A CLINICAL STUDY ON THERAPEUTIC MANAGEMENT OF VIRAL HEPATITIS-A IN PAEDITRICS
1-Final Year Graduate Student
Sri Lakshmi Narasimha College of Pharmacy,
Palluru, Chottoor-517132, Andhra Pradesh, India.
Hepatitis is a general term meaning inflammation of the liver and can be caused by a variety of different viruses such as hepatitis-A, B, C, D, and E. Since the development of jaundice is a characteristic of liver disease, a correct diagnosis can only be made by testing patient’s sera for the presence of specific anti-viral antibiotics. Transmission of HAV is typically by the faecal, oral route. Hepatitis A was formerly called infectious hepatitis, Epidemic hepatitis, Epidemic jaundice, Catarrhal jaundice, type A hepatitis, HA.
Reference Id: PHARMATUTOR-ART-1616
I.HEPATITIS PRIMARY STUDIES:
Many viruses affect the liver function. But only a few are truly infectious to liver itself leading to clinically significant hepatitis. The term viral hepatitis refers to the diseases caused by this subgroup.
Five human viruses have been identified, including hepatitis A (HAV), B (HBV), C (HCV), D (HDV), E (HEV). All forms of viral hepatitis have a similar pathology, causing an acute inflammation of the entire liver.
1. Hepatitis A:
It is the major cause of acute hepatitis worldwide, accounting for 20-25% of clinical hepatitis in the developed world. Most attacks are mild and often pass unnoticed by the patient. HAV is spread via the fecal-oral route. It has incubation period of 2-7 weeks.
2. Hepatitis B:
The prevalence of hepatitis B (HBV) is low in the USA and Britain, with approximately 0.1-0.2% of the population having markers that indicate that they are chronic carrier. HBV is parentrally transmitted. Acute HBV infection has an incubation period of 3-6 months.
3. Hepatitis C:
It is a blood borne virus with greater infectivity than the human immunodeficiency virus (HIV). The global prevalence of HCV infection is estimated at around 3% in the general population with more than 150 million carriers worldwide. HCV is transmitted parenterally.
4. Hepatitis D:
It can establish infection only in patients simultaneously infected by HBV. It is acquired in the same way as HBV infection, can cause both acute and chronic hepatitis.
5. Hepatitis E:
It is endemic in areas of poor sanitation, where it is transmitted enterically and leads to acute hepatitis. It has an incubation period of 40 days.
6. Hepatitis F:
Hepatitis F, another distinct non-A, non-B hepatitis virus, is likely to exist. A virus designated as hepatitis F virus was isolated from the stool of a patient with hepatitis. The hepatitis F was develops in persons receiving coagulation factor from pooled blood of the patients who have already recovered from HCV infection.
7. Hepatitis G:
Recently, new blood borne viruses were discovered simultaneously by two investigators and named hepatitis G virus (HGV). These viruses were later determined into the isolates of the same single stranded RNA virus, identified as a members of the flaviviridae family and are now referred to as HGV.
The primary rate of transmission is parental. The virus is often present in 50% of injection drug users, 30% of hemophiliacs and 20% of haemodialysis patients. There is also evidence of a sexual transmission. The site of viral replication has not been identified.
8. Non-A, Non-B, Non-C Hepatitis viruses:
Non-A, Non-C Hepatitis was the term used previously to describe Hepatitis thought to be due to a virus but not HAV or HBV. HCV and HEV are the main hepatitis viruses to emerge from this group. Further such viruses do exists, but the hepatitis viruses described above now accoynt for the majority of Hepatitis virus infections Hepatitis-B virus.
It is defined as yellowish discoloration of the skin and mucous membrane due to excess amount of bilirubin present in blood.
9.1. Hemolytic jaundice:
If the concentration of bilirubin in the serum rises above normal due to more formation as a result of increased erythrocyte destruction, hemolytic jaundice results. There is lemon-yellow tinge of bulbar conjunctiva.
9.2. Obstructive (Regurgitation) jaundice:
This condition occurs from blockage of the hepatic or common bile ducts. The bile pigment passes from blood to the liver cells as usual. However, failing to be excreted by the bile capillaries, it is absorbed into the hepatic veins and lymphatic.
9.3. Hepatocellular jaundice:
This type of jaundice is caused by liver dysfunction s a result of the damage tom the parenchyma cells by infection, toxins and liver poisons. At a certain stage, the inflammation and damage to liver cells become severe leading to part obstruction to the flow bile. This results in the absorption of conjugated bilirubin and bile into the general circulation cause Orange-Yellow tinge of bulbar conjunctiva
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