sugar and converting it to usable energy forms, and producing many proteins necessary for life.

CHRONIC HEPATITIS. Chronic hepatitis causes slowly progressive liver damage that may lead to cirrhosis, a condition in which healthy liver tissue is replaced with dead, non functional scar tissue. In some cases, cancer of the liver develops.

TYPES OF HEPATITIS. HEPATITIS A VIRUS(HAV). Hepatitis A virus (HAV) lives in faeces in the intestinal tract. It is spread when infected individuals do not wash their hands after using the toilet and then handle food, or when a person changes an infected infant’s diapers and then handles food before washing his or her hands I.P – 2 – 6 weeks after infection. It is an acute condition.

ESTIMATED VALUE OF (HAV). Experts estimate that more than 50,000 people are infected with hepatitis A in the United States each year. Individuals with hepatitis A can spread the disease to others as early as two weeks before symptoms appear. In addition to the general hepatitis symptoms, such as nausea, fatigue, and jaundice, hepatitis A may also cause diarrhoea.

HEPATITIS A TREATMENT. There is no treatment for hepatitis A. Most people will recover on their own without any serious after effects, although a few severe cases may require a liver transplant.

HEPATITIS B VIRUS (HBV). HBV is transmitted from person to person through unprotected sexual intercourse with an infected person, or through the sharing of infected needles or other sharp instruments that break the skin. I.P. – 4 – 25 weeks

ESTIMATED VALUE OF (HBV). Experts estimate that there are more than 70,000 new hepatitis B infections every year in the United States. Drugs used in the treatment of hepatitis B include adenoviral dipivoxil, interferon alfa-2b, pegylated interferon alfa-2a, lamivudine, and entecavir. Liver transplants may be beneficial to infected patients, but the virus remains in the body after transplantation surgery and may eventually attack the new liver.

Pictures of the after-math of HBV.

HEPATITIS C VIRUS (HCV). HCV is transmitted primarily by direct blood contact via blood transfusion and contaminated needles. Less common ways are: sexual contact, from mother to child at birth. I.P. – 5 – 10 weeks.

OTHER FACTS ABOUT (HCV). According to the Centres for Disease Control and Prevention (CDC), anyone who received a blood transfusion prior to 1992, before an accurate routine blood screening was established, may be infected with this virus. HCV can also be spread through the sharing of toothbrushes, razors, and contaminated needles with an infected person; through unprotected sex with an infected person; and from mother to child during childbirth.

ESTIMATED VALUE OF (HCV). An estimated 30,000 cases of hepatitis C develop each year, and although some resolve spontaneously, 55 to 85 percent of all cases progress to chronic hepatitis. Most of the 3.9 million people with chronic hepatitis C in the United States do not look sick and may not even know they are infected. In 1998, a new combination of drugs was approved to treat hepatitis C. The therapy, a combination of interferon and the antiviral drug ribavirin, is currently the treatment of choice and rids the body of the virus in 40 to 80 percent of cases.

HEPATITIS D VIRUS (HDV). HDV is a parasite of HBV, using the B virus to reproduce itself and survive in the body. Only those infected with HBV are easily susceptible to HDV infection. Found mainly in intravenous drug users who are carriers of hepatitis B virus.

HEPATITIS E VIRUS (HEV). Hepatitis E virus (HEV) lives in faeces and is transmitted through contaminated food or water. Hepatitis E is found primarily in countries with poor sanitation.

ALCOHOLIC HEPATITIS. Is the most common cause of cirrhosis. While it may not develop in many patients until several decades of alcohol abuse, it appears in a few individuals within a year after onset of excessive drinking.

TOXIC/DRUG-INDUCED HEPATITIS. Is caused after inhalation or ingestion of a toxin such as CCl 4, Vinyl chloride, poisonous mushroom Several widely used drugs can produce an adverse liver reaction; PCM, AntiTB, Methyldop, etc.

GRANULOMATOUS HEPATITIS Is a condition in which abnormal collection of white blood cells collect in the liver.

NOTE. There are currently no vaccines available to prevent infection with HCV and HEV. The best protection against these viruses is to avoid high-risk activities, including preventing exposure to body fluids of infected individuals, and always washing hands after using the toilet or changing an infant’s diapers.

DIAGNOSIS FOR HEPATITIS. If the diagnostic symptoms of hepatitis—including an enlarged and tender liver, jaundice, and fatigue—are present, a physician may order tests to evaluate liver function, such as a blood test for excess levels of the bile pigments that cause jaundice.

DIAGNOSIS. If liver malfunction is confirmed, the doctor may perform an ultrasound examination to exclude the possibility of gallstones or cancer. The doctor may take the patient’s medical history and ask about recent high-risk activities to further isolate possible viral or chemical causes.

DIAGNOSIS. When the probable cause has been identified, the doctor may order specific laboratory blood tests to distinguish between different forms of hepatitis. The doctor may also order a liver biopsy, a procedure in which small samples of the diseased liver tissue are examined under a microscope to determine the extent of the liver damage.

SYMPTOMS of HEPATITS. Hepatitis produces an initial “acute phase” often with few if any symptoms. If there are symptoms, they tend to mimic “flu-like” symptoms such as: Mild fever Muscle or joint aches Nausea Vomiting Loss of appetite Slight abdominal pain Diarrhoea Fatigue

ACUTE PHASE OF HEPATITIS. The acute phase and its symptoms is rarely serious, or fatal, although occasionally a so- called fulmmant or rapidly progressing form lead to death.

WORSENED PHASE CONDITION. As the condition worsens, the person also may experience these additional symptoms: Jaundice Dark urine Light-coloured stool that may contain pus Itching Enlarged spleen (alcohol) Headaches (toxic/drug) Dizziness (toxic / drug) Drowsiness (toxic / drug) Circulatory problem (toxic / drug)

Hepatitis A There is no specific treatment. Abstinence from alcohol and drugs during recovery. Most cases of Hep. A resolve themselves spontaneously. Hepatitis B Rest combined with a high protein / high carbohydrate diet to repair damaged liver cell and protect the liver. Antiviral agent – interferon is it persists. Hepatitis C Interferon alfa-2b (intron A) TREATMENT.

NON-VIRAL. Removal of harmful substance by flushing out of stomach via inducing vomiting. Corticosteroid for some drug-induced hepatitis.

PREVENTION OF HEPATITIS. To PREVENT HEPATITIS A Wash hands well. Eat only freshly cooked food. Drink only commercially bottled water or boiled water in places where sanitation and the water supply are questionable. Wash fruits and vegetables thoroughly. Get a Hepatitis A vaccination before travelling to areas that are endemic of Hepatitis.

TO PREVENT HEPATITIS B Tell your sex partners if you are carrier. Practice safe sex. Don’t share needles, razors, toothbrushes, manicure, tools or other items that could bear contaminated blood. Get the Hepatitis B vaccination series if you are at risk. Don’t allow yourself to be pierced with non- sterile equipment.

TO PREVENT HEPATITIS C (If carrier) cover open wounds, don’t share razors or manicure tools. Practice safe sex. Don’t allow yourself to be pierced with non- sterile equipment. Limit alcohol intake. Never share I.V. drug needles or other drug equipment.

TO PREVENT HEPATITIS D Since Hep. D virus cannot infect on its own without hep. B, use the preventive measure above.

TO PREVENT HEPATITIS E Wash hands well after using toilet. Eat only well and freshly cooked food. Drink only clean water / boiled water.

TO PREVENT ALCOHOLIC HEPATITIS Limit the amount of alcohol consumption.

TO PREVENT TOXIC/DRUG INDUCED HEPATITIS. Be aware of the lethal contents of all chemicals; face the spray away from the body; wear protective equipment (if applicable).

THANK YOU