HEPATITIS B

• Hepatitis B is a viral infection that attacks the liver and can cause both acute and
chronic disease.
• The virus is most commonly transmitted from mother to child during birth and
delivery, as well as through contact with blood or other body fluids.
• Hepatitis B is a potentially life-threatening liver infection caused by the hepatitis
B virus (HBV). It is a major global health problem. It can cause chronic infection
and puts people at high risk of death from cirrhosis and liver cancer.
• A safe and effective vaccine that offers a 98-100% protection against hepatitis B is
available. Preventing hepatitis B infection averts the development of
complications including the development of chronic disease and liver cancer.
ETIOLOGIC AGENT

• The etiological agent of hepatitis B infection, formerly known

as SERUM HEPATITIS is the HEPATITIS B VIRUS, which
is a Hepadnavirus that attacks the liver causing inflammation
of the livers
RISK FACTORS

Hepatitis B spreads through contact with blood, semen or other body fluids from an
infected person. Your risk of hepatitis B infection increases if you:
• Have unprotected sex with multiple sex partners or with someone who's
infected with HBV
• Share needles during IV drug use
• Are a man who has sex with other men
• Live with someone who has a chronic HBV infection
• Are an infant born to an infected mother
• Have a job that exposes you to human blood
• Travel to regions with high infection rates of HBV, such as Asia, the Pacific
Islands, Africa and Eastern Europe
PATHOPHYSIOLOGY OF HEP B
• The hepatitis B virus is constructed of an outer capsule containing HBsAg
(hepatitis B surface antigen), an inner core containing HBcAg (HBV core
antigen), and the HBeAg (hepatitis Be- antigen).As the blood becomes
exposed to HBV, the body mounts a cell-mediated immune response by
sending cytotoxic T cells and natural killer cells to the virus and release
inflammatory cytokines. The greater the immune response, the greater the
chance of fighting the virus.As the hepatocytes are attacked and infiltrated
by the HBV, they appear to have a “ground glass” look under histological
exam due to the HBsAg infiltrating the cell’s cytoplasm – this is a
differentiator for HBV versus other forms of hepatitis.Because hepatocytes
are continually proliferating, the virus is constantly being shed into the
blood which contributes to chronic infection.
 SIGNS AND SYMPTOMS
• Signs and symptoms of hepatitis B range from mild to severe. They usually appear
about one to four months after you've been infected, although you could see them as
early as two weeks post-infection. Some people, usually young children, may not have
any symptoms.
Hepatitis B signs and symptoms may include:
– Abdominal pain
– Dark urine
– Fever
– Joint pain
– Loss of appetite
– Nausea and vomiting
– Weakness and fatigue
– Yellowing of your skin and the whites of your eyes (jaundice)
INTERVENTION
• Teach the client to: Wash your hands after going to the bathroom
and before handling food or eating.
• Use latex condoms, which may lower the risk of transmission.
• Don’t share drug needles.
• Don’t share personal items such as toothbrushes, razors and nail
clippers with an infected person.
• Bed rest, refraining from alcohol, and taking medication to relieve
symptoms.
• Hepatitis B is treated with drugs, such as lamivudine and adefovir
dipivoxil.Liver transplant of hepatitis B or C, or D-caused liver
failure
Treatment for chronic hepatitis B infectionMost people diagnosed with chronic hepatitis B
infection need treatment for the rest of their lives. Treatment helps reduce the risk of liver
disease and prevents you from passing the infection to others. Treatment for chronic
hepatitis B may include:
• Antiviral medications. Several antiviral medications — including entecavir (Baraclude),
adefovir (Hepsera) and telbivudine (Tyzeka) — can help fight the virus and slow its ability
to damage your liver. These drugs are taken by mouth. Talk to your doctor about which
medication might be right for you.
• Interferon injections. Interferon alfa-2b (Intron A) is a man-made version of a substance
produced by the body to fight infection. It's used mainly for young people with hepatitis B
who wish to avoid long-term treatment or women who might want to get pregnant within a
few years, after completing a finite course of therapy. Interferon should not be used
during pregnancy. Side effects may include nausea, vomiting, difficulty breathing and
depression.
• Liver transplant. If your liver has been severely damaged, a liver transplant may be an
option. During a liver transplant, the surgeon removes your damaged liver and replaces it
with a healthy liver. Most transplanted livers come from deceased donors, though a small
number come from living donors who donate a portion of their livers.
COMPLICATIONS
Having a chronic HBV infection can lead to serious complications, such
as:
• Scarring of the liver (cirrhosis). The inflammation associated with a
hepatitis B infection can lead to extensive liver scarring (cirrhosis),
which may impair the liver's ability to function.
• Liver cancer. People with chronic hepatitis B infection have an
increased risk of liver cancer.
• Liver failure. Acute liver failure is a condition in which the vital
functions of the liver shut down. When that occurs, a liver transplant is
necessary to sustain life.
• Other conditions. People with chronic hepatitis B may develop kidney
disease or inflammation of blood vessels.