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Tuesday, December 16, 2008

Hepatitis B

4:18 PM

Description

* Hepatitis refers to an inflammation of the liver. Hepatitis B is a specific type of hepatitis caused by the hepatitis B virus, which is usually transmitted by blood products, or sexually. Hepatitis B can cause an acute infection or a chronic (persistent) one.

Risk Factors

* Homosexual behavior
* Intravenous drug abuse
* Medical professionals
* Hemodialysis workers
* Infants of mothers with hepatitis B

Symptoms

First phase (lasts 2-3 weeks):
* Fatigue
* Not "feeling well"
* Loss of appetite
* Nasal discharge
* Sore throat
* Skin rashes
* Joint pain
* Fever or chills
* Nausea/vomiting
* Abdominal pain
* Diarrhea or constipation

Second (Icteric) phase (occurs 5-10 days after first phase):
* Yellow skin or eyes
* Usually other symptoms improve
* Third (convalescent) phase:
* Continued steady improvement
* Chronic persistent hepatitis:
* May have none
* Fatigue
* Loss of appetite
* Chronic active hepatitis:
* May have none
* Fatigue
* Yellow skin or eyes may be present

Diagnosis
* Skin-yellow skin or eyes
* Liver tenderness
* Spleen tenderness
* Elevated AST, ALT, and total bilirubin
* Hepatitis B antibody testing to confirm diagnosis
* Acute: positive HBsAg, HbeAg, Anti-HBc IgM
* Chronic persistent: positive HBsAg, positive Anti-Hbe IgG
* Chronic active hepatitis: positive HBsAg, Anti HBc IgG (& low levels IgM), HbeAg
* Liver biopsy to diagnose chronic forms

Similar Conditions

* Mononucleosis
* Hepatitis A
* Hepatitis C
* Cytomegalovirus
* Q fever
* Drug-induced liver disease
* Secondary syphilis
* Cholecystitis
* Alcoholic hepatitis
* Autoimmune hepatitis

Complications

* Infection with delta agent. This is a secondary agent on top of the infection with hepatitis B. It can make the infection much more severe. Diagnosis is made by checking for anti-HDV in the blood.
* Hepatocellular (liver) cancer-patients who have been infected with hepatitis B are at much higher risk of developing liver cancer
* Liver cirrhosis



Treatment

* Acute hepatitis:
* Avoid Tylenol and alcoholic beverages. Bed rest as needed. No medical treatment.
* Chronic active hepatitis:
* Alpha-Interferon
* Lamivudine

Prevention

* Hepatitis B vaccine:
* Hepatitis B vaccine now exists and is routinely given during childhood immunizations. It is also given to high-risk adults, e.g., medical professionals.
* Hepatitis B immune globulin immunization for pregnant mothers
* Universal blood precautions
* Condoms may reduce or eliminate the chances of contracting hepatitis B from sexual relations.



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