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2.  Viral hepatitis may be defined as infection of the liver
caused by any of about half dozen viruses. These are
hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis C
virus (HCV) hepatitis D virus (HDV), hepatitis E virus (HEV)
and hepatitis G virus (HGV). Today we will discuss about
hepatitis B in detail

3.  Hepatitis B is an acute systemic
infection with major pathology
in the liver, caused by hepatitis
B virus (HBV) and results in
jaundice.

4.  Hepatitis B is caused by Hepatitis B
virus. It was first discovered by
Blumberg in 1963. HBV is a complex,
42-nm, double-shelled DNA virus,
originally known as the "Dane
particle". It replicates in the liver cells.

5.  Man is the only reservoir of infection which can be spread
either from carriers or from cases. Hepatitis B is essentially
a blood-borne infection. It is transmitted by infected blood
and blood products through transfusions, dialysis,
contaminated syringes and needles and accidental skin prick
etc.

6.  It may also spread during surgical and dental procedures,
immunization, traditional tattooing, ear piercing, nose
piercing, ritual circumcision, acupuncture if the instrument
is contaminated. The virus is quite stable and capable of
surviving for at least 7 days on environmental surfaces.
Means it can spread through infected surface and
instruments.

7.  Spread of infection from HBV carrier mothers to their babies
appears to be an important factor for the high prevalence of
HBV infection in some areas. the majority of children born
to mothers who are positive, become chronically infected.
 It is also included in sexually transmitted diseases group.

8.  Sign and symptoms of hepatitis includes-
 Yellow discoloration of eyes and skin (jaundice)
 Yellow discoloration of urine
 Pain abdomen
 Nausea
 vomiting

9.  Joint pain
 Loss of appetite
 Weakness and fatigue
 Fever
 33 percent of cases are asymptomatic

10.  Blood investigations-
 specific antigens and/or antibodies confirms diagnosis. Three
clinically useful antigen-antibody systems are identified for hepatitis
B:
 1) hepatitis B surface antigen (HBsAg) and antibody to HBsAg
 2) hepatitis B core antigen (HBcAg) and antibody to HBcAg
 3) hepatitis B e antigen (HBeAg) and antibody to HBeAg

11.  Liver ultrasound-
 A special ultrasound called transient elastography can
show the amount of liver damage.
 Liver Biopsy-
 Liver biopsy can be done to find-out liver condition and
damage to liver cells.

12.  An injection of immunoglobulin (an antibody) given within 12
hours of exposure to the virus may help protect you from
getting sick with hepatitis B. Because this treatment only
provides short-term protection.
 Antiviral medications- Several antiviral medications including
entecavir, tenofovir, lamivudine, adefovir and telbivudine can
help fight the virus and slow its ability to damage the liver.

13.  Interferon injections- Interferon alfa-2b 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.
 Liver transplant- If your liver has been severely damaged, a
liver transplant may be an option.

14.  VACCINATION- Hepatitis B vaccine is available for
prevention of hepatitis B. It is recommended to
immunize a new born baby with hepatitis B zero dose
than it is given in combination as pentavalant vaccine
at 6 months 10 months and 14 months of age. For adult
vaccination 3 doses of hepatitis B vaccine is at 0,1 and
6 months .

15.  PRECATIONS- Hepatitis B can be prevented by taking
some precautions such as-
 All blood donors should be screened for HBV infection, and
those positive for Australia antigen should be rejected
 Voluntary blood donation should be encouraged because
purchased blood has shown a higher risk of post-transfusion
hepatitis

16.  Health personnel should be sensitized to the importance of
adequate sterilization of all instruments and to the practice
of simple hygienic measures
 Carriers should be told not to share razors or tooth
brushes, use barrier methods of contraception and they
should not donate blood.

17.  A sterile syringe and needle are essential for each
individual receiving skin tests, parenteral inoculations or
venepuncture or use disposal one.
 Discourage tattooing; enforce aseptic sanitary practices in
tattoo parlours, including proper disposal of sharp or cutting
tools. Use rules of BMW management.

18. By – SURESH KUMAR ( Nursing Tutor )