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Hepatitis

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Infection of the liver caused by Hepatitis A virus. Geographic Distribution of HAV Infection ... Hepatitis A. Incubation period. 30 days on average (range 15-50 days) ... – PowerPoint PPT presentation

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Title: Hepatitis


1
Hepatitis
  • HIV/AIDS Program
  • Public Health Seattle King County
  • hivstd.info_at_metrokc.gov
  • http//www.metrokc.gov/health/apu
  • 206/205-STDS (7837)

2
Hepatitisinflammation of the liver
  • Can have many causes
  • drugs
  • toxins
  • alcohol
  • viral infections (A, B, C, D, E)
  • other infections (parasites, bacteria)
  • physical damage

3
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4
Liver
  • Functions
  • Stores sugar needed for energy
  • Absorbs good nutrients
  • Breaks down poisons (toxins) and drugs
  • Makes important proteins that help build new
    tissue and repair broken tissue
  • Produces bile, which helps remove waste from the
    body

5
Healthy Liver
Cirrhosis Liver
6
Hepatitis Terms
  • Acute Hepatitis Short-term hepatitis.
  • Bodys immune system clears the virus from the
    body within 6 months
  • Chronic Hepatitis Long-term hepatitis.
  • Infection lasts longer than 6 months because the
    bodys immune system cannot clear the virus from
    the body

7
Hepatitis A
  • What is it?
  • Infection of the liver caused by Hepatitis A virus

8
Geographic Distribution of HAV Infection
Anti-HAV Prevalence
High
Intermediate
Low
Very Low
9
Hepatitis A
  • Incubation period
  • 30 days on average (range 15-50 days)
  • infectious latter half of incubation period while
    asymptomatic through 1 week after having jaundice.

10
Hepatitis A
  • Symptoms
  • Nausea
  • Loss of appetite
  • Vomiting
  • Fatigue
  • Fever
  • Dark urine
  • Pale stool
  • Jaundice
  • Stomach pain
  • Side pain

A person may have all, some or none of these
11
Hepatitis A
  • How do you get it?
  • Feces (stool) on hands that gets on food or in
    water
  • Contaminated shellfish
  • Sex
  • A person is most contagious 2 weeks before they
    feel sick
  • Not spread by kissing, sneezing, saliva

12
Hepatitis A
  • Diagnosis and Treatment
  • Blood test
  • No medicine or treatment to make it go away
  • Rest, fluids, treatment of symptoms
  • Most people recover completely and become immune
    to reinfection

13
Hepatitis A
  • Prevention
  • Shot of immune globulin up to 2 weeks after
    exposure
  • Good hand washing
  • Cook food well
  • Good diaper hygiene
  • Only drink clean water
  • VACCINE!!!

14
Hepatitis A
  • Who needs immune globulin?
  • Living with someone with Hep A
  • Eaten food handled by someone with Hep A
  • Sexual contact with person with Hep A
  • Traveling to an area where Hep A is common
  • Child or employee at a child care program where
    someone else has Hep A

15
Hepatitis B
  • What is it?
  • Hep B is a serious disease caused by a virus that
    infects the liver
  • Can cause lifelong infection, cirrhosis (liver
    scarring), liver cancer, liver failure and death

16
Geographic Distribution of Chronic HBV Infection
HBsAg Prevalence
³8 - High
2-7 - Intermediate
lt2 - Low
17
Hepatitis B
  • Incubation period
  • 60-90 days on average (range 45-180 days)
  • infectious weeks before getting ill and for
    variable period after acute infection
  • chronic carriers remain infectious

18
Hepatitis B
  • Symptoms
  • Nausea
  • Loss of appetite
  • Vomiting
  • Fatigue
  • Fever
  • Dark urine
  • Pale stool
  • Jaundice
  • Stomach pain
  • Side pain

A person may have all, some or none of these
19
Hepatitis B
  • Who is at risk?
  • Anyone can get it
  • In the USA, 200,000 people get Hep B every year
  • 5,000 people die every year of Hep B
  • If you have had other kinds of Hepatitis, you can
    still get Hep B

20
Hepatitis B Infections200,000 per year
Asymptomatic Cases100,000 (50)
Symptomatic Cases100,000 (50)
Clear Virus Healthy170 - 182,000 (90-94)
Death100 (0.05)
Hepatitis B Chronic Carriers12-20,000 (6-10)
Chronic Liver Disease
Death from Cirrhosis3400 (1.7)
Death-Primary Liver Cancer 800 (0.4)
21
Hepatitis B
  • Who is at highest risk?
  • Injection drug users
  • Sex partners of those with Hep B
  • Sex with more than one partner
  • Men who have sex with men
  • Living with someone with chronic Hep B
  • Contact with blood
  • Transfusions, travel, dialysis

22
Hepatitis B
  • How do you get it?
  • Direct contact with blood or body fluids of an
    infected person
  • sharing injection equipment
  • sex
  • baby from infected mother during childbirth
  • Hepatitis B is not spread by food, water or
    casual contact

23
Hepatitis B
  • Who is a carrier of Hep B virus?
  • Some people with Hep B never fully recover from
    the infection (chronic infection)
  • They still carry the virus and can infect others
    for the rest of their lives
  • There are about 1 million carriers of Hep B in
    the USA

24
HEPATITIS B
25
Hepatitis B
  • Diagnosis and Treatment
  • Blood test
  • There is no cure
  • Interferon/Ribaviron

26
Hepatitis B
  • What about Hep B and pregnancy?
  • A woman with Hep B can give it to her baby at
    birth
  • Babies with Hep B can get very sick, can develop
    chronic infection and spread Hep B, can get
    cirrhosis or liver cancer
  • Pregnant women should be tested for Hep B
  • Babies should get Hep B vaccine at birth

27
Hepatitis B
  • Who should get Hepatitis B vaccine?
  • All babies, at birth
  • All children 11-12 who have not had vaccine
  • People at risk
  • MSM
  • Multiple sex partners
  • Injection drug users
  • People with jobs where exposure to blood might
    happen

28
Hepatitis C
  • What is it?
  • Hep C is a liver infection caused by a virus
  • Also known as non A, non B hepatitis

29
Hepatitis C
  • Incubation period
  • 6-7 weeks on average (range 2-6months)
  • infectious one or more weeks before getting ill
  • chronic carriers remain infectious

30
Hepatitis C
  • Symptoms
  • Nausea
  • Loss of appetite
  • Vomiting
  • Fatigue
  • Fever
  • Dark urine
  • Pale stool
  • Jaundice
  • Stomach pain
  • Side pain

3 out of 4 persons have no symptoms and can
infect others without knowing it
31
Hepatitis C
  • Who is at risk?
  • About 35,000 people get Hep C every year
  • down from 180,000 in the 1980s
  • About 3.9 million people in the USA are infected
    with Hep C.
  • It can cause liver failure, cirrhosis, liver
    cancer
  • Responsible for 8,000 to 10,000 deaths/year.

32
Hepatitis C
  • Who is at highest risk?
  • Injection drug users
  • Estimated that over 75 of injectors nationwide
    have Hep C
  • In Seattle/King County, 86

33
Hepatitis C
  • How do you get it?
  • Shared injection equipment (60 of new
    infections)
  • Blood transfusion before May, 1992 (now only 1 in
    100,000 chance of transmission)
  • Blood transfer (HCW, tattoo, piercing )
  • Sex? (HCV in semen and vf but only 1.5 rate of
    transmission for long-term partners)
  • Mother to child (lt5)
  • 10-20 of infections have no identifiable risk
    factors

34
Hepatitis C
  • Diagnosis
  • There is a blood test that screens for Hep C
    antibodies (ELISA or RIBA)
  • Antibodies usually develop within 3 months
  • HIV persons may not develop detectable
    antibodies
  • There is a PCR test (detects parts of actual
    virus) for Hep C but it is not yet FDA approved
  • If infected, liver enzyme tests or a liver biopsy
    can check liver function

35
Hepatitis C
  • What happens when you have Hepatitis C ?
  • 85 of people develop chronic infection (infected
    for the rest of their life)
  • Rapid progression, slow progression, no
    progression
  • HCV subtype
  • Alcohol consumption (alcoholics 3 times more
    likely to develop cirrhosis after 20 years)
  • age (older at time of infection more rapid)
  • gender (men faster progression than women)

36
HEPATITIS C
37
Hepatitis C
  • Long term pathogenesis
  • Over time progressive liver damage may occur
  • 20 -30 of those infected will develop cirrhosis
    over 10 - 30 years
  • Of those with cirrhosis 25-30 (5 of overall)
    will develop end-stage liver disease or liver
    cancer
  • Many live without symptoms for decades
  • Others experience mild symptoms --intermittent
    fatigue, nausea, and muscle aches

38
Hepatitis C
  • Treatment
  • Interferon/Ribaviron (suggest 40 cure rate)
  • Peginterferon Alfa-2a (still in studies - not yet
    FDA approved)

39
Hepatitis C
  • What should a person do who has Hep C?
  • Get regular medical care--tell doctor about ALL
    drugs (including herbs)!!!
  • Have a healthy diet (no iron supplements, reduce
    salt intake, no large doses of vitamin A)
  • Get needed rest
  • No alcohol or Tylenol, cut back on other drug use
  • Avoid chemical fumes and other environmental
    toxins
  • Get vaccinated for A and B!!!

40
Hepatitis C
  • What should a person do who has Hep C?
  • Do not share injection equipment.
  • Do not donate blood or plasma, organs or sperm
  • Do not share toothbrushes, razors
  • Cover areas of open skin
  • Use safer sex?

41
Hepatitis C and HIV
  • 30 - 40 of HIV people in US also infected with
    Hep C
  • More rapid progression of Hep C (twice as fast)
  • Little to no affect on HIV progression (still
    inconclusive)
  • Complications of medication regimens
  • Increases risk of perinatal transmission

42
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43
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