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JUMP TO - 1 Introduction to Hepatitis - 2 Causes of hepatitis - 3 Risk factors for hepatitis - 4 Symptoms and clinical features of hepatitis Symptoms of acute hepatitis: Symptoms of chronic hepatitis: - 7 Differential diagnoses - 8 Complications of hepatitis - 9 Investigations - 10 Treatment for hepatitis - 11 Treatment objectives - 12 Non-drug treatment - 13 Drug treatment Hepatitis A Hepatitis B Acute: Chronic: Chronic Hepatitis C: Hepatitis D Hepatitis E - 21 Notable adverse drug reactions - 22 Prevention of hepatitis Introduction to Hepatitis Hepatitis is an inflammation of the liver which can be caused by either infective agents, drugs and other toxins. It is the most predominant and important presentation of liver disease worldwide. One can easily know the cause, and duration of a particular hepatitis from the suffixes acute, chronic, viral, autoimmune, alcoholic etc. Causes of hepatitis Hepatitis is caused by viruses, heavy alcohol consumption, toxins, some disease conditions and some drugs. Viral hepatitis are the most common type of hepatitis. Viruses causing them include hepatitis A, B, C, D and E Viruses. Hepatitis A and E viruses basically cause acute infections. Other hepatitis viruses can cause both acute and chronic infections. Risk factors for hepatitis - Family history. - Alcohol ingestion - Previous blood transfusion - Contamination of food and water by sewage - Drug ingestion - Sexual contact - Exposure to contaminated sharp objects/instruments Symptoms and clinical features of hepatitis Symptoms of acute hepatitis: - With or without mild fever - Mild-to-moderate jaundice - Vague right upper quadrant discomfort - There may be enlargement of the liver below the costal margin with varying consistency (depending on the stage of the liver disease) Symptoms of chronic hepatitis: - Re-occurence of jaundice may suggest a chronic illness Differential diagnoses - Liver abscess - Metabolic liver disease/disorder - Primary or secondary liver cancer - Cholecystitis Complications of hepatitis Untreated, poorly treated or chronic hepatitis can lead to the following complications: - Fulminant hepatic failure - Bleeding tendencies - Acute or subacute hepatic necrosis. - Chronic active hepatitis. - Chronic hepatitis. - Cirrhosis.. - Hepatocellular carcinoma in patients with hepatitis B and C viruses infection Investigations - Liver Function Tests - Serologic markers of Hepatitis A, B, C, D and E - Abdominal ultrasonography Treatment for hepatitis Treatment objectives - Provide supportive measures - Prevent progression to chronic phase (applicable to Hepatitis C virus only) - Improve patients quality of life Non-drug treatment - High carbohydrate and low protein diet - Discontinuation of hepatotoxic medication - Discontinuation of alcoholic drinks consumption - Bed rest Drug treatment Hepatitis A This type of hepatitis is self-limiting. Therefore, there is no specific drug treatment for it. Hepatitis B Acute: - Acute hepatitis B is self-limiting to fulminant - Its treatment is supportive Chronic: Follow your national treatment guidelines for chronic hepatitis B treatment initiation. Treat only those with viral load exceeding 2000 International Units/ml for e antigen negative patients or 20000 International Units/ml for e antigen positive patients. Monitor those not meeting treatment criteria with bi annual viral load. - Pegylated interferon alfa -2b:180 microgram subcutaneously weekly for 48 weeks. - Tenofovir 300 mg daily for 2-5 years (used when patient has liver failure). - Liver transplant Chronic Hepatitis C: Pegylated interferon alfa – 2b:180 microgram subcutaneously weekly for 48 weeks. Plus Ribavirin 400 mg orally twice daily for adults with body weight less than 65 kg; 400 mg in the morning and 600 mg in the evening for adults weighing 65-85 kg: 600 mg twice daily for adults weighing over 85 kg Hepatitis D Interferon alfa -2b: 3 million units subcutaneously 3 times weekly for 4 months Plus Lamivudine: 100 mg orally once daily for 4 months Hepatitis E - Treatment for hepatitis E is majorly supportive. Notable adverse drug reactions - Interferon alpha 2b and Ribavirin reduce haematopoiesis - Flu-like illness - Leucopenia - Psychiatric-like symptoms - Development of early resistance if therapy exceeds one year Prevention of hepatitis To prevent oneself from having hepatitis, observe the following recommendations: - Screen blood and blood products for hepatotrophic viruses - Immunize against hepatitis A, and B viruses - Prevent faecal contamination of food and water - Reduce drug misuse/abuse - Take pre-exposure prophylaxis - Take post-exposure prophylaxis - Avoid exposure to unsterilized sharp objects.
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Bol u zglobovima ruku s hepatitisom, Navigacijski izbornik MSM i virusni hepatitisi: rizici i zaštita Objavljeno: Virusni hepatitisi su skupina zaraznih bolesti koje zahvaćaju jetru, a mogu uzrokovati akutnu ili kroničnu bolest. Podaci iz literature pokazuju da se oko 10 posto slučajeva infekcija virusima hepatitisa A i oko 20 posto slučajeva infekcije virusima hepatitisa B javlja među MSM populacijom. U zadnjim su desetljećima u nekoliko europskih zemalja zabilježene epidemije hepatitisa A u MSM populaciji. U Europi i Hrvatskoj je Muškarci koji imaju spolne odnose s muškarcima također imaju povećan rizik infekcije virusom hepatitisa C, posebice ako koriste droge injektiranjem. Saznaj više Cijepljenje Najbolji način zaštite od bolesti je cijepljenje protiv hepatitisa B. Preporučuje se svima i može se obaviti već u dojenačkoj dobi ili ranom djetinjstvu. Pomoći ima i za one koji nisu cijepljeni, a došli su u dodir s izvorom zaraze. Bol u zglobovima ruku s hepatitisom se prenose virusi hepatitisi? Hepatitis A se prenosi feko-oralnim putem — unošenjem kontaminirane vode ili hrane stolicom zaražene osobe ili rukama onečišćenim stolicom zaražene osobe, čime se unosi virus hepatitisa A u usta. Infekcija se može brzo proširiti bliskim kontaktima kućnim, spolnim ili kontaktima u kolektivima. No hepatitis A se može prenijeti i spolnim putem, tijekom kontakta koji uključuje genitalije jednog i usta drugog partnera i fekalno-oralne izloženosti. Među MSM populacijom virus hepatitisa A se može širiti tijekom oralno-genitalnog spolnog odnosa, analno-oralnog kontakta ili indirektno putem predmeta ili prstiju koji se koriste tijekom analno-oralnog odnosa s osobom koja je zaražena virusom hepatitisa A. Hepatitis B se prenosi nezaštićenim spolnim odnosom, krvlju najčešće korištenjem nesterilnog pribora za injektiranje droga ili sa zaražene majke na novorođenče. Ljepota i zdravlje Što je hepatitis E i koji su uzroci Hepatitis E virusna infekcija jetre virusom HEV koji postoji kao četiri genotipa, od toga su 1 i 2 nađeni kod ljudi a 3 i 4 genotip kod domaćih i divljih životinja koja rijetko prelazi na ljude. Dovoljna je mala količina virusa da dođe do infekcije. Hepatitis C se prvenstveno prenosi krvlju, kontaktom s krvlju zaražene osobe najčešće korištenjem nesterilnog pribora za injektiranje droga. U rjeđim slučajevima može doći do prijenosa spolnim putem, prilikom nezaštićenih spolnih odnosa, posebice ako uključuju krvarenja, te tijekom poroda. Prijenos hepatitisa B i C krvlju uključuje direktni unos zaražene krvi u krvotok ili kontakt sluznica i zarazne krvi ili tjelesnih tekućina s primjesama krvi. Koji su simptomi virusnog hepatitisa? Simptomi virusnog hepatitisa ovise o dobi osobe i tipu virusa kojim je osoba inficirana. Postoji i razlika između akutnog i kroničnog hepatitisa: kod akutnog hepatitisa se simptomi, ako se pojave, javljaju nekoliko tjedana do mjeseci nakon infekcije, dok se simptomi kroničnog hepatitisa mogu javiti tek nakon više godina, čak i desetljeća nakon infekcije, bez obzira što osoba prije nije imala nikakvih simptoma. Najčešći su simptomi hepatitisa povišena temperatura, slabost i umor, gubitak apetita, mučnina, povraćanje, bolovi u trbuhu, taman urin, žutilo kože i sluznica, bolovi u zglobovima,a kao posljedica kroničnog hepatitisa mogu se javiti ciroza i rak jetre. Prevencija virusnih hepatitisa Savjeti za smanjenje rizika od izlaganja virusima hepatitisa Hepatitis B i C Korištenje zaštite kondomom Izbjegavanje korištenja alkohola i droga Izbjegavanje međusobnog dijeljenja igala i ostalih predmeta za osobnu upotrebu kao što su četkice za zube, grickalice za nokte ili žileti sa zaraženom osobom. DOC formatu Hepatitis A je na našim prostorima sve rjeđi, zahvaljujući boljoj higijeni.