Professional Documents
Culture Documents
Hepatitis
Hepatitis
Hepat: prefix for LIVER Itis: suffix for inflammation ,Hepatitis = liver inflammation
● drugs
● excessive alcohol usage
● medications
● viruses (most common and referred to as viral hepatitis): this is where a
virus attacks the cells of the liver causing them to malfunction.
Liver damage is damage to all. This is because the liver is sort of like the gatekeeper of
the body. It filters, protects, breaks down and stores substances, and releases them
to keep the body in balance, etc.
Where’s it located? It’s found in the upper right quadrant just under the diaphragm.
How is it structured? It has two lobes and 8 segments. Each of the segments are
made up of these functional units called lobules. This is where the liver’s hepatocytes
live and work. These cells do the majority of the work performed by the liver.
● Hepatic artery: this vessel pumps fresh oxygenated blood to the liver from
the aorta to keep the cells of the liver supplied with oxygen so they can
function and won’t die.
● Hepatic portal vein: this vessel pumps blood rich in nutrients (very poor
in oxygen) from the GI system that just broke down the food the person
just consumed. The blood will flow to the hepatocytes, which will decide
what is stored, removed, and goes to the body…so it filters the blood (toxic
chemicals, potential bacteria, drugs).
● It produces bile that will help digest fats. The bile is squirted into the small
intestine to help digest fats. Bile is stored in the gallbladder.
● It plays a role with the coagulation process (remember how Warfarin
worked?).
● Provides immune system protection by producing immune factor
proteins and eliminates dangerous bacteria from the blood.
● It helps regulate the blood glucose levels by storing and creating glucose
based on the body’s needs.
● It turns ammonia into urea. Ammonia is created with the breakdown of
proteins. It is highly toxic to the brain if it accumulates in the blood, which is
why the liver turns it into urea and lets the kidneys dispose of it through the
urine.
● It breaks down red blood cells. When this occurs it will create bilirubin.
Bilirubin is a brownish yellow substance, which is placed in the bile and
excreted in the stool. This is why stool is normally brown.
Comparison of Hepatitis A, B, C, D, E
Hepatitis A:
● Most common is fecal-oral: a person is most likely to get the virus from
consuming contaminated food or water.
● Acute type of infection only: no long term complications likely because
the virus is in the body for a short time and killed by the body
Signs & Symptoms (note: all types of hepatitis have similar symptoms as the ones
below)
Hepatitis A - the patient can be contagious 2 weeks BEFORE the signs and symptoms
appear and 1-3 weeks from when the symptoms appeared.
Diagnosed: anti-HAV (antibodies of the hepatitis A virus) presence with IgM and IgG in
the blood
Prevention:
● Handwashing
● Vaccine: (2 doses given 6 months apart as part of the pediatric vaccine
schedule), want to receive the vaccine if travelling outside US, Hepatitis A
immune globin (IG): if came into contact with the virus, needs to receive IG
within 2 weeks of exposure….it will provide temporary passive immunity.
Hepatitis B:
● blood and other body fluids like semen, salvia, ammonitic or vaginal fluid
etc.
● Most common transmission route is sexual intercourse and intravenous
drug use. It can also be spread via the birthing process if the mother is
Hepatitis B positive. Therefore, it can be spread via the percutaneous (via
a puncture in the skin…example: needle) or mucosal routes.
● Acute and chronic infections can occur. Infants and young children are
at most risk for chronic infections. Mas bata mas prone.
● Chronic infections can lead to major complications like:
cirrhosis, liver failure, and liver cancer
Diagnosed:
Treatment:
Prevention: handwashing, vaccine for all infants (3-4 doses over 6-18 months) and
people at risk for Hepatitis B..example: healthcare workers (3 doses over 6 months),
following sharp precautions, all pregnant women tested due to transmission at birth,
post-exposure Hepatitis B immune globulin within 24 hours of exposure (12 hours
after birth) to provide temporary passive immunity.
Hepatitis C :
● Blood and body fluids…. spread via percutaneous (via the skin through a
puncture) or in body fluids with mucosal route
● Most common transmission route intravenous drugs.
● Other ways but not as common: sexual contact, if received
blood or blood products before 1992, sharp injuries (needle or
instruments), long-term dialysis increases risk of exposure too
Acute and chronic infections can occur. A high percentage of Hepatitis C becomes
chronic, which increases the risk for liver disease.
Treatment:
Hepatitis D:
How do you get it (transmitted)? Only infects a person when they have Hepatitis B.
● Blood and body fluids…. spread via percutaneous (via the skin through a
puncture) or in body fluids with mucosal route…same as Hepatitis B.
● Not as common in the US compared to Southern and Easter Europe and
Mediterranean and Middle East.
● Acute and chronic infections can present.
Hepatitis E:
Prevention: handwashing, no vaccine being used here in the US at this time, if travelling
outside US use bottled water, cook meat thoroughly
Eat low fat and high carb meals (needs proper nutrition to help with liver regeneration
and low fat intake because bile production is altered…remember bile helps digest fats)
Personal hygiene products NOT to be shared (inform about the types of products:
toothbrushes, razors, drinking cups, utensils, towels etc.)
Test results:
Interferon (Peginterferon alfa-2a given subq) and Immune globulin for Hepatitis A (within
2 weeks of exposure) and Hepatitis B Immune globulin (within 24 hours of exposure)
Small but frequent meals…this may help with the nausea and patient should NOT cook
for others until not infectious.
Phases of Viral Hepatitis
Icteric Phase: DECREASE in body symptoms but will have jaundice and dark urine
(from build-up of bilirubin), clay-colored stool (bilirubin not going to stool to give it’s
normal brown color) enlarged liver and pain in this area
Posticteric (convalescent) Phase: jaundice and dark urine start to subside and stool
returns to normal brown color, liver enzymes and bilirubin decrease to normal
Ammonia level (from separate test): 15-45 mcg/dL (elevated with hepatitis and will see
as mental status changes)