PREPARED BY: JIGNA P.

PATEL
 Hepatitis means inflammation of the liver
 Hepat (liver) + itis (inflammation)= Hepatitis
 Viral hepatitis means there is a specific virus that is
causing your liver to inflame (swell or become larger
than normal)
 The word hepatitis comes from the Ancient
Greek word hepar (root word hepat)
meaning 'liver', and the Latin itis meaning
inflammation. Hepatitis means injury to the
liver with inflammation of the liver cells.
 Is located in the upper right quadrant of the
abdomen
•Cleans the blood
•Regulates hormones
•Helps with blood clotting
•Produces bile
•Produces important proteins
•Maintains blood sugar levels
•And much, much, more

• The liver is essential

for life !
Walls of
scar
tissue
begin to Healthy liver cells
form become trapped
by a wall of scar
tissue
5 types:
A: fecal-oral transmission
B: sexual fluids & blood to blood
C: blood to blood
D: travels with B Vaccine
Preventable
E: fecal–oral transmission
Adapted from Corneil, 2003
 Hepatitis A usually is a benign, self-limited
disease with
 an incubation period of 2 to 6 weeks (average 28
days).
 HAV does not cause chronic hepatitis or a carrier
state.
 HBV-induced chronic liver disease is an
important precursor for the development of
hepatocellular carcinoma.
 INCUBATION PERIOD OF HEPATITIS B IS 6
WEEKS TO 6 MONTHS
  Affects each person differently
 No vaccine available
 Many people have the virus and do not
even know it
 Approximately 1 out of 100 Canadians
infected
*
Overall cure rate with new treatment is 55%
*BC Hepatitis Service 2003
 20%
Only 20% will Clear the
show symptoms Virus
Initially !

Healthy Acute Chronic

Liver Infection Infection

80% Virus
Continues
to Damage
Liver
Adapted from Lauer and Walker, NEJM 2001
Hepatitis D - only a person who is already infected
with Hepatitis B can become infected with Hepatitis
D. It is caused by the virus HDV (Hepatitis D Virus).
Infection is through contact with infected blood,
unprotected sex, and perforation of the skin with
infected needles. The liver of a person with Hepatitis
D swells
•Hepatitis E - a person can become infected by
drinking water that contains HEV (Hepatitis E Virus).
The liver swells but there is no long-term consequence.
Infection is also possible through anal-oral sex.
•Hepatitis X - if a hepatitis cannot be attributed to the
viruses of hepatitis A, B, C, D, or E, it is called Hepatitis
X. In other words, hepatitis of an unknown virus.
 Chronic Cirrhosis Liver
Hepatitis 20-30% Cancer
1-4%/year

Most symptoms begin to show only when liver is more severely damaged
 30yrs or longer if:
 Young at time of infection
 Healthy liver at time of infection
 Female

 20yrs or less if:

 Drinking alcohol
 Co-infection (HIV, Hep B)
 Damaged liver before infection

Adapted from Bigham, BC Hepatitis Services 2002

 Individuals may have one or more of the
following symptoms, while others experience
no symptoms:
–Tiredness –Weight loss
–Nausea –Abdominal pain
–Muscle or joint pain –Itchiness
–Trouble sleeping –Depression
–Loss of appetite –Dark urine (pee)
 A few may have specific liver related
symptoms initially:
 Pale stool (poo)
 Jaundice (yellowing of the skin or eyes)
 Hepatitis C is not spread by:
 Casual contact
 Hugging/kissing
 Sharing eating utensils and drinking glasses
 Sneezing/coughing
 Shaking hands
 Sitting on a toilet seat
 Never share drug equipment
 Straws, bills, needles, syringes, water, filter,
cooker, pipes etc…
 Never share tooth brushes/razors or any
personal hygiene articles that have blood on
them (even tiny amounts).
 Practice safer sex
 Always make sure new & sterilized equipment
is being used for tattooing & piercing
 Make sure ink for tattooing is not being shared
 Do not touch dirty needles without proper
equipment or following proper procedures
1. Handle only if you have proper equipment
 Sturdy pair of gloves, tongs or pliers and a puncture proof container
(heavy plastic or metal)
2. Place needle in puncture proof container
 Do not touch needle with bare hands and do not try to recap needle if
cap present
3. Can dispose container in garbage but better if it is
taken to health clinic or needle exchange
MCQ
 CHRONIC CARRIER STAGE IS NOT FOUND
IN
1. HEPATITIS B VIRUS
2. HEPATITIS C VIRUS
3. HEPATITIS A VIRUS
4. BOTH A AND B
INDICATOR OF ACTIVE MULTIPLICATION OF
HEPATITIS B VIRUS IS
1. HBs Ag

2. HBc Ag

3. Hbe Ag

4. Anti- HBs Ab
 HEPATITIS E IS TRANSMITTED BY
1. BLOOD
2. FECO-ORAL
3. VENEREAL
4. ALL OF ABOVE
 IN PREGNANCY, WHICH VIRAL INFECTION
HAS MAXIMUM MORTALITY?
1. HEPATITIS B VIRUS
2. HEPATITIS C VIRUS
3. HEPATITIS A VIRUS
4. HEPATITIS E VIRUS
 INCUBATION PERIOD OF HEPATITIS B IS
1. 6 WEEKS TO 6 MONTHS
2. 6 DAYS TO 6 WEEKS
3. 6 MONTHS TO 6 YEARS
4. MORE THAN 6 YEARS
ANSWER
 CHRONIC CARRIER STAGE IS NOT FOUND
IN
1. HEPATITIS B VIRUS
2. HEPATITIS C VIRUS
3. HEPATITIS A VIRUS
4. BOTH A AND B
INDICATOR OF ACTIVE MULTIPLICATION OF
HEPATITIS B VIRUS IS
1. HBs Ag

2. HBc Ag

3. Hbe Ag

4. Anti- HBs Ab
 HEPATITIS E IS TRANSMITTED BY
1. BLOOD
2. FECO-ORAL
3. VENEREAL
4. ALL OF ABOVE
 IN PREGNANCY, WHICH VIRAL INFECTION
HAS MAXIMUM MORTALITY?
1. HEPATITIS B VIRUS
2. HEPATITIS C VIRUS
3. HEPATITIS A VIRUS
4. HEPATITIS E VIRUS
 INCUBATION PERIOD OF HEPATITIS B IS
1. 6 WEEKS TO 6 MONTHS
2. 6 DAYS TO 6 WEEKS
3. 6 MONTHS TO 6 YEARS
4. MORE THAN 6 YEARS
REFERENCES
1.Pawlotsky, J. M. 2002. Molecular diagnosis of viral
hepatitis. Gastroenterology 122:1554-1568..
2. Hoofnagle JH. Course and outcome of hepatitis C.
HEPATOLOGY 2002; 36(suppl 1):S21–S29.
3. Farci P, Alter HJ, Wong D, Miller RH, Shih JW, Jett
B, Purcell RH. A long-term study of hepatitis C virus
replication in non-A,non-B hepatitis. N Engl J Med
19
4.WHO Hepatitis . Who.int. 2010-12-08. Retrieved
2012-08-2691;325:98–104.