Hepatitis is an injury to liver characterised by presence of inflammatory cells in the liver tissue.
It can be self limiting,or It can progress to scarring of the liver.
Hepatitis viruses cause most cases of liver
damage worldwide
2. Hepatitis
Hepatitis is an injury to liver characterised by
presence of inflammatory cells in the liver tissue.
It can be self limiting,or It can progress to scarring
of the liver.
Hepatitis viruses cause most cases of liver
damage worldwide
2
3. Source of
virus
feces blood/
blood-derived
body fluids
blood/
blood-derived
body fluids
blood/
blood-derived
body fluids
feces
Route of
transmission
fecal-oral percutaneous
permucosal
percutaneous
permucosal
percutaneous
permucosal
fecal-oral
Chronic
infection
no yes yes yes no
Prevention pre/post-
exposure
immunization
pre/post-
exposure
immunization
blood donor
screening;
risk behavior
modification
pre/post-
exposure
immunization;
risk behavior
modification
ensure safe
drinking
water
Types of Hepatitis viruses
A B C D E
3
8. CHRONICITY HEPATITIS B
Chronic infection occurs in:
90% of infants infected at birth
30% of children infected at age 1–5
years
6% of persons infected after age 5
years
8
9. Worldwide epidemiology of
hepatitis B
Hepatitis B virus (HBV) infection is a serious
global health problem
2 billion people infected world wide
350 million suffering from chronic HBV
infection.
The 10th leading cause of death
9
10. Seroepidemiology of hepatitis B
virus in northern part of
Palestine, 1996
The prevalence rate of HBsAg in
healthy blood doners was 3.4%
greater than that in Israel (0.9-1.3%)
lower than that of Jordan (4.4%) and
Saudi Arabia (7.4%).
Al.Rifa’i Ammar W. S. Seroepidemiology of hepatitis B virus in the population of
northern part of Palestine, 1996
10
11. Cont.
The prevalence rate in pregnant
women was 3.9%..... higher than that
in Israel (2.2%).
Among the staff & students of An-
Najah University the prevalence rate
was 4.9%.
11
12. Annual reported incidence rate of hepatitis B cases and
carrier in the Palestine,
2000-2005, (per 100,000)
http://www.moh.gov.ps/pdffiles/communicable%20diseases-2005.pd)
12
13. Prevalence rate of HBV antigens
among high risk groups:
421 sera samples collected during 1995 to
1997
kidney transplants(n=109),
hemodialyzed patients (n=76),
non-vaccinated healthcare workers (n=52)
blood transfusion dependent patients (n=80).
include 60 thalassemic, 6 hemophilic and 14
sickle cell anemia patients.
Medical Journal of Islamic World Academy of Sciences 15:4, 157-160, 2005
13
14. Prevalence rate of HBV antigens
among high risk groups:
Patients group HBsAg + HBeAg +* Anti-HBc +
Kidney transplant 29.4% 43.8% 56.9%
Hemodialysis 17.1% 76.9% 50.0%
Blood transfusion
dependent
22.5% 38.9% 37.5%
Non- vaccinated
healthcare workers
9.6% 00.0% 17.3%
Vaccinated health
care workers
00% 00% 5.8%
Medical Journal of Islamic World Academy of Sciences 15:4, 157-160, 2005
14
16. Hepatitis B vaccination
Globally
Safe and effective vaccines against HBV
infection have been available since 1982
The typical regimen is a 3 doses
should be taken intramuscularly at intervals
of 0, 1 and 6 months
16
17. Hepatitis B vaccination
Globally / cont
Recombinant vaccines have been
investigated in many clinical studies
(WHO) spends on all immunization
programmes about 85 million dollars per
year.
Universal vaccination strategies they prove to
be cost effective
17
18. Hepatitis B vaccination in
palestine
Universal hepatitis B immunization was
introduced in Palestine in1993
high coverage rate of 99%.
it is given free of charge to all children at 0,1
and 6 months of age.
http://www.moh.gov.ps/pdffiles/communicable%20diseases-2005.pdf
18
21. The TARGET and COMPLICATIONS
of HCV
The LIVER is the main target..
Recently -- found in bone marrow.. kidney..
monocytes/ macrophages (CD14) .. B
lymphocyte CD 19 and granulocytes CD 15 ..
Jaundice occurs in only 20-30 %
Complications-- may develop after about 20-40
years of infection…
21
23. Hepatitis C/CHRONICITY
Chronic infection: 55%-85% of
infected persons
Chronic liver disease: 70% of
chronically infected persons
Deaths from chronic liver disease:
1%-5%
23
24. Hepatitis C in Palestine
Surveillance of hepatitis C in Palestine started
in 1994
the incidence rate of hepatitis C cases
&carriers per 100,000 was ranging between
“3-9” in the period 1996-1999.
“4.2-8” in the period 2000-2004.
http://www.moh.gov.ps/pdffiles/communicable%20diseases-2005.pdf
24
25. Hepatitis C in Palestine(cont.)
Screening is performed for blood donors,
multiple blood transfusion, hemodialysis
patients & contacts of a case.
Hepatitis C virus infection is found in 0.5%-
8.0% of blood donors world wide.
Palestine enjoys a very low prevalence rate of
0.2% among blood donors
25
27. Theresultsofthe study
New cases of HCV
Period
6
Period I
(June 99-Nov 99)
0
Period II
(Dec 99- May 2000)
6
Period III
June 2000-Nov 2000)
27
28. Such findings clearly indicates a
NOSOCOMIAL INFECTION within the unit..
Males showed higher rate 63.64% than
females 36.36% of HCV infection..WHYYY
!!!...They found that higher rate ofdiabetic
males compared with females..
29. Depending on these
results we have
separated machines for
HCV, HBV positive
patints
To decrease
contamination
29
30. REFERENCES
Ministry of Health PALESTINEWebsite
WHO website..
A research from AL NAJAH Univ.
EMRO website
Hepatitis CentreWebsite.. 30