Dietary management of hepatitis A, B and C

Introduction

The world “hepatitis” come from the ancient Greek world heper (root world hepat) meaning is liver and Latin it is meaning inflammation of the liver cells. Hepatitis virus refers to the liver inflammation caused by the hepatitis A (formally known as infections hepatitis) is an acute infections disease of the liver caused by the hepatitis A virus (HAV) (Ryan 2004) which is the most commonly transmitted by the faecal oral routes through contaminated food or drinking water. Minimum of people die in the world heavily by the (HAC). Hepatitis B is the most cause of serous inner infection in the world. It is estimated worldwide that more 2 billion people have been infected by HBV and 350 million people have chronic infection and 5% of the world population are chronic carriers. The HBV is highly contagious and relatively easy to transmit from one infected to another, by blood content during birth, unprotected sex and sharing needles, and has relatively higher prevalence in the tropics

Nigeria is classified among the group of countries highly endemic for HBV infection. About 75% of Nigeria population is reportedly lively to hence been exposed to HBV at one time or the other in their infec Sirisena et al 2007. There is a high level of occurrence of blood demanding health conditions in many part of the sub-Saharan area Africa. In Nigeria, the increase in road accident, pregnancy related haemorrhage armed robbery attacks and violent invent increase the possibilities of the transmission of HBV (and other blood borne disease) through contaminated blood is reported by United Nations sustain in Nigeria (UNSN, 2001). Hepatitis C virus is a major worldwide public health problem. The world health organization (WHO) estimated that 30% of the word population is chronically infected with HCV. Most of this case occur in Africa which is reported to have the longest HVC prevalence rate (WHO 1990) although, direct percutioners incubation is the most efficient mode of transmission of HCV, several studies have demonstrated that sexual, household, occupational and vertical transmission of HCV may also be of importance  Neimo, 2002) .

History of hepatitis

The breakthrough understanding of hepatitis came in 1963 when Dr Baruch Blumbery discovered an antigen that dated the presence of hepatitis B (HBV) in blood samples. At the time, Dr Baruch Blumbery was actually researching the genetic disease susceptibility. He did not set out to discovered hepatitis, but his work hed to a major breakthrough and increased understanding of the disease.

In the 1950s, Dr Blumbery started explore whether inherited traits could make different group of people more or susceptive to the same disease. He and his team travelled around the world visiting native populations in remote location to collect blood sample for analysis. The intension was to look for genetic differences to see whether these difference were associated with a particular disease. Specially they studied hemophilia patient who had received multiple transfusion and therefore would be exposed to blood they had received from donors. The consequence of receiving over people’s blood is that the immune system produces “anti bodies” against the foreign blood serum proteins, or antigens from the donors. Dr. Baruch Blumberg and his team identified an unusual antigen from a blood sample of a Australian Aborigine, which they called the Australian antigen. After further research, this turn out to be the antigen that caused hepatitis B. which was officially recognized in 1967.

Just two years later in 1969, Dr Blumberg and his colleague Dr. Triving Millinian, invented the hepatitis B vaccine the U.S. Food and Drugs Administration named it the first anticancer vaccine because the prevention of chronic hepatitis infections result in the prevention of primary liver cancer live to HBV (Approximately 80% of people with chronic hepatitis B with develop livers cancer). More than 500,000 people die each year from liver cancer. The hepatitis B vaccine was been administered to millions of people particularly in Asia and Africa this saving many lives.

In the early 1970s, the causes of infection of hepatitis was named found and named the hepatitis A virus (HAV). In 1989 hepatitis C virus (HAV) was isolated. In fortunately there is no vaccines for hepatitis C, but 80% of carriers who completes a treatment course. In 1990 hepatitis E virus (HEV) were identified

 Hepatitis

Hepatitis is an inflammatory disorder of the liver that caused by virus, drugs and toxic hepatitis means injury to the liver with inflammation of the liver cells.  According to the oxford English dictionary hepatitis is a serums disease that affect the liver of a man or animals according to oxford dictionary of nursing new edition hepatitis is the inflammation of the liver caused by virus, toxic substance, or immological abnormalities  according to American medical association (2003) defined hepatitis. As the inflammation of the liver that can head to swelling tenderness, and permanent damage.

 Types of hepatitis

According to Antonic, there are five type of hepatitis namely

  1. Hepatitis A
  2. Hepatitis B
  3. Hepatitis C
  4. Hepatitis D
  5. Hepatitis E
  6. Hepatitis G

Hepatitis A

Hepatitis A is one of several types of Hepatitis, a disease of two liver. Caused by a virus Hepatitis A has been around for countries, but the virus that causes the disease was not isolated until quite recently. The history of Hepatitis A is long and of vital importance to the modern world we live in today. As global commerce increase, and people increasingly travel to other countries for the business and pleasure, it is important to get vaccinated for the disease if you plan to travel aboard. The form is the least severe, and easily treatable (Tucker, 2009).

The disease has been around since at least the times 7 the ancient Greek doctor Hip, or crates, when it was noted for causing jaundice. Hepatitis A (formerly known as infectious Hepatitis) is an acute infectious disease of the liver caused by fast forward to 1985 the Hepatitis A virus (HAV) (Ray et al., 2004) which is most commonly transmitted by the faecal–oral route through contaminated food or drinking water. Every year, approximately 2 billion of people worldwide are infected with the virus (Thiel, 1998). Hepatitis A is an extremely contagions liver infection caused by the Hepatitis A virus. It is one of several virus which causes inflammation to the liver and affect its ability to function (Adams, 1981). Hepatitis A does not have stage, is not progressive, and does not cause permanent liver damage. Following, infection the immune system makes antibodies against HAV that confer immunity against future infection. The disease can be prevented by vaccination, and Hepatitis A vaccine has been proven effective in controlling out-breaks worldwide (Connn, 2005). In developing countries and regions, with poor hygiene standard, the prevalence of infection with his virus is high ( Steffen, 2005).

Hepatitis B

Hepatitis B is a disease caused by Hepatitis B virus. (HBV) which infects the liver including humans and caused inflammations called Hepatitis, it was initially called serum Hepatitis (Barker, 2000). So, Hepatitis B virus (HBV) is the most common cause of serious liver infection in the world. It is estimated worldwide that more than 2 billion people have been infected by HBV and 350 million people have chronic infection and 5 % of the world population are chronic carriers. The HBV is highly contagious and relatively easy to transmit from one infected individual to another, by blood contact, during birth, unprotected sex and sharing needles, and has relatively higher prevalence in the tropics. Nigeria is classified among two group of countries highly endemic for HBV infection. About 75% of Nigerian population is reputedly lively to have been exposed to HBV at one time or other in their life. (Sena, et al., 2002). There is high level of occurrence of blood demanding health condition in many parts of the sub-Saharan area Africa. In Nigeria, the increase in road, accidents, pregnancy related haemorrhage, armed robbery attacks and violent invent increase the possibilities of the transmission of HBV through contaminated blood is reported by United Nations Sustain in Nigeria (UNSN, 2001).

Hepatitis C

Hepatitis c is a blood borne disease caused by the Hepatitis c virus (HCV). It causes liver inflammation which interferes with proper liver functions. Hepatitis c virus can eventually lead to several, permanent liver damage and cirrhosis (advanced scaring) and may be implicated by liver cancer. Because the initial symptoms are mild, Hepatitis c often goes unnoticed until years later when liver damage is discovered (Berenguers and Wright 2002). According to the Centre for Disease Control and Prevention (CDC). 21% of acute viral hepatitis reported in the word may he attributed to Hepatitis c virus infection whereas 67% of all causes develop chronic liver disease with accompanying increase of liver enzymes (Chen and Inorgan, 2006). Hepatitis c viral infection is also through to be a major contributing factor to hepatocellular carromal (HCV) (thevdora and journal, 2006). Similarly it was observe that the Hcv is the most common causing of post transfusion and community augue non–A, non–B hepatitis and cryptogenic cirrhosis worldwide. Furthermore, HCV is also considered as a major cause parentally transmitted acute and chronic Hepatitis. This virus has been reported to be.

Symptoms

  1. Anorexia
  2. Fever
  3. Rapid weight loss
  4. Loss of muscle
  5. Nausea
  6. Vomiting
  7. Abdominal discomfort able
  8. The colour of
  9. Dark urine
  10. Itching of the body light colour stool
  11. Takes an average of 4 week for the signs of Hepatitis A to appear after being exposed.

Some physical signs of hepatitis A include.

  1. Nausea and headless
  2. Poor appetites and weigh
  3. Abdominal pain
  4. Diarrhoea
  5. Fever
  6. Jaundice (can last 1 – weeks)
  7. Abnormal bowel movement (infectious for 2 weeks)
  8. Enlarged liver (WHO,2007).

Hepatitis B

Acute infection with hepatitis B virus is associated with acute viral Hepatitis which starts a general ill – health, loss of appetite, nausea, vomiting, body ache, mild fever, dark urine and developing of jaundice. It is common to note that itchy skin would also show a system of hepatitis virus types. These symptoms last for few weeks in few people may cause a severe liver dieseas thay may result to death, but the infection may be entirely asymptomatic and may go in recognized (Terroult, et al, 2005).

Hepatitis C

Acute Hepatitis C refers to the first 6 months after infection with between 60% to 70% of people infected develop no symptom during the acute phase in the minority of patient who experience acute phase symptoms are generally mild and non – specific and rarely lead to specific diagnosis of hepatitis C (Kanial, 2008) infection include decreased appetites fatigue abdominal pain jaundice, itching and this live symptoms, dark yellow urine light colour stool

Dietary management of hepatitis A, B and C

High protein, high carbohydrate and moderate fat are recommended. Small attractive meals at regular intervals are better tolerated over feeding should be available.

Energy

A high energy diet is advised to promote weight gain and to ensure maximum protein utilization however initially the patients may not be able to eat enough time to anorexia. Gradually the energy intake should be increased. In nasogastric feeding stages about 100 k cal are supplied. In severe 1,600 k cals to 2,000 kcal   suggested.

Proteins:

Proteins intake needs to be increased promote regeneration of the liver. However, a very protein load may not be tolerated and needs to be adjust depending in the extend of the liver damage in acute cases, with extensive liver damage the protein intake may have to be decrease even below normal. Protein requirement very according to the seventy of the disease. With severe jaundice, 40g while in wild jaundice 60 – 10g of protein is permitted. With hepatic precoma and coma, protein containing foods one withheld as liver cannot metabolise protein and only high carbohydrate containing foods are recommend to be given to the patient. e.g. nut egg, fish, meat, poultry and milk e.g. soybean beans and legumes

Fat:

During the occurrence of hepatitis the digestive and absorption of fat is improved. Therefore it is advisable to decrease fat intake, through not severely. Moderate amount of fat in the diet not only increase the palatability of the food but also promotes recovery of the patient. Emulsified fats such as from milk, butter, cream, eggs should be given as they are easily digested.

Carbohydrate:

High carbohydrate content in the diet with a hepatitis is essential to supply enough calories so that tissue protein are not broken down for energy purpose. When fever, nausea and vomiting present intravenous glucose is suggested. As soon as the protein can take oral feeds, intravenous feeding should be stopped and fruit juice, sugar jiggery and honey are to be given only not to provide (energy) but to also supply adequate electrolyte.

Vitamins:

Vitamins are very essential in the body of the Hepatitis patient to regenerate damage liver of the patient. 500g of vitamin C, long of vitamin K and supplement of B – complex are essential to inlet the daily needs of the patient. If anorexia, nausea or vomiting is there, the vitamins may be given by injection.

Minerals:

If food is not taken orally then a careful health care should be kept on the serum sodium and potassium level. Oral feeds of fruit juice, vegetable and meat soaps with added salt given orally or through nasogastric tube help in maintaining the electrolyte balance. Normal serum level of sodium and potassium must be maintain through supplement calcium e.g. York liver

Prevention of Hepatitis A:

Good personal hygiene, such as washing hands after using the bathroom and proper handing of food can effectively prevent the spread of hepatitis A. people who are infected with HAV should not prepared or handle food that is to be eaten by others. Doctors recommend an HAV vaccine (introduce 1995) for travelers to area in which hepatitis A is endemic. To be effective, the vaccination must be given at least one (1) month before possible exposure. Immunization is also advised homosexual men who hence sex with more than one partners for intravenous (iv) drug users. For people with chronic liver damage or bleeding disorder such as hemophilia, for those who experience occupational exposure to HAV for children who live in high risk communities. The vaccine can be used to HAV infection are diagnosis in a community, immune globletin should be administered to every one who may have been exposed to the virus.

Prevention of hepatitis B:

Because a vaccine for hepatitis B exist, HBV is preventable. In united state, immunization with the hepatitis B vaccine begin at birth order children who have not yet been vaccinated should receive a series of three injections when they are 11 – 12 years old. Adult with multiple sex  partners or who live in a household with cornier of chronic HBV and those with bleeding disorder (such as hemophilia) should be immunized pregnant women in Nigerian row routinely tested for hepatitis B. this will helped to eliminate the passage of the virus from mother to infant. To guild against HBV, doctors advised people who used drugs not to share needles or to have unprotected sex with infected or multiple powers tattoos and body piercing should take place only in sanitary establishments. Although the risk is slight, personal items such as razor and brushes should not be share with an infected person.

Prevention for Hepatitis C

Hepatitis C is the currently the most common reason why for liver transplant in Nigeria and united state. Because there is no vaccine against hepatitis C, prevention key. To guard against this virus, doctor advise people not to share IV needles for that tattoos and body piercing must take place only in sanitary establishments health care workers who have contact with blood and blood products should exercise appropriate precautions. In addition, although the risk is slight, personal items ( such as razor and tooth brushes) should not shared in the home of an infected person.

Conclusion

Hepatitis is a disease which called by virus. Hepatitis kills more than 2 million 7 people in the word ignorant. It is advisable for every individual to maintain good personal hygiene avoid multiple sex partners in the world every pregnant women should for treatment during her pregnant period and also eat healthy food. All health care workers are to be very careful with blood in the hospital. After attending to a patient in the hospital it is advisable to wash your hand with a good detergent to make the virus inactive. This practice is also encourage after visiting the toilet.

References

Bernal, W. & Wendon, J. (2013). Acute Liver Failure. New England Journal of Medicine, 369 (26), 2525–2534.

Dunn, MA (2011). Parasitic Disease. Oxford: Wiley-Blackwell.

Longo, D. L. (2012). Chronic Hepatitis”. Harrison’s Principles of Internal Medicine. (18th ed.). New York: McGraw-Hill.

O’Mara, S.R. & Gebreyes, K. (2011). Hepatic Disorders, Jaundice, and Hepatic Failure. New York: McGraw-Hill.

Kumar, V. Fausto, N. & Abbas, A. (2003). Robbins & Cotran Pathologic Basis of Disease (7th ed.). New York: Saunders.

Papadaikis, M. (2014). Alcoholic Liver Disease in Current medical diagnosis and treatment. New York: McGraw-Hill.

Ryder, S. & Beckingham, I. (2001). Acute hepatitis. BMJ 322 (7279), 151–153.

Suk, K. & Kim, D. J. (2012). Drug-induced liver injury: present and future. Clinical and Molecular Hepatology 18 (3), 249–57.

Teufel, A. Galle, P.R. & Kanzler, S. (2009). Update on autoimmune hepatitis. World Journal of Gastroenterology 15 (9), 1035–41.

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