INTRODUCTION Hepatitis is a disease of the liver which can be caused by viruses, bacteria, protozoa, toxic chemicals, drugs and

alcohol. There several types of viral hepatitis namely: Hepatitis A, B, non A and non B, ( C ) and D (delta), C, E. Hepatitis B, is a sexually transmitted disease is considered to be he most serious due to the possibility of severe complications such as massive liver damage and hepatocarcinoma of the liver. Hepatitis B Overview Hepatitis B is an infectious hepatitis caused by the hepatitis B virus (HBV). This infection has two possible phases; 1) acute and 2) chronic. 1. Acute hepatitis B refers to newly acquired infections. Affected individuals notice symptoms approximately 1 to 4 months after exposure to the virus. In most people with acute hepatitis, symptoms resolve over weeks to months and they are cured of the infection. However, a small number of people develop a very severe, life-threatening form of acute hepatitis called fulminant hepatitis. 2. Chronic hepatitis B is an infection with HBV that lasts longer than 6 months. Once the infection becomes chronic, it may never go away completely. Common symptoms of hepatitis B include: Loss of appetite Easy of fatigability Malaise- a generalized feeling of discomfort, illness, or lack of well-being that can be associated with a disease state. It can be accompanied by a sensation of exhaustion or inadequate energy to accomplish usual activities." Joint and muscle pain ( similar to influenza ) Low grade fever- mild elevation of the temperature above normal. Nausea and vomiting Right-sided abdominal pain- Pain over the location of the liver (on the right side of the abdomen, under the lower rib cage) Jaundice ( yellowish discoloration of skin and sclera ) Dark-colored urine- ( the color of cola or tea ) Pale-colored stools (grayish or clay colored)

Hepatitis B Transmission and Causes The hepatitis B virus is known as a blood-borne virus because it is transmitted from one person to another via blood or fluids contaminated with blood. Another important route of transmission is from an infected mother to a newborn child, which occurs during or shortly after birth.

a. From person to person through: Direct contract with blood may occur through the use of dirty needles during illicit drug use, inadvertent needle sticks experienced by healthcare workers, or contact with blood through other means. Semen, which contain small amounts of blood, and saliva that is contaminated with blood also carry the virus. The virus may be transmitted when these fluids come in contact with broken skin or a mucous membrane (in the mouth, genital organs, or rectum) of an uninfected person. Sexual contact via the vaginal and seminal secretions You cannot get hepatitis B from the following activities: Having someone sneeze or cough on you Hugging someone Handshaking a persons hand Breastfeeding your child Eating food or drinking water Casual contact (such as an office or social setting) b. Parental transmission through: Blood and blood product- transfusion of blood from carriers and non carriers. Use of contaminated instruments for injection, ear piercing, acupuncture and tattooing. Use of contaminated hospital and laboratory equipment such as dialysis apparatus and others. c. Perinatal Transmission This can occur during labor and delivery through leaks across the placenta and can be precipitated by injury during delivery. It may also occur through exposure of the infant to maternal secretions in the birth canal. High Risk Groups to Hepatitis B infection Newborns, infants and children of infected mothers Children in localities where the occurrence of Hepatitis B cases is high. Sexual and household contacts of acute cases and carriers Health workers exposed to handling blood/blood products as doctors, Dentists, nurses, medical technologies, technicians, attendants and others. Persons requiring/undergoing frequent blood/plasma transfusion such as hemophiliacs- rare hereditary (inherited) bleeding disorder in which blood cannot clot normally at the site of a wound or injury. The disorder occurs because certain blood clotting factors are missing or do not work properly. This can cause extended bleeding from a cut or wound. Spontaneous

internal bleeding can occur as well, especially in the joints and muscles. Hemophilia affects males much more often than females. Sexually promiscuous individuals as active heterosexuals and homosexuals. Commercial sex workers ( hospitality girls ) Drug addicts using intravenous drugs

Preventive measures Immunization with Hepatitis B vaccine especially among infants and high groups with negative HB sag test. Wear protected clothing as gowns, gloves, eye cover, when dealing with blood semen, vaginal fluids and secretions. Wash hands and other skin areas immediately and thoroughly after contact with these fluids and after removing gloves and gowns. Avoid injury with sharp instrument as needles, scalpel, blades, etc. Use disposable needles and syringes only once and discard properly or sterilize non-disposable needles and syringes before and after use. Sterilize instrument used for circumcision, ear holing, tattooing, acupuncture and those used for minor surgical-dental procedures. Avoid sharing of toothbrush, razors and other instruments that can become contaminated with blood. Observe safe sex practices such as:

Have sex with only one faithful partner/spouse. Avoid sexual practices which may break the skin like anal intercourse. Use condom properly.

Make sure that blood products for transfusion have been properly screened for hepatitis B. Observe good personal hygiene. Have adequate sleep, rest, exercise and eat adequate nutritious foods to build and maintain body resistance.

Management and Treatment Acute hepatitis B usually resolves on its own and does not require medical treatment. It depends on ones natural body resistance to combat the disease. Symptomatic and supportive measures as analgesicantipyretic (pain and fever) are given. If a person has chronic hepatitis B, they should see their health care provider regularly. Care of the skin and good personal hygiene is advocated. A diet high in carbohydrates is usually advised.

Jaundice

Normal liver. It has a fine lobular texture and smooth capsular surface.

Section of liver damaged by HBV. Note the enlarged cells and blistering of the capsular surface.