1) Chronic hepatitis B virus infection is defined as persistent HBV infection for more than 6 months and can lead to chronic liver disease. It commonly develops in children infected before age 6 and less than 5% of adults.
2) Management involves preventing transmission, vaccinating contacts, monitoring for complications like liver cancer, and treatment with antiviral drugs like tenofovir or entecavir depending on the patient's disease stage and risk factors.
3) Patients are monitored with regular liver function and HBV DNA tests to assess treatment response and watch for flare ups, with the goal of suppressing viral replication and reducing liver damage.
Introduction to chronic Hepatitis B Infection in Malaysia, epidemiology and common treatment. Phases of chronic Hepatitis B Infection, clinical presentation and complications.
This document discusses recent advances in the diagnosis and management of hepatitis B and chronic hepatitis C. It covers the pathogenesis, diagnosis, and treatment of hepatitis B virus (HBV) infection including HBV genotypes, phases of chronic HBV infection, evaluation of HBsAg-positive patients, molecular diagnosis of HBV, screening for hepatocellular carcinoma, antiviral treatment options, and guidelines for treatment. It also discusses hepatitis C virus infection including acute and chronic hepatitis C, HCV genotypes and structures, evaluation of patients, and treatment recommendations.
1) Hepatitis B virus (HBV) infection is a global health problem affecting approximately 350-400 million people worldwide and is a leading cause of death from liver disease and cancer.
2) HBV is a DNA virus that can cause both acute and chronic infection. Chronic infection, defined as persistence of the virus for more than 6 months, puts people at risk for progressive liver disease and liver cancer.
3) Management of HBV involves antiviral therapy to suppress viral replication and prevent progression of liver disease. First line oral antiviral agents with high potency and low resistance include entecavir and tenofovir.
1) Hepatitis B virus (HBV) infection is a global health problem affecting approximately 350-400 million people worldwide and is a leading cause of death from liver disease and cancer.
2) HBV is a DNA virus that can cause both acute and chronic infection. Chronic infection, defined as persistence of the virus for more than 6 months, puts people at risk for progressive liver disease and liver cancer.
3) Management of HBV involves antiviral therapy to suppress viral replication and prevent progression of liver disease. First line oral antiviral agents with high genetic barriers to resistance like entecavir and tenofovir are recommended. Lifelong monitoring is needed due to risk of reactivation and liver cancer development
The document discusses hepatitis C virus (HCV) infection in patients with kidney disease. It covers several topics:
1) HCV is highly prevalent among patients undergoing dialysis, with rates ranging from 1.4-28.3% in developed countries and 4.7-41.9% in developing countries.
2) HCV can accelerate progression of chronic kidney disease and increase risk of end-stage renal disease. Successful treatment of HCV with antiviral therapy can improve kidney function and reduce dialysis risk.
3) Several direct-acting antiviral regimens, including paritaprevir/ritonavir/ombitasvir/dasabuvir, paritaprevir/
Chronic viral hepatitis can be caused by hepatitis B virus (HBV), hepatitis C virus (HCV), or hepatitis D virus (HDV). HBV is responsible for 60-80% of hepatocellular carcinoma worldwide. HCV infection is the most common chronic blood-borne infection and a leading cause of cirrhosis and liver cancer. HDV requires HBV coinfection and can cause a more severe form of hepatitis. Treatment for chronic HBV and HCV infection involves antiviral medications like interferons, nucleoside analogs, and nucleotide analogs to achieve viral suppression and prevent disease progression.
Hepatitis B is a viral infection that affects the liver and can be either acute or chronic. It is transmitted through bodily fluids and can cause both acute and chronic liver disease. While acute hepatitis B resolves in 95-99% of adult cases, chronic hepatitis B affects approximately 350 million people worldwide and increases the risk of cirrhosis and liver cancer. Treatment for chronic hepatitis B involves antiviral medications to suppress the virus and prevent further liver damage.
Introduction to chronic Hepatitis B Infection in Malaysia, epidemiology and common treatment. Phases of chronic Hepatitis B Infection, clinical presentation and complications.
This document discusses recent advances in the diagnosis and management of hepatitis B and chronic hepatitis C. It covers the pathogenesis, diagnosis, and treatment of hepatitis B virus (HBV) infection including HBV genotypes, phases of chronic HBV infection, evaluation of HBsAg-positive patients, molecular diagnosis of HBV, screening for hepatocellular carcinoma, antiviral treatment options, and guidelines for treatment. It also discusses hepatitis C virus infection including acute and chronic hepatitis C, HCV genotypes and structures, evaluation of patients, and treatment recommendations.
1) Hepatitis B virus (HBV) infection is a global health problem affecting approximately 350-400 million people worldwide and is a leading cause of death from liver disease and cancer.
2) HBV is a DNA virus that can cause both acute and chronic infection. Chronic infection, defined as persistence of the virus for more than 6 months, puts people at risk for progressive liver disease and liver cancer.
3) Management of HBV involves antiviral therapy to suppress viral replication and prevent progression of liver disease. First line oral antiviral agents with high potency and low resistance include entecavir and tenofovir.
1) Hepatitis B virus (HBV) infection is a global health problem affecting approximately 350-400 million people worldwide and is a leading cause of death from liver disease and cancer.
2) HBV is a DNA virus that can cause both acute and chronic infection. Chronic infection, defined as persistence of the virus for more than 6 months, puts people at risk for progressive liver disease and liver cancer.
3) Management of HBV involves antiviral therapy to suppress viral replication and prevent progression of liver disease. First line oral antiviral agents with high genetic barriers to resistance like entecavir and tenofovir are recommended. Lifelong monitoring is needed due to risk of reactivation and liver cancer development
The document discusses hepatitis C virus (HCV) infection in patients with kidney disease. It covers several topics:
1) HCV is highly prevalent among patients undergoing dialysis, with rates ranging from 1.4-28.3% in developed countries and 4.7-41.9% in developing countries.
2) HCV can accelerate progression of chronic kidney disease and increase risk of end-stage renal disease. Successful treatment of HCV with antiviral therapy can improve kidney function and reduce dialysis risk.
3) Several direct-acting antiviral regimens, including paritaprevir/ritonavir/ombitasvir/dasabuvir, paritaprevir/
Chronic viral hepatitis can be caused by hepatitis B virus (HBV), hepatitis C virus (HCV), or hepatitis D virus (HDV). HBV is responsible for 60-80% of hepatocellular carcinoma worldwide. HCV infection is the most common chronic blood-borne infection and a leading cause of cirrhosis and liver cancer. HDV requires HBV coinfection and can cause a more severe form of hepatitis. Treatment for chronic HBV and HCV infection involves antiviral medications like interferons, nucleoside analogs, and nucleotide analogs to achieve viral suppression and prevent disease progression.
Hepatitis B is a viral infection that affects the liver and can be either acute or chronic. It is transmitted through bodily fluids and can cause both acute and chronic liver disease. While acute hepatitis B resolves in 95-99% of adult cases, chronic hepatitis B affects approximately 350 million people worldwide and increases the risk of cirrhosis and liver cancer. Treatment for chronic hepatitis B involves antiviral medications to suppress the virus and prevent further liver damage.
HEPATITIS CHILDREN MANAGEMNT PROGNOSIS.pptxneeti70
The document discusses hepatitis B virus (HBV) infection. It notes that HBV infects over 350 million people worldwide and can cause both acute and chronic liver disease. Symptoms range from none to jaundice, fatigue and abdominal pain. Chronic infection is associated with cirrhosis and liver cancer. HBV is transmitted through contact with infected blood or bodily fluids. A vaccine introduced in 1982 is highly effective in preventing infection. Treatment focuses on antiviral drugs to suppress viral replication in chronic cases.
This document provides information about hepatitis C virus (HCV) including its structure, genome, genotypes, epidemiology, transmission, pathogenesis, diagnosis, and management. It discusses:
- HCV has a single-stranded RNA genome within the Flaviviridae family. It exists as different genotypes that determine treatment response.
- HCV is a major cause of liver disease worldwide, with transmission primarily through blood exposure. Diagnosis involves antibody and RNA testing.
- Treatment aims to eradicate HCV and involves pegylated interferon and ribavirin combinations. Response is monitored via viral load decline. Adverse effects require monitoring and management. New direct-acting antivirals are improving treatment outcomes.
Hepatitis is inflammation of the liver that can be caused by five primary viruses. Hepatitis A and E viruses are transmitted through the fecal-oral route while hepatitis B, C, and D viruses are transmitted parenterally or sexually. Hepatitis B, C, and D can result in chronic infection. Most cases of acute viral hepatitis resolve without treatment but hepatitis B, C, and D pose long term risks of cirrhosis and liver cancer if infection is chronic. Diagnosis involves serologic testing to detect viral antigens and antibodies. Treatment focuses on supportive care although antivirals exist for chronic hepatitis B and C. Prevention emphasizes vaccination for hepatitis A and B.
Hepatitis is inflammation of the liver that can be caused by five primary viruses. Hepatitis A and E viruses are transmitted through the fecal-oral route while hepatitis B, C, and D viruses are transmitted parenterally or sexually. Hepatitis B, C, and D can result in chronic infection. Most cases of acute viral hepatitis resolve without treatment but hepatitis B, C, and D pose long term risks of cirrhosis and liver cancer if infection is chronic. Diagnosis involves serologic testing to detect viral antigens and antibodies. Treatment focuses on supportive care although antivirals exist for chronic hepatitis B and C. Prevention emphasizes vaccination for hepatitis A and B.
This document summarizes chronic viral hepatitis caused by hepatitis B, C, and D viruses. It describes the modes of transmission, clinical manifestations, laboratory diagnosis, and morphology of each virus. Chronic hepatitis B and C can lead to cirrhosis and liver cancer over many years. Hepatitis B and D viruses can only replicate in hepatocytes infected with hepatitis B virus. Laboratory tests for hepatitis B, C, and D include detecting viral antigens, antibodies, RNA, and liver enzymes to determine infection and disease status.
The document discusses hepatitis C virus (HCV), including its structure, genome, genotypes, epidemiology, pathogenesis, diagnosis, and management. Some key points:
- HCV is a single-stranded RNA virus of the Flaviviridae family with a genome encoding both structural and nonstructural proteins.
- It exists as different genotypes globally, with genotypes 1, 2, 3 being most common. Genotype helps determine treatment duration and response.
- HCV is a major cause of liver disease worldwide and is transmitted through blood exposure. Diagnosis involves HCV antibody and RNA testing.
- Treatment aims to eradicate the virus and involves use of pegylated interferon and ribavirin
This document discusses viral hepatitis, summarizing the key points about hepatitis A-E viruses. It covers their virology, epidemiology, clinical features, pathogenesis, diagnosis and complications. The main points are:
1. Hepatitis A-E viruses are the primary causes of viral hepatitis. They produce similar illnesses but differ in modes of transmission, incubation periods and likelihood of chronic infection.
2. Hepatitis A and E are typically self-limited and do not usually lead to chronic liver disease. Hepatitis B and C have higher rates of chronic infection.
3. Acute viral hepatitis presents with non-specific symptoms but laboratory tests can identify the specific virus through detection of viral antigens or antibodies. Ful
Hepatitis" means inflammation of the liver and also refers to a group of viral infections that affect the liver .
The most common types are Hepatitis A, Hepatitis B, and Hepatitis C.
Viral hepatitis is the leading cause of liver cancer and the most common reason for liver transplantation.
An estimated 4.4 million Americans are living with chronic hepatitis; most do not know they are infected
This document summarizes the different types of viral hepatitis. It describes 5 main types (A, B, C, D, E), their causes, transmission routes, clinical features, diagnosis, prevention and treatment. Hepatitis A is typically self-limiting while Hepatitis B, C and D can lead to chronic liver disease. Hepatitis D only infects in the presence of Hepatitis B. Prevention focuses on vaccination, hygiene, and screening of blood/organs. Treatment depends on the type but may include antivirals, immunoglobulins or supportive care.
Chronic hepatitis B and C are inflammatory conditions of the liver that persist for at least 6 months. Hepatitis B and C viruses are the most common causes. Chronic hepatitis B can progress to cirrhosis or liver cancer over many years if left untreated. Treatment aims to suppress viral replication and reduce liver inflammation. For hepatitis C, the goal is to eradicate the virus using direct-acting antiviral drugs, which now cure over 99% of patients. Both conditions require long-term management to prevent progressive liver disease.
Hepatitis is inflammation of the liver that can be caused by viruses, drugs/alcohol, or other factors. The main types are viral hepatitis A, B, C, D, and E. Hepatitis A and E are usually acute while B, C, and D often become chronic. Hepatitis B, C, and D are transmitted through blood or bodily fluids while A and E are usually food or water-borne. Symptoms include fatigue, jaundice, abdominal pain and liver enzyme abnormalities. Diagnosis involves blood tests detecting antibodies or viral RNA. Treatment focuses on relieving symptoms, antiviral medication, and liver transplantation in severe cases.
1. Hepatitis B virus (HBV) is a serious disease that can cause lifelong infection, liver cirrhosis, liver cancer, liver failure, and death. It is 100 times more infectious than HIV.
2. HBV is transmitted through contact with infectious blood or body fluids and can lead to either an acute or chronic infection. Chronic infections may progress to complications like cirrhosis or liver cancer.
3. Treatment options for chronic HBV infection include nucleoside/nucleotide analogues like entecavir and tenofovir, as well as interferon-alpha. Vaccination and immunoglobulin can prevent HBV infection in high-risk groups or following exposure.
Hepatitis B and D viruses can cause both acute and chronic liver infections. Hepatitis D virus requires Hepatitis B virus to replicate and is transmitted through contact with infected blood or bodily fluids. Coinfection or superinfection with Hepatitis B and D viruses can lead to severe liver disease and even fulminant hepatic failure. While no treatment directly eliminates Hepatitis D virus, interferon alpha may improve disease conditions in some patients.
- The patient is a 29-year-old Cambodian woman in her first trimester of pregnancy who was found to have chronic hepatitis B virus (HBV) infection. Her liver tests are normal. She is HBsAg+, HBeAg+ with an HBV DNA level of 50,000 IU/ml.
- It is recommended that the patient receive antiviral therapy during pregnancy to reduce the risk of mother-to-child transmission of HBV. Close monitoring of the infant after delivery for prophylaxis is also advised. Counseling on lifestyle modifications and vaccination of household members should be provided.
Aasld guidelines for diagnosis & treatment of chronic hepatitis bsreejith246
- The AASLD guidelines provide recommendations for the diagnosis and treatment of chronic hepatitis B in adults and children. They analyzed literature using a GRADE approach to determine the quality of evidence and strength of recommendations.
- The guidelines address whom to treat, how long to treat, preferred antiviral regimens, management of treatment failure or resistance, and special populations like pregnancy and cirrhosis. Key recommendations include treating immune active CHB with antivirals and considering indefinite treatment for HBeAg-negative or cirrhotic patients.
Hepatitis C is caused by the hepatitis C virus (HCV), which is a single-stranded RNA virus from the Flaviviridae family. It is transmitted through blood and bodily fluids. HCV replicates within liver cells and evades the immune system, leading to persistent infection in some cases. Symptoms are often mild or absent. Diagnosis involves testing for HCV antibodies or RNA. Treatment involves direct-acting antiviral drugs, which have high cure rates. Special populations like those with HIV/HCV coinfection, kidney disease, or other liver diseases may require modified treatment approaches.
This document discusses hepatitis and its complications. It defines hepatitis as inflammation of the liver and classifies it as either acute or chronic based on duration and viral, drug-induced, autoimmune, or other etiologies. Clinical features of acute and chronic hepatitis are described. Specific viral causes like hepatitis A, B, C, and D are explained in detail including transmission, presentation, diagnosis, and treatment. Other causes of hepatitis like drugs, alcohol, and autoimmune hepatitis are also outlined. Complications of chronic liver disease like cirrhosis and portal hypertension are defined and their clinical features and management described.
This document provides information about hepatitis including its definition, causes, pathology, epidemiology, clinical manifestations, laboratory/imaging studies, treatment, complications, prognosis, and prevention. It defines acute and chronic hepatitis. It describes the most common viral causes of hepatitis as HAV, HBV, HCV, HDV, and HEV. It discusses the clinical picture and typical course of viral hepatitis and laboratory findings. It covers hepatitis diagnosis and markers for HAV, HBV, and HCV. It addresses treatment approaches and vaccination for hepatitis B prevention. It also discusses fulminant hepatic failure as a rare but severe complication of acute hepatitis.
HEPATITIS CHILDREN MANAGEMNT PROGNOSIS.pptxneeti70
The document discusses hepatitis B virus (HBV) infection. It notes that HBV infects over 350 million people worldwide and can cause both acute and chronic liver disease. Symptoms range from none to jaundice, fatigue and abdominal pain. Chronic infection is associated with cirrhosis and liver cancer. HBV is transmitted through contact with infected blood or bodily fluids. A vaccine introduced in 1982 is highly effective in preventing infection. Treatment focuses on antiviral drugs to suppress viral replication in chronic cases.
This document provides information about hepatitis C virus (HCV) including its structure, genome, genotypes, epidemiology, transmission, pathogenesis, diagnosis, and management. It discusses:
- HCV has a single-stranded RNA genome within the Flaviviridae family. It exists as different genotypes that determine treatment response.
- HCV is a major cause of liver disease worldwide, with transmission primarily through blood exposure. Diagnosis involves antibody and RNA testing.
- Treatment aims to eradicate HCV and involves pegylated interferon and ribavirin combinations. Response is monitored via viral load decline. Adverse effects require monitoring and management. New direct-acting antivirals are improving treatment outcomes.
Hepatitis is inflammation of the liver that can be caused by five primary viruses. Hepatitis A and E viruses are transmitted through the fecal-oral route while hepatitis B, C, and D viruses are transmitted parenterally or sexually. Hepatitis B, C, and D can result in chronic infection. Most cases of acute viral hepatitis resolve without treatment but hepatitis B, C, and D pose long term risks of cirrhosis and liver cancer if infection is chronic. Diagnosis involves serologic testing to detect viral antigens and antibodies. Treatment focuses on supportive care although antivirals exist for chronic hepatitis B and C. Prevention emphasizes vaccination for hepatitis A and B.
Hepatitis is inflammation of the liver that can be caused by five primary viruses. Hepatitis A and E viruses are transmitted through the fecal-oral route while hepatitis B, C, and D viruses are transmitted parenterally or sexually. Hepatitis B, C, and D can result in chronic infection. Most cases of acute viral hepatitis resolve without treatment but hepatitis B, C, and D pose long term risks of cirrhosis and liver cancer if infection is chronic. Diagnosis involves serologic testing to detect viral antigens and antibodies. Treatment focuses on supportive care although antivirals exist for chronic hepatitis B and C. Prevention emphasizes vaccination for hepatitis A and B.
This document summarizes chronic viral hepatitis caused by hepatitis B, C, and D viruses. It describes the modes of transmission, clinical manifestations, laboratory diagnosis, and morphology of each virus. Chronic hepatitis B and C can lead to cirrhosis and liver cancer over many years. Hepatitis B and D viruses can only replicate in hepatocytes infected with hepatitis B virus. Laboratory tests for hepatitis B, C, and D include detecting viral antigens, antibodies, RNA, and liver enzymes to determine infection and disease status.
The document discusses hepatitis C virus (HCV), including its structure, genome, genotypes, epidemiology, pathogenesis, diagnosis, and management. Some key points:
- HCV is a single-stranded RNA virus of the Flaviviridae family with a genome encoding both structural and nonstructural proteins.
- It exists as different genotypes globally, with genotypes 1, 2, 3 being most common. Genotype helps determine treatment duration and response.
- HCV is a major cause of liver disease worldwide and is transmitted through blood exposure. Diagnosis involves HCV antibody and RNA testing.
- Treatment aims to eradicate the virus and involves use of pegylated interferon and ribavirin
This document discusses viral hepatitis, summarizing the key points about hepatitis A-E viruses. It covers their virology, epidemiology, clinical features, pathogenesis, diagnosis and complications. The main points are:
1. Hepatitis A-E viruses are the primary causes of viral hepatitis. They produce similar illnesses but differ in modes of transmission, incubation periods and likelihood of chronic infection.
2. Hepatitis A and E are typically self-limited and do not usually lead to chronic liver disease. Hepatitis B and C have higher rates of chronic infection.
3. Acute viral hepatitis presents with non-specific symptoms but laboratory tests can identify the specific virus through detection of viral antigens or antibodies. Ful
Hepatitis" means inflammation of the liver and also refers to a group of viral infections that affect the liver .
The most common types are Hepatitis A, Hepatitis B, and Hepatitis C.
Viral hepatitis is the leading cause of liver cancer and the most common reason for liver transplantation.
An estimated 4.4 million Americans are living with chronic hepatitis; most do not know they are infected
This document summarizes the different types of viral hepatitis. It describes 5 main types (A, B, C, D, E), their causes, transmission routes, clinical features, diagnosis, prevention and treatment. Hepatitis A is typically self-limiting while Hepatitis B, C and D can lead to chronic liver disease. Hepatitis D only infects in the presence of Hepatitis B. Prevention focuses on vaccination, hygiene, and screening of blood/organs. Treatment depends on the type but may include antivirals, immunoglobulins or supportive care.
Chronic hepatitis B and C are inflammatory conditions of the liver that persist for at least 6 months. Hepatitis B and C viruses are the most common causes. Chronic hepatitis B can progress to cirrhosis or liver cancer over many years if left untreated. Treatment aims to suppress viral replication and reduce liver inflammation. For hepatitis C, the goal is to eradicate the virus using direct-acting antiviral drugs, which now cure over 99% of patients. Both conditions require long-term management to prevent progressive liver disease.
Hepatitis is inflammation of the liver that can be caused by viruses, drugs/alcohol, or other factors. The main types are viral hepatitis A, B, C, D, and E. Hepatitis A and E are usually acute while B, C, and D often become chronic. Hepatitis B, C, and D are transmitted through blood or bodily fluids while A and E are usually food or water-borne. Symptoms include fatigue, jaundice, abdominal pain and liver enzyme abnormalities. Diagnosis involves blood tests detecting antibodies or viral RNA. Treatment focuses on relieving symptoms, antiviral medication, and liver transplantation in severe cases.
1. Hepatitis B virus (HBV) is a serious disease that can cause lifelong infection, liver cirrhosis, liver cancer, liver failure, and death. It is 100 times more infectious than HIV.
2. HBV is transmitted through contact with infectious blood or body fluids and can lead to either an acute or chronic infection. Chronic infections may progress to complications like cirrhosis or liver cancer.
3. Treatment options for chronic HBV infection include nucleoside/nucleotide analogues like entecavir and tenofovir, as well as interferon-alpha. Vaccination and immunoglobulin can prevent HBV infection in high-risk groups or following exposure.
Hepatitis B and D viruses can cause both acute and chronic liver infections. Hepatitis D virus requires Hepatitis B virus to replicate and is transmitted through contact with infected blood or bodily fluids. Coinfection or superinfection with Hepatitis B and D viruses can lead to severe liver disease and even fulminant hepatic failure. While no treatment directly eliminates Hepatitis D virus, interferon alpha may improve disease conditions in some patients.
- The patient is a 29-year-old Cambodian woman in her first trimester of pregnancy who was found to have chronic hepatitis B virus (HBV) infection. Her liver tests are normal. She is HBsAg+, HBeAg+ with an HBV DNA level of 50,000 IU/ml.
- It is recommended that the patient receive antiviral therapy during pregnancy to reduce the risk of mother-to-child transmission of HBV. Close monitoring of the infant after delivery for prophylaxis is also advised. Counseling on lifestyle modifications and vaccination of household members should be provided.
Aasld guidelines for diagnosis & treatment of chronic hepatitis bsreejith246
- The AASLD guidelines provide recommendations for the diagnosis and treatment of chronic hepatitis B in adults and children. They analyzed literature using a GRADE approach to determine the quality of evidence and strength of recommendations.
- The guidelines address whom to treat, how long to treat, preferred antiviral regimens, management of treatment failure or resistance, and special populations like pregnancy and cirrhosis. Key recommendations include treating immune active CHB with antivirals and considering indefinite treatment for HBeAg-negative or cirrhotic patients.
Hepatitis C is caused by the hepatitis C virus (HCV), which is a single-stranded RNA virus from the Flaviviridae family. It is transmitted through blood and bodily fluids. HCV replicates within liver cells and evades the immune system, leading to persistent infection in some cases. Symptoms are often mild or absent. Diagnosis involves testing for HCV antibodies or RNA. Treatment involves direct-acting antiviral drugs, which have high cure rates. Special populations like those with HIV/HCV coinfection, kidney disease, or other liver diseases may require modified treatment approaches.
This document discusses hepatitis and its complications. It defines hepatitis as inflammation of the liver and classifies it as either acute or chronic based on duration and viral, drug-induced, autoimmune, or other etiologies. Clinical features of acute and chronic hepatitis are described. Specific viral causes like hepatitis A, B, C, and D are explained in detail including transmission, presentation, diagnosis, and treatment. Other causes of hepatitis like drugs, alcohol, and autoimmune hepatitis are also outlined. Complications of chronic liver disease like cirrhosis and portal hypertension are defined and their clinical features and management described.
This document provides information about hepatitis including its definition, causes, pathology, epidemiology, clinical manifestations, laboratory/imaging studies, treatment, complications, prognosis, and prevention. It defines acute and chronic hepatitis. It describes the most common viral causes of hepatitis as HAV, HBV, HCV, HDV, and HEV. It discusses the clinical picture and typical course of viral hepatitis and laboratory findings. It covers hepatitis diagnosis and markers for HAV, HBV, and HCV. It addresses treatment approaches and vaccination for hepatitis B prevention. It also discusses fulminant hepatic failure as a rare but severe complication of acute hepatitis.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Our backs are like superheroes, holding us up and helping us move around. But sometimes, even superheroes can get hurt. That’s where slip discs come in.
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share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
2. Introductio
n
•
• Human hepatitis B virus belongs to the family of Hepadnaviridaeof small,
enveloped,
Chronic hepatitis B virus infection is when the patient is HBsAg seropositive for more
than 6
Chronic infection may develop in nearly half of children infected with HBV before the age of
6 years and in <5% of individuals infected as adults
The virus replicates in the host and assembles exclusively in the hepatocytes and virionsare
released non-cytopathicallythrough the cellular secretory pathway
month
s
–
primarily hepatotropicDNA
viruses
–
Chronic hepatitis B is defined as chronic necro-inflammatory liver disease due to persistent hepatitis B virus
infection
3. Signs and
Symptoms
•
•
The majority of acute viral hepatitis infections are
asymptomaticor they can cause an anicteric illness that
may not be diagnosed as hepatitis
Symptomatic hepatitis B will depend on the mode and
time of transmission
– Vertical transmission from mother to child is
almost always asymptomatic; other routes of
transmission are more likely to produce
symptomatic disease (30% of cases transmitted
4. 1) PreictericPhase
Nonspecificsystemic symptoms (egmyalgia, nausea, vomiting, fatigue, malaise with
discomfort in the right upper quadrant of the abdomen)
•Altered sense of smell or taste, coryza, photophobia, headache, cough, diarrhea, dark
urine
and serum sickness-like syndrome
•Hepatomegaly, splenomegaly and lymphadenopathy may be seen on physical exam
2) Icteric Phase
Jaundice, usually noted after onset of fever or upon lysisof fever
Development of symptoms of hepatic encephalopathy (egconfusion, drowsiness within 8
weeks of symptoms or within 2 weeks of onset of jaundice)
•Hypoglycemia, prolonged prothrombintime (PT)
3) Fulminant
Hepatitis
5. Histor
y
Important points in the clinical history of patients with suspected viral
hepatitis
•Contacts with jaundiced patients
•IV drug use
•History of blood transfusion
•Surgery or hospitalizations
•Family history of chronic liver disease
• Occupation
•Food and water sources
•Alcohol use
6. Serological
Tests
•
•
•
•
–
Anti-HBc(anti-core antibody) is the 1st antibody to appear in the serum and is a marker of
natural
immunity
Usually characterized by the presence of hepatitis B surface antigen (HBsAg) which suggests
infectivity
HBV DNA tests for HBV replication and aids in the evaluation of treatment efficacy with
antiviral agents New biomarkers of HBV infection are:
–
–
–
–
Anti-HBs is produced following a resolved infection and is the only hepatitis B virus (HBV) antibody marker
present after immunization
This may be negative at the time that the patient is evaluated for acute hepatitis B since viral replication may
have already ceased
Its presence indicates an immune response against HBV within liver cells and is a specific marker of acute
hepatitis B infection Presence of anti-HBcIgMis diagnostic for acute HBV infection but may occur during a flare of
chronic hepatitis B
Viral covalently closed circular DNA (cccDNA) -shown to persist in the liver of infected patients even after long-term
nucleotide analogue therapy and even after HBsAgloss and seroconversion; used in clinical trials evaluating treatment
concepts to cure HBV infection
–Hepatitis B core-related antigen (HBcrAG) -helpful in defining the phase of chronic HBV infection especially in the HBe-
negative
patients as well as predicting the long-term HCC risk
–Circulating HBV RNA
Persistence of HBsAgfor at least 6 months indicate chronic
infection
• Hepatitis B e antigen (HBeAg) is a marker of active viral
replication
7.
8. •
•
•
–
Prothrombintime (PT), international normalized ratio (INR), renal
function
tests
Noninvasivetests such as the aminotransferase/platelet ratio index
(APRI)
or fibrosis-4 (FIB-4)may be used to assess the degree of hepatic
fibrosis
Other lab tests that are recommended in patients suspected to have
viral hepatitis:
Liver function tests (LFTs)
– Aspartate aminotransferase (AST) and alanine
aminotransferase (ALT)
–
Serum bilirubin, alkaline phosphatase
(ALP)
Transient elastographymay be an option for patients with
contraindications to liver biopsy
•
9. Evaluatio
n
If patient meets criteria for chronic hepatitis B:
Liver biopsy must be done:
•to grade stage of liver diseaseas chronic
hepatitis
B may evolve to cirrhosis and hepatocellular
cancer
•Liver biopsy is essential in determining disease
activityin cases of inconclusive biochemical and
HBV markers
10. Phases of Chronic
Hepatitis B
1) HBeAg-positive Chronic HBV Infection (Immune-tolerant)
•Presence of serum HBeAg
•Very high levels of HBV DNA
•ALT persistently within the normal range (<19 U/L for females and <30 U/L in males) or minimally elevated
•Minimal or no liver necroinflammationor fibrosis
•Frequently occurred and prolonged in patients infected perinatallyand is associated with preserved HBV
specific T
cell function at least until young adulthood
•Patients at this stage are highly contagious because of the high levels of HBV DNA
2) HBeAg-positive Chronic Hepatitis B (Immune-clearanceHBeAg-positive)
•Presence of serum HBeAg
•High levels of HBV DNA
•Elevated ALT
•Moderate to severe liver necroinflammationand accelerated progression of fibrosis
•Usually occurs in patients infected during adulthood
•Patients may have HBeAgseroconversionand HBV DNA suppression that progress to HBeAg-negative
11. Absence of serum HBeAgusually with detectable anti-HBe
Persistent or fluctuating moderate to high levels of serum
HBV DNA Fluctuating or persistently elevated ALT
There is liver necroinflammationand fibrosis
3) HBeAg-negative Chronic HBV Infection (Inactive Carrier/Immune Control)
•Absence of serum HBeAg
•Undetectable or low (<2,000 IU/mL) HBV DNA levels
•Normal ALT
•Minimal liver necroinflammationand variable fibrosis as a result of previous hepatic injury during the
HBeAg-
positive immune-active phase
•Low risk of progressing to cirrhosis or HCC but progression to chronic hepatitis B may occur
5) HBsAg-negative (Occult HBV Infection)
•Serum negative HBsAgand positive antibodies to HBcAgwith or without detectable antibodies to HBsAg
•Normal ALT
•Usually, but not always, undetectable serum HBV DNA
•Liver has frequently detectable HBV DNA (cccDNA)
•Several studies have shown that almost all patients with occult HBV infection have normal liver
biochemistry and
minimal or no liver necroinflammationand fibrosis
•However, it may still be associated with the development of liver cirrhosis and HCC
•
•
•
•
• Associated with low rates of spontaneous disease
remission
4) HBeAg-negative Chronic Hepatitis B (HBeAg-negative Immune
Reactivation/Escape)
15. General
management
1) Serologic screening of chronic Hepatitis B virus infection amongst patient’s family
members
2) Prevention of transmission of Hepatitis B virus to others :
-Ensure that their sexual partners are vaccinated
-No sharing of toothbrushes and razors
-Cover open wounds
-No donation of body parts
-Clean blood spills with bleach/detergents
Note: Hepatitis B virus transmission is nottransmissible through:
• Sharing of utensils, food or kissing as part of social greetings
• Participating in all activities including contact sports
• Social interaction with others (e.g. in schools, day care centres)
3) Prevention of super-infection -Unless contraindicated, hepatitis A vaccination should be
given to
prevent superimposed acute hepatitis A in patients with chronic hepatitis B virus infection.
16. Specific
management
Management of patients with chronic hepatitis B should be tailored according to the patients’ clinical
state of liver disease(compensated versus decompensated liver disease) as well as their virologicand
biochemical (i.e. the liver function test, in particular the serum transaminase levels) status.
17.
18.
19.
20.
21. Selection of antiviral drug for CHB:
• In all adults, adolescents and children aged 12 years or older in whom antiviral therapy is indicated, the
NAs which have a high barrier to drug resistance (tenofovir or entecavir) are recommended.
• In woman of childbearing age Tenofovir may be preferred as the drug of choice in the eventuality of a
pregnancy. Entecavir is not recommended in pregnancy.
• Tenofovir is preferred in patients who have been exposed to lamivudine who have a potential for
Entecavir resistance.
• Entecavir is recommended in children aged 2–11 years.
• Entecavir may be preferred over Tenofovir in:
• Age > 60 years; bone disease due to chronic steroid use or use of other medications that worsen bone
density,
• history of fragility fracture, osteoporosis; altered renal function with eGFR < 60 mL/min/1.73 m2 or
albuminuria
• > 30 mg/ 24 hr or moderate dipstick proteinuria or Low phosphate (<2.5 mg/dL) or in patient on
hemodialysis
22.
23. Monitorin
g
•
•
Monitor patient to ensure that fulminant liver failure
does not develop
Monitor liver function tests (LFT) every 1-4 weeks until
normal; ALT every 3-6 months if patient did not meet
criteria for treatment
Further monitoring of HBV DNA every 3-6 months in
non- responders is recommended to recognize
delayed response and to plan retreatment if required
Monitor for hepatocellular carcinomain high-risk
patients
every 6-12 months using ultrasound and alpha-
fetoprotein
•
•