Hepatitis

Pathophysiology of Viral Hepatitis Risk Factors: Poor sanitation and hygiene Contaminated food and water Multiple sexual partners Immunosupressed Injecting drug users Blood transfusion Health care workers Infants born to HBV-infected mother

Etiology:

Hepatitis A, B, C, D, E

Acute liver inflammation

Induction of immune

Cytotoxic cytokines and natural

response

killer cells cause lysis of infected hepatotocytes Pre - icteric phase

Antigen-antibody complexes

Kupffer cells proliferate and Activation of complement system S/S: Anorexia, RUQ  pain, nausea, malaise, Cell injury

wt loss (1 – 21 days*)

Immune complex formation in circulation

*maximum infectivity Fibrous scars

Obstruction of  blood and bile

Ischemia

Necrosis

for HAV

Immune complex deposition in vascular

Vasculitis (inflammation of blood vessels)

Impairs blood supply to the

Ischemia

Liver damage

Liver

Virus is not If managed:

Icteric phase

killed

Adequate rest Avoid alcohol and drugs detoxified by the liver Vitamin supplements

Same GI s/s as Pre  – Icteric phase,

Viral antigens persists in the liver

dark urine, jaundice, hepatomegaly (2 -4 weeks duration) Viral infection

High in calorie and protiencarbohydrates and low in fat diet.

Carrier of state B, C, D, (asymptomatic)

Promotes liver cells for regeneration

Transmit disease

Liver resume to normal appearance and function

May progress to: Hepato cellular carcinoma

Post - icteric phase

Liver cirrhosis Liver failure

Malaise, Fatigue, Hepatomegaly may remain (2 – 4 months duration)

Death

Diagnostic Examinations: Liver function test: Aspartate aminotransferase(AST) Alanine aminotransferase (ALT) Gamma-glutamyl transpeptidase Bilirubin Alkaline phosphatase Serum albumin Serum belirubin Prothrombin time -hepatitis A surface antigen (HAsAg) or hepatitis B surface antigen(HBsAg)

Symptomatology: Preicteric (prodomal phase) -Last for 1wk -Elevated temperature and chills -Nausea and vomiting -Dyspnea -Head ache -Arthralgia -Weakness -Weigth loss -Hepatomegaly -lymphadenopathy

Icteric Phase -Starts with the onset of jaundice -Intensity in 2wks and last for 4-6 wks -worsening of anorexia -N/V -Dyspnea -weakness and malaise -liver tenderness increases

Posticteric Phase -begins with the disappearance of jaundice, normally last for several wks up to 4 months