Know aboutJAUNDICE And Its Treatment ,Jaundice in INDIA , HEPATITIS VIRUSES,Hepatitis C,Hepatitis E,Acute Hepatitis B ,Treatment

1. Know about
JAUNDICE
And
Its Treatment
Dr. Rashmi Jain
Dr. Indu Tyagi
Public Awareness Series
Dr Sharda Jain
Dr. Jyoti Agarwal
ISO 14001:2004 (EMS)
…..Caring hearts, healing hands

2. Jaundice in INDIA
• Many Indians suffer from jaundice during
monsoons.
• In our country, the most common cause of
jaundice, which is characterized by a yellowish
discoloration of the eyes, is viral Hepatitis.
• The inflammation of the liver is caused by
infection due to viruses (Hepatitis A, B, C, D and
E). Hepatitis A and E are transmitted by
contamination of food and water and unhygienic
conditions.”

3. HEPATITIS VIRUSES
• Hepatitis A (HAV) Picornaviridae (1973)
• Hepatitis B (HBV) Hepadnaviridae (1970)
• Hepatitis C (HCV) Flaviviridae (1988)
• Hepatitis D (HDV) ? (1977)
• Hepatitis E (HEV) (Caliciviridae) (1983),
Hepeviridae
• Hepatitis F – Not separate entity – Mutant
of B Virus.
• Hepatitis G (HGV) Flaviviridae (1995)

4. Viral Hepatitis - Historical Perspectives
“Infectious” A
Viral hepatitis NA:NB
E
Enterically
transmitted
“Serum” B D C
Parenterally
transmitted
F- Mutant
Of B
G

5. Type of Hepatitis
A B C D E
Source of
virus
Feces Blood
Blood derived
Body fluids
Blood
Blood derived
Body fluids
Blood
Blood derived
Body fluids
Feces
Route of
Transmission
Feco-oral Percutaneous
Permucosal
Percutaneous
Permucosal
Percutaneous
Permucosal
Feco-
oral
Chronic
Infection
No Yes Yes Yes No
Prevention Pre Post
Exposure
Immunization
Pre Post
Exposure
Immunization
Blood donor
screening
Blood donor
screening
Pre Post
Exposure
Immunization
Ensure
Safe
Drinking
water

6. Fecal
HAV
Symptoms
0 1 2 3 4 5 6 1
2
2
4
Hepatitis A Infection
IgG anti-HAV
Titre ALT
IgM anti-HAV
Months after exposure
Typical Serological Course

7. Symptoms
HBe Ag anti- HBe
Total anti- HBc
IgM anti- HBc anti- HBsHBs Ag
0 4 8 12 16 20 24 28 32 36 52 100
Acute Hepatitis B Virus Infection with Recovery
Typical Serologic Course
Weeks after Exposure
Titre

8. Symptoms
anti-HCV
ALT
Normal
0 1 2 3 4 5 6 1 2 3 4
Hepatitis C Virus Infection
Typical Serologic Course
Titre
Months Years
Time after Exposure

9. Symptoms
ALT IgG anti-HEV
IgM anti-HEV
Virus in stool
0 1 2 3 4 5 6 7 8 9 10 11 12 13
Hepatitis E Virus Infection
Typical Serologic Course
Titer
Weeks after Exposure

10. Hepatitis B Virus

11. HEPATITIS C VIRION: spherical,
icosahedral,
NUCLEIC ACID: ss (+) RNA

12. Hepatitis B,C, & D.
• Jaundice usually lasts for four to six weeks.
Hepatitis B and C are transmitted by
contaminated blood and syringes, sexual
transmission, needle –stick injury and
intravenous drug abuse.
• Hepatitis D occurs only in the presence of
Hepatitis B and this could be many times fatal.
• When Hepatitis B occurs as an acute infection, it
resolves in 90% of cases and does not require
treatment, and is preventable by vaccination.

13. Possible Outcomes of HBV Infection
Acute hepatitis B infection
Chronic HBV infection
3-5% of adult-acquired
infections
95% of infant-
acquired infections
Cirrhosis
Chronic hepatitis
12-25% in 5 years
Liver failureHepatocellular
carcinoma
Liver transplant
6-15% in 5 years 20-23% in 5 years
DeathDeath

14. Hepatitis C
• Hepatitis C infection becomes chronic and
requires long-term treatment.
• Jaundice can also occur due to blockage of the
biliary system, can be caused because of stone
or cancer or because of increased breakdown of
red blood cells.
• The differentiation between the various causes
of jaundice can be diagnosed by tests like liver
function test and ultrasound examination of the
abdomen.

15. 15
OUTCOMES of HCV Hepatitis

16.  Incubation period: Average 40 days
Range 15-60 days
 Case-fatality rate: Overall, 1%-3%
Pregnant women,
15%-25%
 Illness severity: Increased with
age
 Chronic sequelae: None identified
Hepatitis E - Clinical Features

17. How to suspect Acute Liver failure.
• One should remember that if a person is
suffering from viral Hepatitis and starts
vomiting, becomes restless and experiences
behavioral abnormalities , it might be
possible that he/she is progressing to acute
liver failure.
• This condition requires immediate medical
attention and ICU care and even a liver
transplantation.

18. Treatment
• All causes of jaundice are treatable, but require
consultation with a specialist.
• Jaundice cases should not be treated by quacks
who often use herbal and Ayurveda drugs
leading to a fatal out-come for a potentially
curable disease.
• The blockage of the bile duct can be treated by
surgery or by an endoscopic procedure called
ERCP depending on the stage of the disease.

19. • Many cases occur in community-wide outbreaks
– no risk factor identified for most cases
– highest attack rates in 5-14 year olds
– children serve as reservoir of infection
• Persons at increased risk of infection
– travelers
– homosexual men
– injecting drug users
Hepatitis A Vaccination Strategies
Epidemiologic Considerations

20. Hepatitis B Vaccine
• Infants: several options that depend on status of
the mother
– If mother HBsAg negative: birth, 1-2m,6-18m
– If mother HBsAg positive: vaccine and Hep B immune
globulin within 12 hours of birth, 1-2m, <6m
• Adults
* 0,1, 6 months
• Vaccine recommended in
– All those aged 0-18
– Those at high risk

21.  Screening of blood, organ, tissue
donors
 High-risk behavior modification
 Blood and body fluid precautions
Prevention of Hepatitis C

22.  Avoid drinking water (and beverages
with ice) of unknown purity, uncooked
shellfish, and uncooked fruit/vegetables
not peeled or prepared by travele.
 Vaccine?
Prevention of Hepatitis E

23. ADDRESS
11 Gagan Vihar, Near
Karkari Morh Flyover,
Delhi - 51
CONTACT US
9650588339
9599044257
011-22414049
WEBSITE :
www.lifecareivf.in
www.lifecarecentre.in
www.lifecareabs.in
ISO 14001:2004 (EMS)
…..Caring hearts, healing hands
ISO 9001:2008
Helpline : 9599044257
Web.www.lifecareivf.in
Helpline : 9910081484
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