Acute Viral Hepatitis Year 4 Internal Medicine Notes

Acute Viral Hepatitis Year 4 · Internal Medicine Collection: 4TH YEAR ALL NOTES / IMED / I MED BEAUTIFUL NOTES / GIT -- ● Objectives: ● Recognise​ ​the​ ​different​ ​type​ ​of​ ​acute​ ​viral​ ​hepatitis ● Know​ ​the​ ​possible​ ​complications​ ​and​ ​outcome​ ​of​ ​acute​ ​viral​ ​hepatitis ● Aware​ ​of​ ​the​ ​other​ ​cause​ ​of​ ​acute​ ​hepatitis​ ​in​ ​KSA ● To​ ​have​ ​fair​ ​knowledge​ ​about​ ​the​ ​latest​ ​results​ ​of​ ​epidemiological​ ​aspect​ ​of​ ​viral\nhepatitis​ ​A,B,C​ ​IN​ ​KSA\n\n [​ ​Color​ ​index​ ​:​ ​ ​Important​ ​ ​ ​ ​Notes​ ​ ​ ​Extra​ ​]\n[​ ​ ​ ​ ​Editing​ ​file​ ​ ​ ​ ​ ​ ​ ​ ​ ​Feedback​ ​ ​ ​ ​ ​ ​ ​ ​ ​Share​ ​your​ ​notes​ ​ ​ ​ ​ ​ ​ ​ ​ ​Shared​ ​notes​ ​ ​ ​ ​ ​ ​ ​Twitter​ ​ ​ ​ ​] ● Resources: ● 435​ ​slides\n\n● Done​ ​by:​ ​Munira​ ​Al-hussaini​ ​and​ ​Rifan​ ​Hashim ● Team​ ​sub-leader:​ ​Jwaher​ ​Alharbi ● Team​ ​leaders:​ ​Khawla​ ​AlAmmari​ ​&​ ​Fahad​ ​AlAbdullatif ● Revised​ ​by:​ ​Ahmad​ ​Alyahya,​ ​Luluh​ ​Alzeghayer \n\nEpidemiology​ ​of​ ​Hepatitis​ ​in​ ​Saudi:\n​ ​What​ ​the​ ​doctor​ ​mentioned​ ​regarding​ ​the​ ​epidemiology​ ​of​ ​Hepatitis​ ​in​ ​Saudi:\n● Overall​ ​prevalence​ ​of​ ​HBsAg​ ​among​ ​saudis​ ​in​ ​the​ ​80s​ ​according​ ​to​ ​regions​ ​was​ ​5-10%​ ​which​ ​is\nconsidered​ ​very​ ​high\n● Good​ ​news​ ​about​ ​HBV:​ ​when​ ​the​ ​prevalence​ ​of​ ​HBeAg​ ​positive​ ​saudi​ ​pregnant​ ​females​ ​was​ ​calculated\n5.4%​ ​were​ ​positive​ ​for​ ​its​ ​ANTIBODY​ ​while​ ​only​ ​3.7%​ ​were​ ​positive​ ​for​ ​the​ ​antigen\n● History​ ​of​ ​HBV​ ​infection​ ​control​ ​in​ ​KSA:\n-Vaccination​ ​of​ ​all​ ​infants​ ​at​ ​birth​ ​+​ ​all​ ​children​ ​at​ ​school​ ​entry\n-Vaccination​ ​of​ ​all​ ​groups​ ​at​ ​risk​ ​of​ ​HBV​ ​(including​ ​healthcare​ ​workers)​ ​became​ ​mandatory​ ​from​ ​1990!\n-Screening​ ​of​ ​all​ ​expatriates​ ​coming​ ​to​ ​work​ ​in​ ​KSA.\n● Comparison​ ​of​ ​prevalence​ ​of​ ​HBsAg​ ​among​ ​saudi​ ​children​ ​in​ ​1989​ ​and​ ​1997-according​ ​to\nage(0-12yrs):This​ ​study​ ​showed​ ​that​ ​the​ ​prevalence​ ​majorly​ ​decreased​ ​AFTER​ ​VACCINE​ ​(from​ ​5-10%\nto​ ​0-2%)\n● Prevalence​ ​of​ ​HBsAg​ ​among​ ​Saudi​ ​population​ ​before​ ​and​ ​after​ ​vaccination​ ​in​ ​over​ ​18​ ​yrs:\n​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​NO​ ​ONE​ ​WAS​ ​POSITIVE​ ​FOR​ ​HBsAg​ ​AFTER​ ​VACCINE\n● Note​ ​that​ ​anti-HBs​ ​against​ ​surface​ ​antigen​ ​will​ ​not​ ​stay​ ​positive​ ​for​ ​life,however​ ​repeating​ ​the\nvaccination​ ​is​ ​not​ ​necessary​ ​in​ ​all​ ​groups​ ​because​ ​the​ ​immune​ ​system​ ​can​ ​react​ ​to​ ​the​ ​virus​ ​by\nMEMORY!\n● In​ ​certain​ ​groups​ ​monitoring​ ​of​ ​the​ ​antibody​ ​levels​ ​is​ ​favorable​ ​because​ ​these​ ​groups​ ​are​ ​at​ ​higher​ ​risk ,thus​ ​require​ ​monitoring​ ​and​ ​booster(ex:healthcare​ ​workers).\n● If​ ​a​ ​person​ ​tested​ ​positive​ ​for​ ​HBV​ ​,he/she​ ​will​ ​not​ ​transmit​ ​to​ ​spouse​ ​nor​ ​children​ ​if​ ​they​ ​were\nvaccinated.\n● This​ ​person​ ​should​ ​measure​ ​the​ ​viral​ ​load:if​ ​it​ ​was​ ​less​ ​than​ ​2000​ ​IU​ ​then​ ​he​ ​is​ ​only​ ​a​ ​chronic​ ​carrier\n(disease​ ​not​ ​active)\n● Study​ ​done​ ​to​ ​calculate​ ​the​ ​number​ ​of​ ​positive​ ​cases​ ​of​ ​HBV​ ​and​ ​HCV​ ​(2009-2014):only​ ​1%​ ​have​ ​HBV\nfrom​ ​the​ ​age​ ​of​ ​(18-70)​ ​due​ ​to​ ​the​ ​successful​ ​vaccination​ ​program.\n● HCV:​ ​overall​ ​prevalence​ ​in​ ​Saudi​ ​in​ ​the​ ​last​ ​18​ ​yrs​ ​is​ ​very​ ​low\n● Why​ ​is​ ​HCV​ ​more​ ​common​ ​in​ ​Egypt​ ​compared​ ​to​ ​Saudi?\n-because​ ​before​ ​information​ ​was​ ​collected​ ​on​ ​hepatitis​ ​,egyptians​ ​tries​ ​to​ ​cure​ ​schistosomiasis(Bilharzia​ ​)​ ​using​ ​a\ndrug​ ​called​ ​“foadi”.\nThis​ ​drug​ ​was​ ​given​ ​by​ ​20​ ​injections​ ​which​ ​lead​ ​to​ ​the​ ​wide​ ​spread​ ​of​ ​hepatitis​ ​C​ ​(because​ ​the​ ​Egyptians​ ​only\nboiled​ ​the​ ​injection-poor​ ​infection​ ​control)\n● HAV:13​ ​regions​ ​in​ ​Saudi​ ​children​ ​were​ ​checked​ ​for​ ​HAV\n-It​ ​was​ ​noticed​ ​the​ ​highest​ ​prevalence​ ​rate​ ​was​ ​at​ ​the​ ​borders​ ​in​ ​areas​ ​like​ ​Jazan​ ​and​ ​Tabook​ ​(why?due​ ​to​ ​low\nsocioeconomic​ ​status!!!)\n● In​ ​a​ ​comparison​ ​of​ ​prevalence​ ​of​ ​anti-HAV​ ​amongst​ ​Saudi​ ​children​ ​in​ ​1989​ ​-1997​ ​-according​ ​to\nregion:ALL​ ​REGIONS​ ​SHOWED​ ​A​ ​DROP​ ​IN​ ​PREVALENCE​ ​EXCEPT​ ​JAZAN!\n● The​ ​changing​ ​pattern​ ​of​ ​hepatitis​ ​A​ ​prevalence​ ​within​ ​the​ ​Saudi​ ​population​ ​over​ ​18​ ​yrs:from​ ​53%​ ​to\n18%​ ​due​ ​the​ ​development​ ​in​ ​the​ ​socioeconomic​ ​status.\n\n 2 \n\n ❖ Acute​ ​hepatitis​ ​definition​: An​ ​infection​ ​or​ ​inflammation​ ​of​ ​the​ ​liver.​ ​most​ ​cases​ ​of​ ​acute​ ​hepatitis​ ​are​ ​from​ ​viral​ ​hepatitis​ ​A​ ​or​ ​B​. Hepatitis​ ​C​ ​for​ ​unknown​ ​reasons​ ​rarely​ ​presents​ ​with​ ​an​ ​acute​ ​infection,​ ​and​ ​is​ ​found​ ​as​ ​a​ ​silent​ ​infection​ ​on blood​ ​tests.\n\n Types​ ​of​ ​hepatitis \nInfectious Noninfectious \n-Hepatitis​ ​A -​ ​Alcoholic​ ​hepatitis\n-Hepatitis​ ​B -​ ​Drug​ ​induced​ ​hepa