HEPATITIS

DR. APPU JHA

CARDIOLOGIST
 What is Hepatitis
• The word hepatitis simply means an inflammation of the liver
without pinpointing a specific cause. 

It is parenchymal liver damage due to many agents like:

• Viral infection
• Non viral (toxoplasma, leptospira & coxiella burntii)
• Drugs (paracetamol- halothane)
• Poisons (Mushrooms- carbon tetrachlorid)
• Others (pregnency-circulatory insufficency- wilson diseases)
• Alcohol
THE LIVER ORGAN
What is the common forms?
• Hepatitis virus A
• Hepatitis virus B
• Hepatitis virus C
• Hepatitis virus D
• Hepatitis virus E
 What is the main effect of viral
Hepatitis?

Acute Chronic
usually with viral hepatitis usually
with
hepatitis (A-B-D-E) viral hepatitis(B-C)
 Persons with Hepatitis
• Have one of several disorders, including viral or bacterial
infection of the liver
• Have a liver injury caused by a toxin (poison)
• Have liver damage caused by interruption of the organ's
normal blood supply
• Be experiencing an attack by his or her own immune
system through an autoimmune disorder
• Have experienced trauma to the abdomen in the area of
the liver
 Hepatitis A
• In children, the most common form of hepatitis is
hepatitis A (also called infectious hepatitis).
• This form is caused by the hepatitis A virus (HAV),
which lives in the stools (feces or poop) of infected
individuals.

• Infected stool can be present in small amounts in

food and on objects (from doorknobs to diapers)
 HAV is spread by
• When someone ingests anything that's contaminated with
HAV-infected stool (this makes it easy for the virus to spread
in overcrowded, unsanitary living conditions)

• In water, milk, and foods, especially in shellfish

 Hepatitis B

• Hepatitis B (also called serum hepatitis) is

caused by the hepatitis B virus (HBV).

• HBV can cause a wide spectrum of symptoms

ranging from general malaise to chronic liver
disease that can lead to liver cancer
• infected body fluids, such as blood, saliva, semen, vaginal
fluids, tears, and urine

• a contaminated blood transfusion

• shared contaminated needles or syringes for injecting drugs

• sexual activity with an HBV-infected person

• transmission from HBV-infected mothers to their newborn

babies
 Hepatitis C

• The hepatitis C virus (HCV) is spread by direct contact

with an infected person's blood.

• The symptoms of the hepatitis C virus can be very similar

to those of the hepatitis A and B viruses. However,
infection with HCV can lead to chronic liver disease
 HCV,How people get infected:
• sharing drug needles
• getting a tattoo or body piercing with unsterilized tools
• blood transfusions
• transmission from mother to newborn
• sexual contact (although this is less common)
 Hepatitis D
• Hepatitis D (HDV), sometimes referred to as the delta
virus or delta agent, is an incomplete virus that
requires the presence of the hepatitis B virus to survive
in your body.
• This means that it is only possible to have hepatitis D
if you have hepatitis B.
• Hepatitis D is seen mainly in central Africa, the Middle
East and central South America.
• Hepatitis D, like hepatitis B and C, is called a
‘bloodborne virus’ (BBV) indicating that it is spread by
blood to blood contact
 Hepatitis E
• Hepatitis E is also known as epidemic non-A,
non-B hepatitis. Like hepatitis A, it is an acute
and short-lived illness that can sometimes cause
liver failure.
• HEV, discovered in 1987, is spread by the fecal-
oral route.
• It is constantly present (endemic) in countries
where human waste is allowed to get into
drinking water without first being purified.
Spread By: A B C D E

Blood Rare Yes Yes Yes No

Sexual Rare Yes Rare Yes No

Saliva Yes Yes No Yes No

Fecal Yes No No No Yes

Vertical No Yes Rare Rare No

The viral Hepatitis symptoms

NON SPECIFIC Specific

• Fatigue , Tiredness • Yellowish discoloration of

• Anorexia skin & mucous membrane
• Fever • Distaste for cigarettes
• Muscular pain • Dark urine
• Rarely skin rash • Pale stool
 symptoms
• But some people with hepatitis may have no
symptoms at all and may not even know they're
infected. Children with hepatitis A, for example,
usually have mild symptoms or have no symptoms
 symptoms
• If hepatitis progresses, its symptoms begin to point to the liver
as the source of illness. Chemicals normally secreted by the
liver begin to build up in the blood, which causes:
• jaundice
• foul breath
• a bitter taste in the mouth
• dark or "tea-colored" urine
• white, light, or "clay-colored" stools
 symptoms
• There can also be abdominal pain, which may be centered
below the right ribs (over a tender, swollen liver) or below the
left ribs (over a tender spleen).
 What is the disease Signs

• Hepatomegaly
• Splenomegaly (10% of the patient )
• Rarely skin rash
• Generalized lymphadenopathy
• Dark urine & pale stool
 Diagnosis
All of these viral hepatitis conditions can be diagnosed and
followed through the use of readily available blood tests

• ↑ bilirubin

• ↑ bleeding time

• ↑serum aminotrasferase

Viral marker antibodies (IgM to HAV,HBV,HCV)

 Treatment
• Bed rest, abstaining from alcohol, and taking medication to help
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.

• There is NO vaccine to prevent HCV. Vaccines for
Hepatitis A and B do not provide immunity against
hepatitis C. There are various genotypes of HCV and the
virus undergoes mutations making it difficult to develop a
vaccine
 What are the complications?
Acute Complications (rare) :
• Arthritis,,
• Myocarditis &
• Renal failure

Dangerous complications (very rare)

Fulminant hepatitis
Hepatic encephalopathy & death

Chronic complications :
liver cirrhosis
 Prevention
Hepatitis A

• Immunization of children (1-18 years of age) consists of two or three

doses of the vaccine.
• Adults need a booster dose six to 12 months following the initial dose
of vaccine. The vaccine is thought to be effective for 15–20 years or
more.
Hepatitis B

• Safe and effective vaccines provide protection against hepatitis B for

15 years and possibly much longer.
• Currently, the Center for Disease Control and Prevention
recommends that all newborns and individuals up to 18 years of age
and adult participating at risk of infection be vaccinated.
• Three injections over a six to 12 month period are required to provide
full protection.
 In General:

• Wash your hands after going to the bathroom and before fixing
food or eating.

• Use latex condoms, which may lower the risk of transmission.

• Avoid tap water when traveling to certain countries or regions.
      .

• Don't share drug needles.

• Don't share personal items—such as toothbrushes, razors and

nail clippers—with an infected person.
THANK YOU