world hepatitis day awareness presentation july 2022.pptx

World Hepatitis Day (WHD) is recognized annually on July 28th, the birthday of Dr. Baruch Blumberg (1925–2011). Dr. Blumberg discovered the hepatitis B virus in 1967, and 2 years later he developed the first hepatitis B vaccine

1. DR.ANJALATCHI MUTHUKUMARAN M.SC (N) MD(AM) PH.D(N), MBA(HA) VICE PRINCIPAL ERA COLLEGE OF NURSING WORLD HEPATITIS DAY AWARENESS PROGRAM JULY 2O22

2. Theme of the year 2022 In 2022 the theme is ' I Can't Wait '. On World Hepatitis Day, 28 July, we call on people from across the world to take action and raise awareness of hepatitis because Hepatitis Can't Wait. WHD is a day for the world's hepatitis community to unite and make our voices heard.

3. Introduction World Hepatitis Day is observed each year on  28 July  to raise awareness of viral hepatitis, an inflammation of the liver that causes severe liver disease and hepato -cellular cancer.

4. Anatomy view of liver The liver is the largest gland in the body and possesses remarkable regeneration capabilities . The gland secretes  bile, a green-colored digestive enzyme stored in the gall bladder during fasting . Bile acids aid in digestion, among other functions.

5. What is function of bile The human liver produces approximately 400ml to 800ml of bile each day. Hepatocytes of the liver secrete bile, which is then released into the canaliculi before entering the bile ducts. The bile ducts add to this secretion a liquid rich with bicarbonates. Next , a hormone called cholecystokinin (CCK), causes gall bladder contraction, which discharges bile into the duodenum . The duodenum is the first section of the small intestine. Here the fluid mixes with pancreatic enzymes to further digest the food. The fluid is alkaline and neutralizes stomach acids in the small intestine.

6. Normal liver

7. Problems statement The world is currently facing a new outbreak of unexplained acute hepatitis infections affecting children. WHO , together with scientists and policymakers in affected countries, are working to understand the cause of this infection that does not appear to belong to any of the known 5 types of hepatitis viruses: A,B,C,D, and E. 

8. Function of liver

9. Continued This new outbreak brings focus on thousands of acute viral hepatitis infections that occur among children, adolescents and adults every year. Most acute hepatitis infections cause mild disease and even go undetected . But in some cases, they can lead complications and be fatal . In 2019 alone, an estimated 78 000 deaths occurred worldwide due to complications of acute hepatitis A to E infections.

10. Liver normal to abnormal

11. Global efforts prioritize the elimination of the hepatitis infections B, C and D infections. Unlike acute viral hepatitis, these 3 infections cause chronic hepatitis that lasts for several decades and culminate in over 1 million deaths per year from cirrhosis and liver cancer.

12. These 3 types of chronic hepatitis infections are responsible for over 95% of hepatitis deaths . While we have the guidance and tools to diagnose, treat, and prevent chronic viral hepatitis, these services are often out of reach of communities and are sometimes only available at centralized/specialized hospitals.

13. WHO planning on hepatitis day 2022 On World Hepatitis Day 2022, WHO is highlighting the need for  bringing hepatitis care closer to the primary health facilities and communities  so that people have better access to treatment and care, no matter what type of hepatitis they may have.

14. WHO aims to achieve hepatitis elimination by 2030. To get there, WHO calls on countries to achieve specific targets: Reduce new infections of hepatitis B and C by 90%; Reduce hepatitis related deaths from liver cirrhosis and cancer by 65%; Ensure that at least 90% of people with hepatitis B and C virus are diagnosed; and At least 80% of those eligible receive appropriate treatment.

15. Definition of hepatitis Hepatitis is an inflammation of the liver that is caused by a variety of infectious viruses  and noninfectious agents leading to a range of health problems, some of which can be fatal.

16. Types of hepatitis There are five main strains of the hepatitis virus, referred to as types A, B, C, D and E . Hepatitis A Hepatitis B Hepatitis C Hepatitis D Hepatitis E

17. Chronic disease of hepatitis In particular, types B and C lead to chronic disease in hundreds of millions of people and together are the most common cause of liver cirrhosis, liver cancer and viral hepatitis-related deaths .  An estimated 354 million people worldwide live with hepatitis B or C, and for most, testing and treatment remain beyond reach.

18. Others hepatitis status in I ndia and world wide Some types of hepatitis are preventable through vaccination. A WHO study found that an estimated 4.5 million premature deaths could be prevented in low- and middle-income countries by 2030 through vaccination, diagnostic tests, medicines and education campaigns.

19. Hepatitis A Key facts Hepatitis A is an inflammation of the liver that can cause mild to severe illness. The hepatitis A virus (HAV) is transmitted through ingestion of contaminated food and water or through direct contact with an infectious person. Almost everyone recovers fully from hepatitis A with a lifelong immunity. However, a very small proportion of people infected with hepatitis A could die from fulminant hepatitis . The risk of hepatitis A infection is associated with a lack of safe water and poor sanitation and hygiene (such as contaminated and dirty hands). A safe and effective vaccine is available to prevent hepatitis A.

20. Hepatitis B Key facts Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic disease. The virus is most commonly transmitted from mother to child during birth and delivery, as well as through contact with blood or other body fluids during sex with an infected partner, unsafe injections or exposures to sharp instruments. WHO estimates that 296 million people were living with chronic hepatitis B infection in 2019, with 1.5 million new infections each year. In 2019, hepatitis B resulted in an estimated 820 000 deaths, mostly from cirrhosis and hepato -cellular carcinoma (primary liver cancer). Hepatitis B can be prevented by vaccines that are safe , available and effective.

21. Hepatitis C Key facts Antiviral medicines can cure more than 95% of persons with hepatitis C infection, but access to diagnosis and treatment is low. There is currently no effective vaccine against hepatitis C. WHO estimated that in 2019, approximately 290 000 people died from hepatitis C , mostly from cirrhosis and hepato -cellular carcinoma (primary liver cancer). Globally, an estimated 58 million people have chronic hepatitis C virus infection, with about 1.5 million new infections occurring per year . There are an estimated 3.2 million adolescents and children with chronic hepatitis C infection.

22. Continued Hepatitis C is an inflammation of the liver caused by the hepatitis C virus. The virus can cause both acute and chronic hepatitis , ranging in severity from a mild illness to a serious, lifelong illness including liver cirrhosis and cancer. The hepatitis C virus is a blood borne virus and most infection occur through exposure to blood from unsafe injection practices, unsafe health care, unscreened blood transfusions, injection drug use and sexual practices that lead to exposure to blood .

23. Hepatitis D Key facts Hepatitis D virus (HDV) is a virus that requires hepatitis B virus (HBV) for its replication. Hepatitis D virus (HDV) affects globally nearly 5% of people who have a chronic infection with hepatitis B virus (HBV). HDV infection occurs when people become infected with both hepatitis B and D simultaneously (co-infection) or get hepatitis D after first being infected with hepatitis B (super-infection).

24. Continued Populations that are more likely to have HBV and HDV co-infection include indigenous populations, recipients of haemodialysis and people who inject drugs . Worldwide, the number of HDV infections has decreased since the 1980s, due mainly to a successful global HBV vaccination programme . The combination of HDV and HBV infection is considered the most severe form of chronic viral hepatitis due to more rapid progression towards liver-related death and hepato -cellular carcinoma. Hepatitis D infection can be prevented by hepatitis B immunization, but treatment success rates are low.

25. Hepatitis E Key facts Every year there are an estimated 20 million HEV infections worldwide, leading to an estimated 3.3 million symptomatic cases of hepatitis E. Hepatitis E is an inflammation of the liver caused by infection with the hepatitis E virus (HEV). A vaccine to prevent hepatitis E virus infection has been developed and is licensed in China , but is not yet available elsewhere. Hepatitis E is found worldwide, but the disease is most common in East and South Asia. WHO estimates that hepatitis E caused approximately 44 000 deaths in 2015 (accounting for 3.3% of the mortality due to viral hepatitis). The virus is transmitted via the fecal-oral route , principally via contaminated water .

26. Hepatitis F virus Over the past decade, several hepatitis viruses have been identified. Hepatitis F virus (HFV)  first appeared as togavirus -like 60- to 70-nm enveloped particles that were recovered from the hepatocytes of a number of patients transplanted for fulminant hepatic failure . Hepatitis A, E, and F viruses are transmitted  through the ingestion of contaminated food or water  (called the fecal-oral route); the spread of these agents is aggravated by crowded conditions and poor sanitation. Hepatitis F: It was formerly believed that a virus isolated from rare blood samples was able to cause hepatitis, and this virus was designated hepatitis F virus. Further investigation has failed to confirm the existence of this virus.  There is no known hepatitis F virus .

27. Hepatitis F and G Some cases of hepatitis transmitted through contaminated food or water are attributed to the hepatitis F virus (HFV), which was first reported in 1994. Another virus isolated in 1996, the hepatitis G virus (HGV), is believed to be responsible for a large number of sexually transmitted and bloodborne cases of hepatitis. HGV causes acute and chronic forms of the disease and often infects persons already infected with HCV.

28. Hepatitis F and G virus Hepatitis F  is a hypothetical  virus  linked to  viral hepatitis . Several hepatitis F candidates emerged in the 1990s; however, none of these claims were substantiated. [1][2][3] In 1994, Deka   et al.  reported that novel viral particles had been discovered in the stool of post-transfusion, non- hepatitis A , non- hepatitis B , non- hepatitis C , non- hepatitis E  patients. [4]  Injection of these particles into the bloodstream of Indian  rhesus monkeys  caused hepatitis, and the virus was named hepatitis F or  Toga virus . Further investigations failed to confirm the existence of the virus, and it was delisted as a cause for infectious hepatitis. [3][5] A subsequently-discovered virus thought to cause hepatitis was named Hepatitis G, though its role in hepatitis has not been confirmed and it is now considered synonymous with  GB virus C . It is an " orphan virus " with no causal links to any human disease

29. What is hepatitis? Hepatitis refers to inflammation of the liver. Inflammation is a tissue’s reaction to irritation or injury which generally results in swelling and can cause pain.

30. How does someone get or spread hepatitis? Hepatitis A can be spread through food or drinking water carrying the virus through bits of fecal matter from an infected person. (This is called the fecal-oral route.) You can also get hepatitis A from sexual contact. A person can get hepatitis B in many ways, including: Having sex with an infected person. Sharing dirty needles. Being in direct contact with infected blood. Getting needle stick injuries. Being transferred from mother to unborn child. Being in contact with an infected person's body fluids.

31. A person can get hepatitis C from: Sharing dirty needles. Being in direct contact with infected blood. Getting needle stick injuries. Having sex with an infected person (less common).

32. You can get  hepatitis D  from: Being passed from mother to child during childbirth. Having contact with infected body fluids or blood. You can only get hepatitis D if you have hepatitis B. Hepatitis D is not common in the U.S.

33. Hepatitis incubation period

34. Who is at risk of getting hepatitis? You are at a higher risk of getting hepatitis if you: Share needles to take drugs. Practice unprotected oral and/or anal sex. Have many sex partners. Drink significant amounts of alcohol. Have poor nutrition. Work in a hospital or nursing home. Receive long-term kidney  dialysis. Travel to areas with poor sanitation.

35. What are the symptoms of hepatitis? The most common symptoms of hepatitis include: Dark urine. Stomach pain . Yellow skin or eye whites, called  jaundice . Pale or clay-colored stool . Low-grade  fever . Loss of appetite. Fatigue. Feeling sick to your stomach . Aching joints.

36. How is hepatitis diagnosed? Your healthcare provider will ask about your symptoms like history collection and do a physical exam, systemic examination . There are blood tests that will find out if you have a form of hepatitis caused by a virus . Blood test for routine , LFT, liver biopsy Chest X rays USG – hepatomegaly CT , MRI, other investigation

37. List of enzymes secreted in liver

38. Treatment of hepatitis Can hepatitis be treated? There are no treatments to cure  hepatitis A , aside from carefully monitoring liver function. If you know you have hepatitis A early enough, you might be able to stop the infection if you get a dose of the hepatitis A vaccine or something called hepatitis A immune globulin.

39. Hepatitis B treatment Hepatitis B , when chronic, can often be treated successfully. The most commonly used drugs to treat chronic hepatitis B are: Entecavir ( Baraclude ®). Telbivudine ( Tyzeka ®). Tenofovir alafenamide ( Vemlidy ®). Tenofovir disoproxil fumarate ( Viread ®). Interferon alfa-2b ( Intron A®). Peginterferon alfa-2a ( Pegasys ®).

40. H epatitis be treated? There are no treatments to cure  hepatitis A , aside from carefully monitoring liver function. If you know you have hepatitis A early enough, you might be able to stop the infection if you get a dose of the hepatitis A vaccine or something called hepatitis A immune globulin. Hepatitis B , when chronic, can often be treated successfully. The most commonly used drugs to treat chronic hepatitis B are: Entecavir ( Baraclude ®). Telbivudine ( Tyzeka ®). Tenofovir alafenamide ( Vemlidy ®). Tenofovir disoproxil fumarate ( Viread ®). Interferon alfa-2b ( Intron A®). Peginterferon alfa-2a ( Pegasys ®).

41. For  hepatitis C , the following drugs are used: Simeprevir ( Olysio ®). Daclatasvir ( Daklinza ®). Sofosbuvir ( Solvadi ®); sofusbuvir / velpatasvir ( Epclusa ®); sofusbuvir / velpatasvir / voxilaprevir ( Vosevi ®); ledipasvir / sofosbuvir ( Harvoni ®). Ombitasvir / paritaprevir / ritonavir ( Technivie ®); ombitasvir / paritaprevir / ritonavir / dasabuvir ( Viekira ® Pak, Viekira ® XR). Elbasivir / grazoprevir ( Zepatier ®). Glecaprevir / pibrentasvir ( Mavyret ®). These new drugs are sometimes given with older drugs like ribavirin and peginterferon alfa-2a and peginterferon-2b. You might have to take these medicines for some time, even as long as six months .

42. Hepatitis D treatment If you have chronic  hepatitis D , your doctor may prescribe drugs with interferons and might also add medicines for hepatitis B.  Hepatitis E  treatments include peginterferon alfa-2a and ribavirin .

43. How I protect myself against viral hepatitis? There are many ways you can reduce your chances of getting hepatitis: Get the vaccines for hepatitis A and hepatitis B. Use a  condom  during sex. Don't share needles to take drugs. Practice good personal hygiene such as thorough  hand-washing  with soap and water. Don't use an infected person's personal items. Take precautions when getting any tattoos or body piercings. Take precaution when traveling to areas of the world with poor sanitation. (Make sure to get your vaccines.) Drink bottled wate r when traveling.

44. Vaccine for infected pregnancy An infected mother has a high chance of giving hepatitis B to her child during or after birth. All   pregnant  women should be tested for hepatitis B. Within 12 hours of birth, infants born to mothers with hepatitis B need to receive treatment with hepatitis B antibody and hepatitis B vaccine. This can prevent transmission of hepatitis B from mother to the baby.

45. Status of vaccine for hepatitis? Present in world wide There are vaccines for hepatitis A and hepatitis B that are available in the U.S . There is no vaccine for hepatitis C. Since you can only get hepatitis D if you have hepatitis B, getting the vaccine against B should protect you against hepatitis D . There is no FDA approved vaccine against hepatitis E, but vaccines against hepatitis E exist overseas (for example, in China).

46. What is the outlook for hepatitis? Hepatitis A and E usually only cause short-term (acute) infections that your body can overcome. The others (B, C and D) can also cause acute infections, but might also cause chronic (long-term) infections. The chronic forms are more dangerous. Hepatitis non-E is usually acute, but can become chronic.

47. Any questions ?

48. Reference WHO guideliness CDC guidelines Myo clinic guidelines

49. Thank you for listening