VIRAL HEPATITISPRESENTATION: VIRAL HEPATITIS PRESENTATION Dr. Mahmoud Hussain
Ibn Sina company
What is Hepatitis ? : What is Hepatitis ? It is parenchymal liver damage due to many agents :
Non viral (toxoplsma,leptospira & coxiella burntii)
Drugs ( paracetamol – halothane )
Poisons ( Mushrooms – carbon tetrachlorid )
Others ( pregnancy – circulatory insufficiency – Wilson disease )
Alcohol . THE LIVER ORGAN: THE LIVER ORGAN LIVER PANCRIASE DUDENUM What is the common forms ?: What is the common forms ? Virus ( A )
Virus ( B )
Virus ( C )
Virus ( D )
Virus ( E ) Epstein Barr virus
Yellow fever virus
Others – rare. What is the main effect of viral hepatitis ?: What is the main effect of viral hepatitis ? Chronic viral hepatitis usually with viral hepatitis ( B-C ) Acute viral hepatitis usually with viral hepatitis ( A-B-D-E ) Slide7: Post mortem for liver cirrhosis What is the mode of viral hepatitis infection?Take care!!!: What is the mode of viral hepatitis infection? Take care!!! What are the viral hepatitis symptoms?: What are the viral hepatitis symptoms? Specific symptoms:
Yellowish discoloration of skin & mucous membrane
Distaste for cigarettes
Dark urine .
Pale stool . Nonspecific :
Fatigue , tiredness .
Rarely skin rash. How can you suspect jaundice ?: How can you suspect jaundice ? Yellowish discoloration appears in sclera .
It will be seen if you look to eyes during day light or white light . What is the disease signs ?: What is the disease signs ? Hepatomegaly.
Splenomegaly (10% of the patient).
Rarely skin rash.
Dark urine & pale stool . What are the complications ?: What are the complications ?
Acute complications (rare):
Arthritis,vasculitis,myocarditis & renal failure.
Relapses occasionally occur .
Dangerous complications (very rare):
Fulminant hepatitis .
Hepatic encephalopathy &death. Slide13: Chronic Complications :
Chronic a symptomatic carriers of HBV .
Chronic Viral Hepatitis .
Liver cirrhosis (on long run complication)
Primary hepatocellular carcinoma .
Complications of cirrhosis it self . What are the investigations of the disease?: What are the investigations of the disease? Specific:
Viral markers antibodies (IgM to HAV,HBV,HCV).
PCR to detect virus ( C ) Nonspecific:
Raised serum aminotransferase :- (AST.ALT) A.phosphatase .
Raised s.bilirubin (bilirubinemia).
Increased prothrombin time .
Increased E.S.R .
Increased bleeding time.
Leucopoenia with relative lmyphocytosis .
What is the treatment available ?: What is the treatment available ? Admitted and isolate the patient to the hospital.
Specific regimen on high carbohydrate diet ,low protein & fat.
Symptomatic treatment for fever , vomiting & pain .
Treatment of complications .
We can use antiviral therapy (interferon) to treat acute cases with hepatitis ( B – C ). How can we avoid risk factors?: How can we avoid risk factors? Avoid direct contact with contaminated blood :-
Avoid contaminated needles , surgical tools , dentist tools.
Avoid barbers equipments .
Avoid transfusion of contaminated blood , plasma , & anti hemophilic agents .
Avoid using patient tools ( shaver machine , table utensils & towel .
Avoid direct contact with victim blood .
Slide17: Avoid contaminated water , food that can spread of infection of viruses ( A – E ) .
Avoid tattooing & similar habits might cause infection by viruses ( B – C ) .
Lastly infected mother can transfer the disease to her fetus mainly HBV . What are the methods of prophylaxis?: What are the methods of prophylaxis? Passive immunization especially used to prophylaxis against HBV by giving hepatitis B immunoglobulin .
Active immunization against :
Hepatitis A virus .
Hepatitis B virus . EPIDIMIOLOGY :: EPIDIMIOLOGY : Hepatitis ( A ) virus :
It is the most common type of viral hepatitis occurring worldwide , often in epidemics .
It is commonly seen in the autumn & usually affect the children and young adult .
Hepatitis ( B ) virus :
It is present worldwide and has infected more than 200 million people .
There are estimated 300 million carriers .
Lower carrier rate is in U.K & U.S.A but it is rises to 10% - 15% in parts of Africa , middle & far east . Slide20: Acute HBV
Infection Transient sub clinical
hepatitis 25% 65% Recovery Death 100% 99% 01% Chronic HBV
infection 10% Healthy HBsAg
Carriers 70 – 90% Chronic
Hepatitis Cirrhosis Hepatoma 10 – 30% Hepatitis ( C ) Virus : : Hepatitis ( C ) Virus : It was identified in 1988 and was found to be responsible for pos transfusion hepatitis .
It is transmitted by blood and blood products and it is postulated that 80% of people with hemophilia in U.K may have been infected.
The incidence in intravenous drug abusers is high, up to 90%.
Vertical transmission from mother to child can occur .
In 20% of cases the exact mode of transmission is unknown .
Hepatitis ( D ) virus :
Hepatitis D viral infection can occur either as a co-infection
With HBV or as a super-infection in an HBsAg – positive patient . THANK YOU: THANK YOU Dr. Mahmoud Hussain