PRESENTATED BY ROLL NO:11-15 BN 1ST YEAR

OBJECTIVES
Introduction
Incidence Risk factors

Clinical features
Treatment Management Complication Prevention

INTRODUCTION
Infectious disease affecting the liver,
caused by the hepatitis c virus, i.e. HCV. HCV is RNA

virus primarily transmitted percutaneously.

INCIDENCE
180 million people have chronic hepatitis C worldwide

Around 300,000 new acute infection and 8000 10000 death occur each year.
Of persons infected with hepatitis C
85% will remain infected for life; of those:

60 - 70% will develop chronic liver disease 10 20% will develop cirrhosis (scarring of the liver) 1 5% will develop liver cancer

RISK FACTORS
1. Direct percutaneous exposure such as: Injecting drugs Transfusion of blood products Haemodialysis Tattooing High risk sexual behavior Organ transplantation Exposure to blood and blood products by health workers. 2. Less frequent routes are sexual and prenatal.

MODES OF TRANSMISSION
Mainly transmitted through transfusion of

contaminated blood or body fluids. Upto 50% cases are related to IV drug users sharing needles.

INCUBATION PERIOD
6-7 weeks

Clinical manifestation
Preicteric or prodramal phase: Anorexia Nausea & vomiting Fever Right upper quadrant discomfort Constipation or diarrheoa Decrease sense of taste Hepatomegaly Splenomegaly Weight loss

Contd..
Icteric phase Jaundice Purities Dark urine Bilirubinuria White stool Fatigue Continual Hepatomegaly with tenderness Weight loss

Contd
Post icteric phase Malaise Easy fatigable Hepatomegaly

COMPLICATIONS
Cirrhosis of liver
Liver cancer Liver failure

Diagnostic studies
Liver function studies
Hepatitis serology Anti HCV

Liver biopsy if HCV positive

CT/ MRI to make sure of cancer

MANAGEMENT
Rest Benificial for healing and liver cell regeneration Induce metabolic demand on the liver and promotes cell generation Degree of rest depends upon severity of symptoms. Diet Well balanced diet that pt can tolerate Low fat & high carbohydrate diet Restrict protein & sodium Avoid alcohool

Contd..
Hospitalization If billirubin level 10mg/dl or more Medical management symptomatically Vitamin K for prolonged prothombin time Antihistamine for pruritis associated jaundice Antiemetics for nausea Unnecessary medicine including sedatives should be discontinue Coagulation defects may be treated with administration of fresh frozen plasma.

Contd
Fluid and electrolyte balance Monitor intake/output Intravenous fluid continuously Electrolytes administered in vomitting & diarrhoea.

PREVENTIVE MEASURES
Proper hand washing by patient and staffs. Wearing gloves, gowns, goggles & mask when

splattering of blood & body fluids is likely. Proper cleaning, bagging and labeling of contaminated equipments & linens. Proper disposing of needles or any items exposed to the patients blood or body fluids. Teaching patients to avoid sexual contact until results of liver function tests have returned to normal. Avoid alcohol

REFERENCES
Medical Surgical Nursing
Essentials of Community Health Nursing , K Park Sarojs Applied Epidemiology in Nepalese context

Current Medical Diagnosis & Treatment

Internet sources

THANK YOU