VIRAL HE

PATITIS (A-E)
Precious Diane S. Quiamco
BSN-III
 1
Viral Hepatitis
2
Inflammatory liver
disease, characterized by jaundice,
3
abdominal pain, and anorexia due to
viral infection caused by viruses A, B,
4
C, D, and E, alcohol abuse, or various
PATHOPHYSIOLO
GY
 Caused by acute viral infection, toxicity,
or drug induced
Liver is enlarged and congested
a. Distortion of lobular pattern
b. Results in increased portal circulation

pressure
c. Circulation then decreased to liver
Edema of biliary channels
a. Results in obstructive jaundice
Types of Hepatitis
Hepatitis A – Infectious hepatitis
Hepatitis B – Serum hepatitis
Hepatitis C – Non-A non-B or Post
transfusion hepatitis
Hepatitis D – with Hep B
Hepatitis E - Epidemic hepatitis
 HEPATITIS A
Caused © : HepatitisAVirus


Reservoir1
® : Humans
Source of Contamination (SOC): Infected feces, &
2
HAV contaminated food
Period of Communicability (POC): 1-2 wks before the onset of
3
symptoms until about 7 days after the patient becomes jaundiced
 Transmission (T) : Fecal & oral contamination, oral & anal sexual
4
activty contamination, Shellfish from contaminated water
 Incubation Period (IP): 18-45 days
 SIGNS AND SYMPTOM
S
•Most are anicteric and asymptomatic
•Flu-like UTI with low-grade fever
•Anorexia
•Indigestion
•Nausea
•Aversion to cigarette smoke and
other strong odors
•May or may not be jaundiced
DIAGNOSIS PREVENTION
• Blood Test
• Vaccine
TREATMENT
• Follow safety
• Rest
precautions when
• Manage nausea traveling

• Avoid alcohol and use • Practice good hygiene

medications with care

Nursing MX
The patient must be isolated (enteric isolation).
1
1. Patient should be encouraged to rest during acute or symptomatic phase.
2. Improve nutritional status.
3. Utilize appropriate measures to minimize spread of the disease.
2
4. Observe the patient for melena and check stool for the presence of blood.
5. Provide optimum skin and oral care.
6. Increase in ability to carry out activities.
3
a. Encourage the patient to limit activity when fatigued.
b. Assist the client in planning periods of rest and activity.
c. Encouraged gradual resumption of activities and mild exercise during
recovery.
4
 HEPATITIS B
 Hepatitis B Virus (HBV)
 Reservoir: Humans
Source of infection:
1


-infected individuals
- receipt of blood transfusion or other blood products
- use of shared needles
-2history of tattooing, ear or body piercing,
- or acupuncture
 Incubation: 30-180 days

3
Period of communicability:
-1-2 months before and after the onset of symptoms
Mode of transmission: Heterosexual transmission, contact with blood and
4


body fluids
SIGNS AND SYMPTOM
S
-Loss of appetite -Dyspepsia,
-Abdominal pain -Jaundice
-Gen. aching malaise and weakness
-Light-colored stools and dark urine
-Hepatomegaly and splenomegaly
-Enlarged posterior cervical lymph nodes
DIAGNOSI
S
• Blood Test
PREVENTION
• Know the HBV status of any sexual partner.
• Liver ultrasound
• Use a new latex or polyurethane condom every time
• Liver Biopsy you have sex.

TREATMENT • Don't use illegal drugs.

• Be cautious about body piercing and tattooing.

• Antiviral medications
• Ask about the hepatitis B vaccine before you
• Interferon injections travel.

• Liver transplant
 HEPATITIS C
 Hepatitis C Virus (HCV)
Reservoir: Humans
 Source of infection:
1
-Parenteral drug, needlestick injuries, Blood transfusion

-High-risk sexual 2
contact (multiple partners, history of other STDs, anal sex,
etc.)
 Mode of transmission: Contact with blood and body fluids: transfusion of blood

and blood products 3

 Period of communicability:

-one or more weeks before onset of symptoms and persists in most person
4
Incubation: 15-160 days
SIGNS AND SYMPTOM
S
-Fatigue -Jaundice -Headaches
-Joint aches -Muscle aches -Nausea
-Abdominal pain and poor appetite
DIAGNOSI PREVENTION
S
• Blood Test
• Stop using illicit drugs, particularly
• Magnetic resonance elastography if you inject them
(MRE)
• Be cautious about body piercing and
• Transient elastography tattooing

• Liver biopsy. • Practice safer sex

TREATMENT
• Antiviral medications

• Liver transplant
Hepatitis D
Hepatitis D Virus (HDV)
1 Humans
Reservoir:
Animals: chimpanzee and pigs
Source of
2 infection: Same as Hepa-B
Incubation: 30-180 days
Period of
3 communicability: Not been yet
determined, but virus excretion in stool has been
demonstrated
4 up to 14 days after onset of illness
Co-infects with hepatitis B, close personal contact
SIGNS AND SYMPTOM
S
Similar to those with hepatitis B
May progress to chronic active hepatitis and
cirrhosis
Always associated with a coexistent hepatitis B
virus infection, either simultaneous new
infections (co- infection) or a chronic
hepatitis B infection (superinfection)
DIAGNOSIS PREVENTION
• Blood Test
• Vaccine
TREATMENT
• Follow safety
• ANTIVIRAL
precautions when
• Interferon traveling
• Practice good hygiene
 Hepatitis E
 Hepatitis E Virus (HEV)
 Reservoir: Infected 1
Humans and Animals: wild and domestic esp. swine
 Incubation: 14-60 days

 Period of Communicability: -Not known.

2 detected in stools 14 days after the onset of jaundice and
- Hepa-E virus has been
approximately 4 weeks after ingestion of contaminated food or water and persists
for about 2 weeks.
3
 Source of infection:
- Contaminated water in areas of poor sanitation
-household member,sex partners, shared injection equipment
4
S/S: JAUNDICE is almost always present
Diagnosis (OVER ALL)
Diagnosis of hepatitis is made by biochemical assessment of liver function.

Initial laboratory evaluation should include bilirubin, alanine aminotransferase (ALT),

aspartate aminotransferase(AST), alkaline phosphatase, prothrombin time, total
protein, albumin, globulin, complete blood count and coagulation studies.

Hepatitis A, B,C,D, E diagnosis depends on demonstration of specific antigen and/or

antibody (detected by an ELISA) in sera.

Liver biopsy tests are also conducted to know the extent of liver damage.
Management (OVER ALL)
Bed rest, refraining from alcohol, and taking medication to relieve
symptoms.

Most people who have hepatitis A and E get well on their own after a
few weeks.

Hepatitis B is treated with drugs, such as lamivudine and adefovir

dipivoxil.

Hepatitis C is treated with a combination of peginterferon and

ribovarin.
Liver transplant of hepatitis B or C, or D-caused liver failure
Thank you