Hepatitis B and Hepatitis C by Dr Debashis Nanda

Awareness session on Hepatitis B and Hepatitis C by Dr Debashis Nanda with the Rotaract club of Cuttack Golden Star.

1. HEPATITIS B & HEPATITIS C -DR DEBASHIS NANDA MEDICAL OFFICER, SUB-DIVISIONAL HOSPITAL, HINDOL

2. LIVER The liver is located in the upper right-hand portion of the abdominal cavity, beneath the diaphragm, and on top of the stomach, right kidney, and intestines. Shaped like a cone, the liver is a dark reddish-brown organ that weighs about 3 pounds. The liver holds about 13% of the body's blood supply at any given moment.  Functions of the liver The liver regulates most chemical levels in the blood and excretes a product called bile. This helps carry away waste products from the liver. All the blood leaving the stomach and intestines passes through the liver. The liver processes this blood and breaks down, balances, and creates the nutrients and also metabolizes drugs into forms that are easier to use for the rest of the body or that are nontoxic.  HEPATITIS: IT IS THE INFLAMMATION OF LIVER DUE TO ANY CAUSE.

3. VIRAL HEPATITIS VIRAL HEPATITIS: IT IS THE INFLAMMATION OF LIVER DUE TO A VIRUS. THERE ARE 5 DIFFERENT TYPES OF VIRUSES CAUSING 5 DIFFERENT TYPES OF VIRAL HEPATITIS.

4. CLINICAL FEATURES COMMON TO BOTH HEPATITIS : B & C SYMPTOMS ARE VARIABLE AND INCLUDE YELLOWING OF THE EYES , ABDOMINAL PAIN AND DARK URINE . SOME PEOPLE, PARTICULARLY CHILDREN, DON'T EXPERIENCE ANY SYMPTOMS. IN CHRONIC CASES, LIVER FAILURE, CANCER OR SCARRING CAN OCCUR.

5. HEPATITIS - B

6. HEPATITIS-B VIROLOGY

7. OVERALL: VERTICAL >> PER-CUTANEOUS HEPATITIS – B : MECHANISM OF TRANSMISSION DESPITE VIGOROUS SCREENING, ABOUT 1 CASE OF HEP-B TRANSMISSION IS SEEN FOR NEARLY 2 LAKHS UNITS OF BLOOD TRANSFUSED. (AS SOME DONORS HAVE LOW LEVEL OF HBsAg TITRES , WHICH ISN’T DETECTED BY THE ROUTINE SCREENING PROCESS) FECO-ORAL & BREAST MILK AREN’T MOT FOR HEP-B (VIRUS IS DESTROYED IN THE GASTRIC PH)

8. HEPATITIS B: QUICK FACTS INCUBATION PERIOD = 60 DAYS MOST COMMON VIRAL CAUSE OF CHRONIC HEPATITIS : HEP-B MOST COMMON CAUSE OF HEPATO-CELLULAR CARCINOMA : HEPA-B

9. HEPATITIS-B : SEROLOGY

10. HEPATITIS-B : MANAGEMENT MELD SCORE MODEL for END STAGE LIVER DISEASE PARAMETERS SERUM CREATININE SERUM BILIRUBIN INR ANTI-VIRAL D/O/C : TENOFOVIR ( IN NORMAL GFR ) ENTECAVIR ( IF GFR <60 ML/MIN ) DURATION OF TREATMENT : 1YR (APPROX.) TARGET OF TREATMENT : HBV DNA : <2000 IU/ML

11. HEPATITIS - C

12. HEPATITIS-C : VIROLOGY

13. HEPATITIS-C : MODE OF TRANSMISSION FECO-ORAL AND BREAST FEEDING AREN’T MOT FOR HEP-C

14. HEPATITIS-C : QUICK FACTS INCUBATION PERIOD : 50 DAYS MOST COMMON VIRAL CAUSE OF LIVER CIRRHOSIS : HEPATITIS-C MOST COMMON ACUTE VIRAL HEPATITIS LEADING TO CHRONIC HEPATITIS : HEPATITIS-C MOST COMMON INDICATION OF LIVER TRANSPLANTATION : HEP-C

15. HEPATITIS-C : SEROLOGY MAIN POSSIBILITY : HEPATITIS C PROGRESSING TO A CHRONIC INFECTION ( VIRUS > 6 MONTHS ) SCREENING INVESTIGATION FOR HEPATITIS-C : ANT-HCV ------ +VE ---- > HCV RNA ( CONFIRMATORY TEST )

16. HEPATITIS-C : MANAGEMENT ANTI-VIRALS : SOFOSBUVIR ( DOC ) , VELPATASVIR DURATION OF TREATMENT : 12 WEEKS TARRGET OF TREATMENT : HCV-RNA UNDETECTABLE IN BLOOD

17. HOW TO PREVENT ? TAKE VACCINES AND GET YOUR CHILDREN VACCINATED. HEP-B VACCINE : ZERO DOSE AT BIRTH (PREFERRABLY < 24 hrs OF LIFE), THEN 3 MORE DOSAGES WITH PENTA V VACCINE AT 6, 10 & 14 WEEKS. HEP-C VACCINE : No vaccine is currently available, but several vaccines are currently under development. SCREENING OF VIRAL GENOMES SCREENING OF IG M & IG G ANTIBODIES AVOID MULTIPLE SEXUAL EXPOSURE AVOID UNNECESSARY BLOOD TRANSFUSIONS MAINTAIN PROPER BLOOD HYGIENE

18. THANK YOU DR DEBASHIS NANDA [email protected] Fb @drdebashisnanda Insta @drdebashisnanda Twitter @drdebashisnanda Koo @drdebashisnanda Yt @debashisnanda http://drdebashisnanda.weeblysite.com