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DEPARTMENT OF PUBLIC
HEALTH DENTISTRY
SEMINAR
HEPATITIS B
CONTENTS
HISTORY
INTRODUCTION
PREVALENCE OF HEPATITIS B
HEPATITIS B VIRUS
STRUCTURE OF HEPATITIS B VIRUS
REPLICATION OF HEPATITIS B VIRUS
MODES OF TRANSMISSION
HIGH-RISK GROUPS FOR HBV INFECTION
STAGES OF THE DISEASE
HISTORY (1)
o
INTRODUCTION (1)(2)
Every year there are over 4 million acute causes of HBV, and
about 25% of carriers, 1 million people a year, die from
chronic active hepatitis, cirrhosis or primary liver cancer.
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11
14
eradicate
the
infectious
agents.
As
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DNA)
Core antigens located in the center (nucleocapsid)
* Core antigen (HBcAg)
* e antigen (HBeAg
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18
19
20
22
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RNA
HBs
and
other
undetected
DNA
messenger RNA.
from
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Perinatal transmission
Horizontal transmission
Perinatal
90% of
infected
infants
become
chronically
infected
Mother
Host
Infant
6% of
people
infected over
the age of 5
become
chronically
infected
Recipient
Child-to-child
Contaminated needles
Sexual contacts
Healthcare worker
Blood transfusion
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Heterosexual*
(41%)
Injecting
Drug Use
(15%)
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FIRST STAGE
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SECOND STAGE
THIRD STAGE
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FOURTH STAGE
In the fourth stage, the virus cannot be detected and
antibodies to various viral antigens have been produced.
of
these
stages,
including
age,
sex,
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PATHOLOGY (11)(12)
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2) HBcAganti-HBc system
3) HBeAganti-HBe system
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PATHOGENISIS (11)
HBV
Via blood flow enters the liver and other organs such as
pancreas, bile ducts, vessels, WBC, bone marrow,
glomerular basement membrane.
HBcAg,HBsAg,HBeAg
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cause cytopathy
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0.5%-1%
Chronic infection
15%-25%
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CLINICAL FEATURES
ACUTE HEPATITIS B
Phases of disease
1.
Preicteric
2.
Icteric
3.
Convalescent
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Preicteric
a.
Tiredness
b.
Anorexia
c.
d.
e.
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Icteric
a.
b.
Yellowish discoloration of
mucous membranes.
c.
d.
Hepatosplenomegaly
e.
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Convalescent
a.
b.
c.
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Chronic Hepatitis B
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CLINICAL OUTCOMES OF
HEPATITIS B INFECTIONS (14)(15)
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HEPATOCELLULAR CARCINOMA
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FULMINANT HEPATITIS
Usually fatal
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DIAGNOSIS (16)(17)
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High
Moderate
Low/Not
Detectable
blood
serum
wound exudates
Semen
Vaginal fluid
Saliva
Urine
Feces
Sweat
Tears
Breast Milk
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1973
1981
1986
1991
1996
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COMBINATION VACCINES
The HBsAg vaccines can be combined with other
vaccines such as Calmetta-Guerin Bacillus(BCG),
measles, mumps, and rubella, Haemophilus influenzae b,
diptheria, tetanus and petussis combined with polio.
Neonates born to mother who are HBsAg positive should
be given a combination of passive and active
immunization to provide immediate protection in the
first 6 hours after delivery, followed by long term
immunity with the vaccine.
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HEPATITIS B VACCINE
ADOLESCENT AND ADULT SCHEDULE
Dose
Primary 1
Primary 2
Primary 3
Usual
Interval
--1 month
5 months
Minimum
Interval
--4 weeks
8 weeks*
Recombivax HB
Dose (mcg)
0.5 mL (5)
Engerix-B
Dose (mcg)
0.5 mL (10)
0.5 mL (5)
0.5 mL (10)
1.0 mL (10)
1.0 mL (20)
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DENTAL CONSIDERATION
For
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Chronic
Hepatitis B (20)(21)
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TERTIARY PREVENTION
There is no surgical treatment for hepatitis B.
In case of advanced liver damage because of hepatitis and
condition becomes life-threatening, their is need a liver
transplant.
In rare cases, acute hepatitis B progresses rapidly to liver
failure, a deadly condition called fulminant hepatitis. For
people who develop this condition, a liver transplant is the
only treatment choice.
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CONCLUSION
Hepatitis B is the most common serious liver infection in
the world. It is caused by the hepatitis B virus (HBV)
that attacks liver cells and can lead to liver failure,
cirrhosis scarring) or cancer of the liver. The virus is
transmitted through contact with blood and bodily fluids
that contain blood.
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REFERENCES
1. Hepatitis B Epidemiology and Prevention of VaccinePreventable Diseases The Pink Book: Course Textbook - 12th
Edition Second Printing (May 2012) Center Of Diseases
Control
2. Fauci ,Braunwald, Isselbacher Harrisons Principle of internal
mediciene vol-2 14th edition.
3. Haslett, Chivers, Boon Davidsons Principles and Practice of
Mediciene. 2004 19th edition.
4. Churchills Illustrated Medical Dictionary, New York ,
Churchill Livingstone, 1989.
5. Harmanjit Singh Hira Text book of General Medicine for
Dental Students.
6. Manual of Clinical Microbiology, Patrick R Murray 9 th edition.
7. Topely and Wilsons, Virology volume-1 ,9th edition.
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THANK YOU
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