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Hepatitis

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Emma Jaroslawski

on 17 April 2014

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Transcript of Hepatitis

1.4 million people worldwide die each year from various forms of viral hepatitis

HEPATITIS VIRUS FACTS
HEPATITIS A VIRUS
300 – 500 cases per year in Australia

Usually no long term effects

One-time infection protects you against re-infection for life

Jaundice presents acute infection
HEPATITIS A: FACTS
Liver Function Test

Screens for elevated levels of serum billirubin and aminotransferase (ALT and AST)

In acute hepatitis, levels of ALT are higher than of AST

This testing does not differentiate Hepatitis A from other strains serological diagnosis
BIOCHEMICAL DIAGNOSIS
Detection of anti-HAV IgM antibodies by Enzyme Immunoassays

Anti-HAV IgG antibodies indicate past infection

Persist for years and provide protection against reinfection
SEROLOGICAL DIAGNOSIS
HEPATITIS B VIRUS
"Serum" or "Post-Transfusion" Virus

Non-cytopathic virus

Causes inflammation of liver, but not from virus itself; inflammation is from immune system's harsh response to virus
TREATMENT
Treated with prescription drugs which lower the concentration of the virus in the bloodstream, allowing the immune system to fight the virus and cause it to become inactive

Patient's blood needs to be strictly monitored during this process for an increase in liver enzymes and hepatitis b DNA, as this can indicate viral resistance to the drugs

Viral resistance is a common side effect

Prescription drugs for hepatitis b are to be taken over the course of a year or more

Drugs used for hepatitis b are: Lamivudine (Zeffix); Adefovir (Hepsera); Entecavir (Baraclude); and, Tenofovir (Viread)

They work to support the body's immune system while it is fighting the virus
PREVENTION
Hepatitis B vaccinations are recommended for newborns, adolescents, and adults

Newborns receive the vaccination shortly after birth, and at two, four, and 12 months of age

Adolescents aged 11 to 15 should be immunised with two adult doses of the vaccination, spaced six moths apart

Adults should be vaccinated with three adult doses spaced zero, four, and six moths apart

Post-vaccination blood tests are able to determine whether ther vaccination was successful in immunising the patient against hepatitis b.
HEPATITIS C
Hepatitis C Virus

Public health problem

"Silent epidemic"

TRANSMISSION
Blood to blood

Unsterile tattooing

Skin piercing

Injury from medical needles

Infected blood from blood transfusions
MONITORING TESTS
Liver function tests

Fibroscan tests

Liver biopsy
TREATMENT
Weekly injections of Interferon

Daily Ribavirin pills

Chance of cure - 50% to 80%
Type of hepatitis C
How patient responds to treatment
DIAGNOSTIC TESTING
Serology testing detects acute, recovered, chronic, actively replicating or inactive virus

Blood is analysed for the presence of hepatitis b antibodies

Serum analysed for hepatitis b DNA

Six week to six month period is defined as the 'window period'
Inflammation of the liver caused by virus or non-virus cause
Viral-caused types includes A, B, C, D and E strains
Jaundice: yellowing of skin and eyes

TREATMENT
Patients usually recover completely within two months
Vaccine, made up of inactive Hep A virus, is available

Two doses of vaccine required for long-term protection
For only Hepatitis A vaccination each injection is $75.00 (Incl GST)
(Frost, 2012): news.com.au

Medscape: Laboratory diagnosis of Hepatitis A

Medscape: Laboratory diagnosis of Hepatitis A

Travel Clinic Matraville; Hepatitis Australia

Medscape: Laboratory diagnosis of Hepatitis A

MANIFESTATIONS
Virus is destroyed by the immune system

Acute infection

Chronic infection
LIVER ILLNESS
Liver cirrhosis

Hepatitis failure

Hepatocellular carcinoma
WORLD HEALTH ORGANIZATION HEPATITIS VIRUS FACTS
WHO campaigns: Hepatitis
WHO campaigns: Hepatitis
DIAGNOSTIC
TESTS
Hepatitis C antibody tests

Hepatitis PCR Tests
Viral detection test
Viral load test
Genotype test
TRANSMISSION
Infected blood

Bodily fluids, including semen and vaginal secretions

Unprotected sex

Infected drug equipment (injectable and non-injectable) shared between multiple users

From mother to her baby during birth or through breast feeding with cracked nipples (possible risk of contact with infected blood)
POSITIVE TESTING TO HEPATITIS B SURFACE ANTIGEN
Patient is infected with hepatitis b virus
POSITIVE TESTINGTO HEPATITIS B SURFACE ANTIBODY
Patient had the virus and is now 'immune'
POSITIVE TESTING TO HEPATITIS B CORE ANTIBODY
Indicates past or present infection in patient

(Interpretation of this result relies on other two tests)
ANTIBODIES PRODUCES AGAINST HEPATITIS B
Immunoglobulin M (IgM; initial antibody)

Immunoglobulin G (IgG; replaces IgM in later stages)
HEPATITIS
HepMag: Hepatitis B - The Basics
RIT: Medical and Scientific Illustrations
Health Engine: Hepatitis Serology Test
Hepatitis WA: Hepatitis B - Testing
University of Washington: Hepatitis B Web Study - Health Educator
Hep Mag: Hepatitis B - The Basics
ATSU: Viral Hepatitis - Blood Borne Hepatitis
ATSU: Viral Hepatitis - Blood Borne Hepatitis
US Pharmacist: Chronic Hepatitis B Infection
Hepatitis WA: Hepatitis B - Testing
WHO: Immunizations, Vaccines and Biologicals - Hepatitis B
WHO: Immunizations, Vaccines and Biologicals - Hepatitis B
CDC: World Hepatitis Day, 28th July
Hep Mag: Hepatitis B - The Basics
Hepatitis Australia: Vaccination for Hep B
Doctor Rajput: Hepatitis
HepMag: Hepatitis B - The Basics
Doctor Rajput: Hepatitis
John Hopkins Medicine: Hepatitis C - Introduction
SF Gate: Hepatitis C Drugs Offer Hope for Cure
APExBIO: Hepatitis C Virus
Full transcript