021616Detels_Hepatitis - Hepatitis Primary causes of chronic liver disease Hepatitis(Liver-Attacking Viruses Hepatitis A fecal\/oral contaminated food

021616Detels_Hepatitis - Hepatitis Primary causes of...

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Hepatitis
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Primary causes of chronic liver disease
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Hepatitis (Liver-Attacking) Viruses Hepatitis A* – fecal/oral, contaminated food, vaccine available Hepatitis B – blood, semen, vertical (mother-child), vaccine available Hepatitis C – blood (IV drug use, transfusion, organ donation, unsterile injecting equipment, sexual intercourse) Hepatitis D – survives only in cells co-infected with hepatitis B Hepatitis E * – contaminated food or water, fecal/oral *causes short-term disease and is not a chronic carrier state
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Viral Hepatitis When they occur, the signs and symptoms of viral hepatitis can include: – Fever – Fatigue – Loss of appetite – Nausea – Vomiting – Abdominal pain – Jaundice – Dark urine – Clay-colored stool – Joint pain
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Viral Hepatitis
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Viral Hepatitis Viral hepatitis is the leading cause of liver cancer and the most common reason for liver transplantation In the United States, an estimated 1.2 million Americans are living with chronic Hepatitis B and 3.2 are living with chronic Hepatitis C – Many do not know they are infected Each year an estimated 21,000 persons become infected with Hepatitis A; 35,000 with Hepatitis B, and 17,000 with Hepatitis C
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Hepatitis A
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Hepatitis A Epidemiology
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Hepatitis A Epidemiology Prevalence of antibody to hepatitis A virus, 2010 Source: CDC YellowBook
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Hepatitis A Hepatitis A has an incubation period of approximately 28 days (range: 15–50 days) HAV replicates in the liver and is shed in high concentrations in feces from 2 weeks before to 1 week after the onset of clinical illness HAV infection produces a self-limited disease that does not result in chronic infection or chronic liver disease Humans are the only natural host
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Hepatitis A Features Incubation period: 28-30 days Symptoms: None (especially children <5 years old) Fever Malaise Anorexia Nausea Jaundice Fulminant death (acute) Likelihood of clinical disease increases with age Duration: 25-30 days
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Hepatitis A Acute Illness In children aged <6 years, 70% of infections are asymptomatic; if illness does occur, it is typically not accompanied by jaundice. Among older children and adults, infection is typically symptomatic, with jaundice occurring in >70% of patients. Symptoms usually last less than 2 months, although 10%–15% of symptomatic persons have prolonged or relapsing disease for up to 6 months.
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Diagnosis : Anti-IgM detectable 5-10 days before symptoms; disappears by six months Anti-IgG – convalescent, life-long, confers protection Treatment : Supportive Diagnosis, Treatment & Reservoir of Hepatitis A
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Hepatitis A Diagnosis
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Transmission & Risk Groups for Hepatitis A Transmission : fecal-oral, contaminated food, water, sexual Risk groups : international travellers, MSM, child care-givers, persons with chronic liver disease, injection drug users Period of communicability : 1-2 weeks before symptoms, to one week after onset of jaundice Endemic areas : Central & South America, Middle East, Asia, and western Pacific Reservoir : Humans
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