Hepatitis: Nursing

Hepatitis refers to an inflammation of the liver due to infection or injury, and it’s often self-limiting, but some cases can result in extensive liver damage.

Now, let’s quickly review some anatomy and physiology. The liver is a large, solid organ located in the right upper quadrant of the abdomen, which has several functions, including the production of bile, cholesterol, and certain blood proteins like albumin and clotting factors; as well as helping with glucose and fat metabolism; detoxification through medication and alcohol metabolism; and it also plays a big role in bilirubin metabolism.

Now, hepatitis can be caused by a viral infection, called viral hepatitis, or other kinds of injury, in which case it’s called non-viral hepatitis.

The more common one is viral hepatitis, which is caused by hepatitis viruses A, B, C, D, or E. Hepatitis A virus is usually transmitted through the fecal-oral route, through contaminated food or water, or through person-to-person contact; and risk factors include living or working in nursing homes, daycare centers, and living in or traveling to countries with poor access to clean water, sanitation, and hygiene; as well as sexual contact with an infected individual.

Next, we have hepatitis B, C, and D viruses, which are primarily transmitted through blood and other body fluids; so the main risk factors include intravenous drug use, blood transfusions, hemodialysis, and working as a healthcare professional; as well as high-risk sexual behavior, such as having multiple partners or not using protection. Hepatitis B can also be transmitted vertically to the baby before or after birth.

Of note, the hepatitis D virus can’t cause an infection in the absence of hepatitis B virus. So the most important risk factor for a hepatitis D infection is a hepatitis B infection.

Lastly, hepatitis E is transmitted through the fecal-oral route, mostly through consuming contaminated food or water.