Management of Patients With Viral Hepatic Disorders
Viral hepatitis is a systemic, viral infection in which necrosis and inflammation of liver cells produce a characteristic cluster of clin-ical, biochemical, and cellular changes. To date, five definitive types of viral hepatitis have been identified: hepatitis A, B, C, D, and E. Hepatitis A and E are similar in mode of transmission (fecal–oral route), whereas hepatitis B, C, and D share many characteristics. Terms associated with viral hepatitis are listed in Chart 39-5. The increasing incidence of viral hepatitis is a public health concern. The disease is important because it is easy to transmit, has high morbidity, and causes prolonged loss of time from school or employment.
It is estimated that 60% to 90% of cases of viral hepatitis go un-reported. The occurrence of subclinical cases, failure to recognize mild cases, and misdiagnosis are thought to contribute to the under-reporting. Although approximately 40% of all persons in the United States have antibodies against hepatitis A virus, many can-not recall an earlier episode or the occurrence of the symptoms of hepatitis (O’Grady et al., 2000). Table 39-4 compares the major forms of viral hepatitis.
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