Hepatitis B

Hepatitis B

I . Introduction

Unlike hepatitis A , which is transmitted primarily by the fecal - oral route , hepatitis B is transmitted primarily through blood (percutaneous and permucosal . HBV has been found in blood , saliva , semen , and vaginal secretions and can be transmitted through mucous membranes and breaks in the skin . HBV is also transferred from carrier mothers to their babies , especially in areas with a high incidence (ie , Southeast Asia . The infection is usually not via the umbilical vein , but from the mother at the time of birth and during close contact

afterward

HBV has a long incubation period . It replies in the liver and remains in the serum for relatively long periods , allowing transmission of the virus . Those at risk for developing hepatitis B include surgeons clinical laboratory workers , dentists , nurses , and respiratory therapists . Staff and patients in hemodialysis and oncology units and sexually active homosexual and bisexual men and injection drug users are also at increased risk . Screening of blood donors has greatly reduced the occurrence of hepatitis B after blood transfusion

Most people 90 ) who contract hepatitis B infections will develop antibodies and recover spontaneously in 6 months . The mortality rate from hepatitis B has been reported to be as high as 10 . Another 10 of patients who have hepatitis B progress to a carrier state or develop chronic hepatitis with persistent HBV infection and hepatocellular injury and inflammation . It remains a major cause of cirrhosis and hepatocellular carcinoma worldwide (Chart A

Chart A Risk Factors for Hepatitis B

Frequent exposure to blood , blood products , or other body fluids

Health care workers : hemodialysis staff , oncology and chemotherapy nurses , personnel at risk for needlesticks , operating room staff respiratory therapies , surgeons , dentists

Hemodialysis

Male homosexual and bisexual activity

IV /injection drug use

Close contact with carrier of HBV

Travel to or residence in area with uncertain sanitary conditions

Multiple sexual partners

Recent history of sexually transmitted disease

Receipt of blood or blood products (eg , clotting factor concentrate This scrutinizes and defines the history , signs and symptoms environment , family history , treatment , patient teaching , and nursing interventions and application to nursing of hepatitis B

II . Discussion

A . Clinical Manifestations

Clinically , the disease closely resembles hepatitis A , but the incubation period is much longer (1 to 6 months . Signs and symptoms of hepatitis B may be insidious and variable . Fever and respiratory symptoms are rare : some patients have arthralgias and rashes . The patient may have loss of appetite , dyspepsia , abdominal pain generalized aching , malaise , and weakness . Jaundice may or may not be evident . If jaundice occurs , light-colored stools and dark urine accompany it . The liver may be tender and enlarged to 12 to 14 cm vertically . The spleen is enlarged and palpable in a few patients the posterior cervical lymph nodes may also be enlarged . Subclinical episodes also occur frequently

B . Assessment and Diagnostic Findings

HBV is a DNA virus composed of the following antigenic particles

HBcAg - hepatitis B core antigen (antigenic material in an inner core

HBsAg - hepatitis B surface antigen...