Hepatitis



Hepatitis







QUICK LOOK AT THE CHAPTER AHEAD

Hepatitis may be caused by a viral infection, or it may result from sensitivity to a hepatotoxic drug or chemical, from chronic excessive alcohol consumption, or from autoimmune factors. It can be acute, chronic, or fulminant. People with viral hepatitis can be carriers in that they transmit the virus but have no evidence of infection themselves. Hepatitis may also be in an active or dormant state. There are currently five types of viral hepatitis known, and two types are currently undergoing further research. Hepatitis and its sequelae affect more than 500 million people worldwide. Both sexes and all age groups are equally affected. Hepatitis can cause cirrhosis or liver cancer, and it is the underlying basis for most liver transplants.











Table 54-1 Viral Hepatitis: Important Characteristics



























































































































Characteristic

Type A

Type B

Type C

Type D

Type E


Mode of transmission

Water-borne
Fecal-oral
Venereal

Perinatal
Blood/skin
Venereal

Venereal
Blood/skin

Venereal
Blood

Water-borne
Fecal-oral


Incubation period (range in days) average

15 to 42

42 to 160

14 to 160

28 to 49

14 to 56


30

90

50

35

40


Onset

Abrupt

Insidious

Insidious

Insidious

Abrupt


Symptoms

Fever

Common

Uncommon

Uncommon

Common

Common

Nausea/vomiting

Common

Common

Common

Common

Common

Jaundice

More common in adults than children

Occasionally

Uncommon

Common

Common


Outcome

Severity

Mild

Moderate

Mild

Moderate to Severe

Severe

Fulminating hepatitis

>.5%

<1%

Rare

3% to 4% with coinfection with hepatitis B

.3% to 3% 20% in pregnant women


Mortality rate

Low (<1%)

Low (1% to 3%)

Low (2%)

High (5%)

Moderate; high with pregnancy


Chronic hepatitis

No

Yes (5% to 10%)

Yes (80%)

<5% with coinfection 80% with superinfection

No


Carrier state

No

Yes (1 million in United States)

Yes

Yes

No


Relapse

Yes

Yes

Persistent

Unknown

Unknown


Carcinoma

No

Yes (25% to 40%)

Yes (25% to 30%)

No increase above that for hepatitis B

Unknown but not likely


Develop cirrhosis

No

40%

30%

Yes, with superinfection

No










Table 54-2 Clinical Manifestations of Hepatitis









Prodromal phase: viral symptoms such as nausea, vomiting, malaise, anorexia, low-grade fever, headache; 2 weeks after exposure to virus, which ends with the onset of jaundice


Icteric phase: jaundice, dark tea-colored urine or clay-colored stools, hepatomegaly and right upper quadrant pain; begins 1-2 weeks after prodromal phase and lasts up to 6 weeks


Recovery phase: resolution of jaundice approximately 6-8 weeks after exposure; liver may remain enlarged for up to 3 months

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Oct 21, 2016 | Posted by in NURSING | Comments Off on Hepatitis

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