hepatitis%20-%20viral
HEPATITIS - VIRAL
The majority of acute viral hepatitis infections are asymptomatic or they can cause an anicteric illness that may not be diagnosed as hepatitis.
Hepatitis A generally causes minor illness in childhood with >80% of infections being asymptomatic but more likely to produce clinical symptoms in adults. 
Hepatitis B, C, and D may also be asymptomatic.
Hepatitis A is predominantly transmitted through oral-fecal route.
Hepatitis B is transmitted through perinatal, percutaneous, or sexual routes or close person-to-person contact via open cuts and sores.
Hepatitis C infections are transmitted through perinatal, percutaneous, or sexual routes, blood transfusions, or organ transplants.
Hepatitis D's route of transmission is sexual or percutaneous, especially IV drug use.
Hepatitis E is transmitted primarily through contaminated drinking water and oral-fecal transmission.

Patient Education

Hepatitis A and E
  • Provide the patient with a detailed explanation of his condition
  • Provide clear, accurate, written information
  • Patients must avoid food handling and unprotected sexual intercourse until they become noninfectious because transmission of hepatitis A is mainly by the oral-fecal route
  • Screen for other sexually transmitted diseases (STDs) in cases of sexually acquired hepatitis or if otherwise appropriate

Partner Notification

  • Partner notification should be performed for at-risk sexual contacts (oral/anal, digital/rectal, and penetrative anal sex) within 2 weeks before to 1 week after the onset of jaundice

Acute Hepatitis B

  • Provide the patient with a detailed explanation of his condition
    • Emphasize the disease’s long-term implications for their and their partners’ health
    • Provide clear, accurate, written information
  • Advise patients to avoid unprotected sexual intercourse, emphasize condom use  
  • Screen for other sexually-transmitted diseases in cases of sexually acquired hepatitis or if otherwise appropriate

Partner Notification

  • Partner notification for at-risk contacts
    • Contact tracing should include any sexual contact (penetrative vaginal or anal or oral/anal) or needle-sharing partners within 2 weeks before onset of jaundice until the patient becomes negative for HBsAg
  • All non-immune sexual and household contacts must be screened and vaccinated

Chronic Hepatitis B

  • Provide the patient with a detailed explanation of his condition 
    • Emphasize the disease’s long-term implications for their and their partners’ health
    • Provide clear, accurate, written information
  • Abstinence or limited use of alcohol to prevent further liver injury 
  • Counseling regarding prevention of transmission of HBV 
    • Sexual transmission: Protected sexual intercourse ie condom use
    • Perinatal transmission: Hepatitis B immune globulin (HBIG) and hepatitis B vaccine at delivery for babies of HBV-infected mothers
    • Inadvertent transmission via environmental contamination from a blood spill

Partner Notification

  • Trace contacts as far back as any episode of jaundice or to the time when infection is thought to have been acquired

Hepatitis C

  • Provide the patient with a detailed explanation of his condition
    • Emphasize the disease’s long-term implications for their and their partners’ health
    • Provide clear, accurate, written information
  • Advise patient not to donate blood, semen or organs
  • Advise patient to avoid sharing items of personal hygiene eg toothbrushes, shaving equipment
  • Counsel patient to stop using illicit drugs
  • Advise patient regarding sexual transmission
    • HCV is not considered to be a sexually transmitted disease, but sexual promiscuity, HIV and herpes simplex virus (HSV-2) co-infections are associated with sexual transmission of hepatitis C
    • Avoid unprotected sex during menstruation
  • Advise patient regarding the potential deleterious effect of alcohol especially in association with development of HCC, progression of liver fibrosis and increase in HCV replication

Partner Notification

  • Partner notification for at-risk contacts
    • Contact tracing to include any sexual contact (penetrative vaginal or anal sex) or needle-sharing partners from 2 weeks before the onset of jaundice
    • If without acute infection, trace back to the likely time of infection eg blood transfusion, 1st needle sharing

Hepatitis D

  • Provide the patient with a detailed explanation of his condition
    • Emphasize the disease’s long-term implications for their and their partners’ health
    • Provide clear, accurate, written information
  • Advise patients to avoid unprotected sexual intercourse

Partner Notification

  • Partner notification for at-risk contacts

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