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What is the underlying cause of your hepatitis?

What type of treatment, if any, are you receiving for your hepatitis?

Do you have any increased bleeding tendencies?

Have you been told you cannot take certain medications?

Do you drink any alcoholic beverages?

What types of medications are you taking?

Hepatitis A Virus (HAV)

Hepatitis B Virus (HBV)

Hepatitis C Virus (HCV)

Hepatitis D Virus (HDV)

Hepatitis E Virus (HEV)

SEN Virus (SENV)

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What is the underlying cause of your hepatitis?

Hepatitis is an inflammation of the liver that can be caused by a toxic substance, such as alcohol, or by a virus.

There are six different hepatitis viruses that cause disease in humans: hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis D virus (HDV), hepatitis E virus (HEV), and SEN virus (SENV).

What type of treatment, if any, are you receiving for your hepatitis?

Treatment for virus-induced hepatitis usually consists of different formulations of interferon, sometimes in combination with ribavirin, or of a single nucleoside reverse transcriptase inhibitor.

Interferon may reduce the absolute neutrophil count.

Do you have any increased bleeding tendencies?

Chronic hepatitis may result in liver cirrhosis. In cases of severe liver destruction, coagulation factors will not be produced, which will impair secondary hemostasis (fibrin production). A diminished number of platelets may also be produced, or platelet destruction in the spleen may be increased, resulting in increased bleeding tendencies.

Have you been told you cannot take certain medications?

Two of the major functions of the liver are detoxification of foreign substances and metabolism of drugs. A severely destroyed liver will not be able to perform these functions; this may limit the types of medications the patient can safely take.

Do you drink any alcoholic beverages?

Alcohol, even in small quantities, may cause increased bleeding tendencies in patients with severe liver disease.

What types of medications are you taking?

In addition to the medications used to treat the hepatitis, the patient may be taking other medications to treat associated conditions, such as hypertension or vitamin deficiencies.

Hepatitis A Virus (HAV)

  • Transmitted through close personal contact or contaminated food and water.
  • Incubation period is 40 days (range, 15-60 days).
  • Fatality rate is estimated at 1%-3% but may be as high as 15%-25% among pregnant women.
  • No chronic disease stage.

Serology:

  • HAV indicates presence of the virus
  • Anti-HAV indicates presence of antibody to HAV

Hepatitis B Virus (HBV)

  • Transmitted through sexual contact or blood and blood products.
  • Chronic infection occurs in 30%-90% of individuals infected before the age of 5 years and in 2%-10% of individuals infected after the age of 5 years.
  • 15%-25% of chronically infected individuals die prematurely from liver disease.
  • Percutaneous exposure through a needlestick with HBV-contaminated blood confers a 6%-30% risk of infection.
Serology:
  • HBsAg indicates acute or chronic infection;
  • HBeAg indicates active viral replication;
  • Anti-HBsAg is a marker of immunity.
Risk for the development and complications of cirrhosis and hepatocellular carcinoma.
  • More than 70% of patients who are negative for HBeAg develop complications;
  • An elevated HBV DNA level of more than 2,000 IU/mL (104 copies/mL);
  • Alanine aminotransferase levels at the upper normal level;
  • Highest risk when alanine aminotransferase levels are 1 to 2 times the upper normal level.

Hepatitis C Virus (HCV)

  • Mainly transmitted by blood and blood products.
  • Incubation period averages 6-7 weeks (range, 2-26 weeks).
  • Clinical illness occurs in 30%-40% of exposed individuals.
  • Chronic hepatitis C develops in 55%-85% of all exposed individuals.
  • 85%-95% of all exposed individuals become chronically infected.
  • 7%-8% of chronically infected individuals develop liver cirrhosis within 20 years.
  • Percutaneous exposure through a needlestick with HCV-contaminated blood confers a 1%-3% risk of infection.

Serology:

  • Presence of HCV RNA in the blood indicates active infection
  • Presence of anti-HCV indicates exposure to HCV, but not necessarily immunity

Hepatitis D Virus (HDV)

  • Transmitted through sexual contact or blood and blood products, mainly through injection drug use.
  • HBV must be present for infection to occur.
  • Coinfection with HBV (infection with HBV and HDV at the same time) causes an acute severe disease and is associated with a *6%-7% risk of developing chronic disease.
  • Superinfection with HBV (infection with HDV of an already-HBV-infected individual) is associated with a 10%-40% risk of developing chronic liver disease.

Hepatitis E Virus (HEV)

  • Transmitted through close personal contact or contaminated food and water.
  • Incubation period is 40 days (range, 15-60 days).
  • Fatality rate is estimated at 1%-3% but may be as high as 15%-25% among pregnant women.
  • No chronic disease stage.

SEN Virus (SENV)

  • A recently discovered virus that has been associated with posttransfusion hepatitis.
  • Found in 30%-70% of individuals who have received blood transfusions, but in only 2%-3% of nontransfused individuals.
  • Exposure results in chronic disease in 15%-20% of individuals.
  • No data are available regarding immunity, treatment, immunization, or mortality.

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