Viral HepatitisTakera S. GreenVance Granville Community College INTRODUCTION Viral hepatitis is caused by different viruses that attack the liver causing inflammation and impairment to the liver. The liver is responsible for producing bile that helps the body break down fat, detoxifies the blood, and store vitamins. (Pearson,2015) Hepatitis can cause disruption and create severe health problems throughout the body. There are some illnesses and conditions that can cause inflammation of the liver such as alcohol consumption, certain drugs, autoimmune diseases, bacteria, parasites, and fungus also chemicals. (Pearson,2015) Complications include chronic liver disease, liver failure, and liver cancer.

(Pearson,2015) According to the CDC, there are several types of the hepatitis viruses named hepatitis HAV, HBV, HCV, HDV, and HEV. Each virus is transmitted in different ways. All cases of hepatitis are reportable to the CDC. Viral hepatitis can be classified as acute or chronic and mild or life threatening. There are many risk factors for Viral hepatitis, such as, infants born to mothers with hepatitis B or C, children that attends daycare, childcare workers who change diapers or toilet train children, men who have sex with men, anal sex, multiple sex partners and people who inject illegal drugs and share needles (“Hepatitis Risk Factors Slideshow: Foods, Sex, & Other Causes,” n.d.

). According to the Center for Disease Control, viral hepatitis accounts for more than fifty percent of acute hepatitis cases in the United States. This paper will be focusing on the three most common types of viral hepatitis which are HAV, HBV and HCV. PATHOPHYSIOLOGY  The hepatic cells of the liver are damaged by toxins, viruses and other mechanisms. Cell mediated immune responses damages hepatocytes which leads to hyperplasia and necrosis, which ultimately leads to impairment of the liver, (Pearson ,2015). Hepatitis A virus is transmitted person to person, through fecal oral route and through contaminated food and water, (Pearson ,2015). Hepatitis A is a self-limited disease, in other words it’s a short term virus. Those that are at an increased risk for transmission of HAV include people who traveled to countries with a high infection rate, kids that are in daycare, men who have sex with men, having a clotting factor disorder, and those that use injectable drugs, (“Hepatitis Risk Factors Slideshow: Foods, Sex, & Other Causes,” n.

d.). HBV is transmitted through contact with infected blood and bodily fluids and can cause liver failure and cancer; it can become fatal if not treated in a timely fashion (Braun ; Anderson, 2017). Those at risk for HBV include: healthcare workers, having renal disease, being promiscuous, over the age of 60 with diabetes, and people traveling to countries with a high rate of HBV infection.

(“Hepatitis Risk Factors Slideshow: Foods, Sex, & Other Causes,” n.d.). Hepatitis C virus is contracted through infected blood. It can be both a short term illness or a long term illness. The risk factors associated with contracting HCV includes: a mother that is infected with the virus passes it to her child during childbirth, having body piercings, tattoos with infected equipment and working in the health field (Pearson ,2015).

Nurses and Doctors are more likely to contract HCV by accidental exposure. CLINICAL MANIFESTATIONS Clinical manifestations are similar in all viruses. During the incubation period, patients are usually asymptomatic; however, once that period ends symptoms usually appear in three different phases.

The prodromal phase, the icteric phase and the convalescent phase (Pearson ,2015). As stated in “Pearson” Hepatitis manifests with some of the same symptoms that would occur in any other infection such as a low grade fever, fatigue, lack of appetite and abdominal pain in the right upper quadrant which occurs in the first phase known as the prodromal phase and, lasts about two weeks. (Pearson, 2015). During the second phase known as the icterus phase, the sclera of the eyes, the skin and mucous membrane all become yellow in color also known as jaundice do to the increased levels of bilirubin in the blood. (Pearson, 2015).

The persons’ urine may become darkened in color and their stools appear clay- colored, the liver is enlarged and tender to touch (Braun & Anderson, 2017). This phase lasts appoximately two to six weeks. During the last stage, also known as the recovery stage, symptoms begin to disappear. The jaundice subsides, their apetite is improved, and the pain begins to resolve (Braun & Anderson, 2017).

DIAGNOSTIC CRITERIA The hepatits viruses A, B, and C can be diagnosed by sypmtoms, a complete physical exam, blood tests and sometines a CAT scan a liver biopsy, or a liver function test. Diagnostic criteria for HAV, HBV, and HCV are based off of the detection of viral antibodies. Hepatits A virus has anti-HAV, HCV has anti-HCV and HBV has two antigens one being a core antigen (HBcAg) and e antigen (HBeAg) which are seen in acute infections. The HBsAg surface antigen can be present in both acute or chronic asymtomatic carriers. A dectection of bilirubin in the urine and longer than normal clotting time can also indicate liver impairment. TREATMENT According to the “US Department of Health and Human services”, there are several ways that viral hepatits can be treated.

Treatment can begin by receiving, vaccinations for HAV and HBV. Both HAV and HBV have two vaccinations. There is a hepatits A vaccine that protects infants, kids and adults, and a combination vaccine of A and B that protects adults from both A and B. The same goes for hepatits B vaccine. There are no vaccinations for hepatits C, however, there are viral medications that’s used as treatment in chronic HCV to stop replication. For acute HCV, HBV, and HAV adequate rest, fluids, and medications to manage pain. Avoidance of strenous activity, infected persons, contact sports, and use of good hand hygiene is recommended for treatment.

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