Steve West

1. Viral Hepatitis Steve West

2. What is Hepatitis? • Hepatitis is a type of liver disease, which comes in multiple forms • While some types of hepatitis can occur from exposure to certain chemicals, the most common type is caused by a virus • The disease, caused by the hepatitis virus, is the inflammation and improper function of the liver • There are five main types of viral hepatitis: Type A Type B Type C Type D Type E

3. What is Hepatitis? (cont.) • Each type of the hepatitis virus has its own specific symptoms, methods of contraction, and possible treatments • There are two general types of the hepatitis disease: Acute and Chronic • Acute Hepatitis is by far more common, and usually less dangerous • Some individuals do not fully recover from a case of acute hepatitis, and develop chronic hepatitis, which can last for years Here is a diagram of the liver:

4. What Causes Hepatitis? The following graph illustrates various risk factors for acquiring acute hepatitis C: • Each type of the hepatitis virus has its own specific method of transmission • Types A and E usually enter the body through food or water that has been contaminated by infected sewage • Type B is usually transmitted sexually, though it can also travel from contact with infected blood • Type C is likely the most dangerous. It is contracted most often through intravenous drug use and infected blood transfusions, but 40% of cases have an unknown mode of transmission • Type D can only infect individuals already infected with type B. The method of transmission is the same, but can occur at the same time as the contraction of type B, or years later

5. Risk Prevention • Risk of contraction increases with travel to areas with poor sanitation, use of intravenous, mind altering drugs, alcoholism, and work in areas where diseases are common, such as hospitals or daycare centers • Certain medical procedures, such as kidney dialysis treatment and treatment for hemophiliacs can also increase risk Immunization and Hygiene Things To Avoid: • Injections of Gamma-Globulin can reduce the risk of infection for short periods of time • If you are in a high risk group, vaccination against hepatitis type B is available • Proper hygiene and sanitation can also reduce the risk of contracting types A and E

6. Symptoms • Infection with acute hepatitis usually begins with flu-like symptoms • This will progress to include jaundice (a yellowing of the skin caused by bile leaking into the bloodstream) and Icterus (a yellowing of the eyes) Examples of Jaundice/Icterus:

7. General Symptoms • Other Symptoms May include: Nausea Sore Muscles Vomiting Joint Pain Loss of Appetite Itchy red hives on skin Fever Tenderness in right, upper abdomen • These are the symptoms of a case of acute hepatitis

8. General Symptoms (cont.) • Symptoms of chronic hepatitis include: • Feeling ill • Poor appetite • Fatigue • Low fever • Symptoms of chronic liver disease (enlarged spleen, spiderlike blood vessels in skin, fluid retention)

9. Diagnosis In order to diagnose a patient, the following will likely be conducted: • Medical history exam by a physician • Blood tests to identify the type of infection • Liver function studies • In severe cases, a liver biopsy may be needed Doctor’s treatment will likely also occur, and hospitalization may be necessary if a severe case is diagnosed

10. Infection • Once you are diagnosed with viral hepatitis, progression of the disease differs, depending on the type of infection • Hepatitis A, B, and E will often cause damage to the liver, but only a small fraction of cases proceed to chronic hepatitis (type A will never create a chronic infection) • Type B on its own may show only mild symptoms, or may develop (rarely) into chronic liver disease, but an infection with type D will greatly increase the chances of sustaining liver damage or suffering cirrhosis • Type C begins with mild symptoms and progresses slowly, but leads to chronic liver disease in the majority of patients Healthy Liver Hepatitis B Infected Liver

11. Infection (cont.) There are two types of chronic hepatitis that may result from an infection: chronic active and chronic persistent • Chronic active hepatitis results in extreme inflammation and destruction of liver cells at a high rate • This usually results in cirrhosis • Chronic persistent hepatitis causes a milder inflammation • Does not usually cause cirrhosis, but can last for years

12. Treatment • Many cases of acute hepatitis can be tended to in the household • Patient will require a lot of rest • If complications arise, doctor’s treatment or hospitalization may be required • Generally, symptoms will peak, then gradually disappear • An individual in good health will often recover in 1-4 months • Recovery almost always provides complete immunity • In severe cases, certain drugs can be used to mitigate symptoms • Gamma globulin can be used to help patients with hepatitis A • Chronic Hepatitis C can be treated with Alpha- Interferon • Cortisone drugs can be prescribed to reduce liver inflammation • There is no vaccine or treatment for hepatitis E

13. Random Facts • Hepatitis B was discovered by accident in the 1960’s • After alcohol, Hepatitis is the leading cause of chronic liver disease in the U.S. • Worldwide, it IS the top cause • Hepatitis A cannot create a chronic infection; the patient will either fully recover or – in rare cases – die • The Hepatitis B virus contains a protein with a function that is still unknown

14. The Future of Hepatitis • Recently, a new strain of Hepatitis has been discovered • Known as Hepatitis G, very little has been confirmed about it • Transmission is believed to be mainly through blood • As of now, Hepatitis G often shows no clinical symptoms, and has not been found as a cause of acute or chronic Hepatitis • There is, as with every virus, the possibility of mutation occurring, and Hepatitis G may become a danger in the future

15. Works Cited Bunch, B. (Ed.). (2003). Hepatitis A and E. In Diseases (Rev. ed., Vol. 4, pp. 87-89). Conneticut: Scientific Publishing. (Original work published 1997) Griffith, H. W. (n.d.). Hepatitis, Viral. In MDAdvice.com. Retrieved April 22, 2009, from http://www.mdadvice.com/library/symp/illness264.html Hepatitis. (n.d.). Digestive and liver disorders. Retrieved May 17, 2009, from University of Virginia Web site: http://www.healthsystem.virginia.edu/uvahealth/peds_digest/hepatiti.cfm What is acute Hepatitis? What is chronic Hepatitis? (n.d.). Viral Hepatitis. Retrieved May 17, 2009, from Ohio State University Web site: http://medicalcenter.osu.edu/patientcare/ healthcare_services/infectious_diseases/vh/Pages/index.aspx Worman, H. J., M.D. (2006). The A, B, C, D, E's of Viral Hepatitis. In The Liver Disorders and Hepatitis Sourcebook (pp. 53-109). McGraw-Hill.

16. Additional Sources • http://thelivercarefoundation.org/cache/liver_diagram1.jpg • http://www.merckfrosst.ca/images/en/patients/diseases/vaccines/fioles.jpg • http://liver-disease-symptoms.com/wp-content/uploads/2009/04/liver-disease2.jpg • http://literacyfacts.files.wordpress.com/2008/12/medical_symbol_12.gif • http://www.hepar-p.com.my/images/normal_liver.jpg • http://www.stanford.edu/group/virus/hepadna/2004tansilvis/liver%20cirrhosis.gif • http://www.epidemic.org/theFacts/essentials/images/riskGraph.jpg Images Image Editing • Helios Paint