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Of the 5 types of viral hepatitis (HAV-HEV), HBV and HCV are by far the most common causes of chronic hepatitis in both pregnant and nonpregnant populations, causing more than 50% of cirrhosis cases and 78% of cases of primary liv...
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Of the 5 types of viral hepatitis (HAV-HEV), HBV and HCV are by far the most common causes of chronic hepatitis in both pregnant and nonpregnant populations, causing more than 50% of cirrhosis cases and 78% of cases of primary liver cancer. Infection during pregnancy can have adverse effects on both the mother and her fetus. For all 5 viral hepatitis syndromes, early identification allows appropriate measures to be taken to optimize pregnancy outcomes and minimize the risk of perinatal transmission. This article reviews the prevention and management of all 5 viral hepatitis syndromes during pregnancy.
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Zusammenfassung Mit Virushepatitis?A bis?E werden verschiedene infekti?se Entzündungen des Leberparenchyms bezeichnet, die durch die Hepatitisviren?A bis?E (HAV, HBV, HCV, HDV und HEV) ausgel?st werden. Zwar ?hneln sich die Krank...
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Zusammenfassung Mit Virushepatitis?A bis?E werden verschiedene infekti?se Entzündungen des Leberparenchyms bezeichnet, die durch die Hepatitisviren?A bis?E (HAV, HBV, HCV, HDV und HEV) ausgel?st werden. Zwar ?hneln sich die Krankheitsbilder, die Erreger geh?ren jedoch zu verschiedenen Virusfamilien und unterscheiden sich bezüglich der Pathogenese, der übertragungswege, des klinischen Verlaufs und der Pr?ventions- und Therapiem?glichkeiten. In Deutschland besteht eine namentliche Meldepflicht nach Infektionsschutzgesetz (IfSG) für den direkten oder indirekten Nachweis und für Verdacht, Erkrankung und Tod. Die Daten werden an das Robert Koch-Institut übermittelt.In diesem Beitrag wird die Epidemiologie der Hepatitiden?A bis?E anhand publizierter Studien und Meldedaten beschrieben und es werden aktuelle Herausforderungen und Pr?ventionsans?tze aufgezeigt. Letztere bestehen insbesondere in der verbesserten Umsetzung bereits bestehender Impfempfehlungen (Hepatitis?A und?B), dem verbesserten Zugang zu Pr?vention, Testung und Versorgung, einschlie?lich Therapie mit antiviralen Medikamenten (Hepatitis?B, C?und?D), und der Erkennung und Verhinderung lebensmittelbedingter Infektionen und Ausbrüche und Verbesserungen auf dem Gebiet der Lebensmittelsicherheit (Hepatitis?A und?E).
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Mongolia has one of the highest hepatitis A, C, B and D infection incidences worldwide. We sought to investigate changes in the proportion of acute viral hepatitis types in Mongolia over the last decade. The cohort comprised 546 c...
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Mongolia has one of the highest hepatitis A, C, B and D infection incidences worldwide. We sought to investigate changes in the proportion of acute viral hepatitis types in Mongolia over the last decade. The cohort comprised 546 consecutive patients clinically diagnosed with acute viral hepatitis from January 2012 to December 2014 in Ulaanbaatar Hospital, Mongolia. A time trend analysis investigating the change in proportion of acute hepatitis A virus, hepatitis C virus (HCV), hepatitis B virus (HBV) and hepatitis delta virus (HDV) infection among the cohort with respect to a previous published study was undertaken. Acute hepatitis A, B and C was diagnosed in 50.9%, 26.2% and 6.0% of the cohort. Notably, 16.8% of the cohort had a dual infection. The etiologies of acute viral hepatitis were varied by age groups. The most common cause of acute viral hepatitis among 2-19 year olds was hepatitis A, HBV and superinfection with HDV among 20-40 year olds, and HCV among 40-49 year olds. Patients with more than one hepatitis virus infection were significantly older, more likely to be male and had a higher prevalence of all risk factors for disease acquisition. These patients also had more severe liver disease at presentation compared to those with mono-infection. Acute viral hepatitis is still prevalent in Mongolia. Thus, the need for proper infection control is increasing in this country.
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Many microbes, toxins, autoimmune diseases, and neoplastic diseases may cause liver inflammation; however, 5 viruses whose main pathogenesis is liver disease are referred to as hepatitis A, B, C, D, and E viruses. These viruses ca...
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Many microbes, toxins, autoimmune diseases, and neoplastic diseases may cause liver inflammation; however, 5 viruses whose main pathogenesis is liver disease are referred to as hepatitis A, B, C, D, and E viruses. These viruses cause a significant burden of global illness. With the exception of hepatitis A virus, all may cause chronic infection potentially leading to cirrhosis and hepatocellular carcinoma. Excellent serologic and nucleic acid detection methods are available for determining the precise cause and, in some cases, the duration of infection. Diagnostics are critical for identifying individuals needing treatment and for monitoring the treatment success.
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Hepatitis caused by hepatitis B and C virus is increasingly becoming a significant global health threat, with widespread prevalence that may have severe disease and economic impacts in the future. Yet, preventative measures are no...
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Hepatitis caused by hepatitis B and C virus is increasingly becoming a significant global health threat, with widespread prevalence that may have severe disease and economic impacts in the future. Yet, preventative measures are not implemented universally and high costs of medicines limits treatment efforts. The global response to HIV/AIDS faced similar issues, but overcame them through a global movement that brought attention to the crisis and ultimately resulted in the creation and implementation of and access to better tools for HIV prevention and treatment. This also included effective policies and programmes behind and supporting the movement. Such could be done for hepatitis, specifically using lessons from the HIV response. Here, we will discuss the current and potentially severe future burden of hepatitis globally, the challenges in addressing this epidemic, and how principles applied from the global HIV response can facilitate a successful and similar hepatitis movement.
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Infectious hepatitis in pregnancy is clinically significant in both the acute and chronic phases. Here, we review the perinatal implications of chronic hepatitis B and C and acute hepatitis A and E. Familiarity with screening, tra...
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Infectious hepatitis in pregnancy is clinically significant in both the acute and chronic phases. Here, we review the perinatal implications of chronic hepatitis B and C and acute hepatitis A and E. Familiarity with screening, transmission, diagnosis, and management of infectious hepatitis is of ongoing importance during obstetric care, as these diseases are endemic in much of the world. Pregnancy and interpregnancy care provide opportunities to prevent infection and transmission of hepatitis.
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Overview Over the past 15 years, the incidences of hepatitis A and B virus infection in the United States have declined significantly. By contrast, the incidence of hepatitis C virus infection, formerly stable or in decline, has i...
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Overview Over the past 15 years, the incidences of hepatitis A and B virus infection in the United States have declined significantly. By contrast, the incidence of hepatitis C virus infection, formerly stable or in decline, has increased by 75% since 2010. Suboptimal therapies of the past, insufficient provider awareness, and low screening rates have hampered efforts to improve diagnosis, management, and treatment of viral hepatitis. New screening recommendations, innovations in assessment and treatment, and an updated action plan from the U.S. Department of Health and Human Services (HHS) seem likely to lead to significant progress in the coming years. This article reviews the epidemiology, natural history, and diagnosis of viral hepatitis; discusses new screening recommendations, assessment tools, and treatments; and outlines the HHS action plan, focusing on the role of nurses in prevention and treatment.
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Viral hepatitis contributes to significant morbidity and mortality worldwide. While acute infection may be self-limiting, unrecognised chronic infection and under-utilisation of guideline-based approaches to therapy contribute to ...
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Viral hepatitis contributes to significant morbidity and mortality worldwide. While acute infection may be self-limiting, unrecognised chronic infection and under-utilisation of guideline-based approaches to therapy contribute to increasing rates of cirrhosis, hepatocellular carcinoma and death. Our aim was to review the current evidence for screening, diagnosis and treatment in hepatitis A to E. Evidence for this review was sourced from international and Australian guidelines and high-quality clinical trials. MEDLINE was searched using structured key word strategy and retrieved articles were reviewed methodically to inform a brief and up-to-date synopsis of hepatitis A to E. We share some of the recent developments in viral hepatitis, specifically the new therapies for hepatitis C. Direct-acting antiviral therapies are safe, well-tolerated and effective. Subsidies allow access for all Australians with most strains of hepatitis C. We outline evidence underpinning efficacy and safety of treatment for hepatitis B, while clarifying some of the nuances in the setting of pregnancy and immunosuppression. We provide a simplified concept to facilitate understanding of the five phases of hepatitis B; practical for real-world setting. Hepatitis A to E is a broad topic, not all aspects of these viruses can be covered in this short review. We provided suggestions for evidence based guidelines, which are a suitable supplement to this article.
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Background: At least five different types of viral hepatitis cause problems of significant public health importance in Africa, where together they constitute a huge burden of disease. But until now, efforts to control the infectio...
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Background: At least five different types of viral hepatitis cause problems of significant public health importance in Africa, where together they constitute a huge burden of disease. But until now, efforts to control the infections have been largely piecemeal. Analysis of the strategies needed to control each virus, however, reveals major overlaps. Proposal: We propose that the control of these infections in the WHO African Region should start with the common strategies rather than with each disease. But this approach presents potentially huge problems to overcome, such as the difficulty of integrating multiple health service elements - the track record for successful integration of such services is not good. This is despite encouraging rhetoric from donors and national leaders alike. And to succeed, disparate programmes must work closely together. But we believe that the time is right to create new opportunities for prevention and treatment of hepatitis, including increasing education, and promoting screening and treatment for more than 500 million people already infected with hepatitis B and C viruses. Impact: The impact of these efforts on decreasing mortality and morbidity will be significant because of the high burden of disease from these infections, and also because the effect will spill over to benefit the control of other communicable diseases and health systems strengthening. Such a project will inevitably involve multiple strategies that will vary somewhat according to the epidemiology of the diseases and the location.Digital Object Identifier http://dx.doi.org/10.1016/j.vaccine.2012.11.001
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The interdisciplinary guidelines at the S3 level on the diagnosis of and therapy for hepatocellular carcinoma (HCC) constitute an evidence- and consensus-based instrument that is aimed at improving the diagnosis of and therapy for...
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The interdisciplinary guidelines at the S3 level on the diagnosis of and therapy for hepatocellular carcinoma (HCC) constitute an evidence- and consensus-based instrument that is aimed at improving the diagnosis of and therapy for HCC since these are very challenging tasks. The purpose of the guidelines is to offer the patient (with suspected or confirmed HCC) adequate, scientifically based and up-to-date procedures in diagnosis, therapy and rehabilitation. This holds not only for locally limited or focally advanced disease but also for the existence of recurrences or distant metastases. Besides making a contribution to an appropriate health-care service, the guidelines should also provide the foundation for an individually adapted, high-quality therapy. The explanatory background texts should also enable non-specialist but responsible colleagues to give sound advice to their patients concerning specialist procedures, side effects and results. In the medium and long-term this should reduce the morbidity and mortality of patients with HCC and improve their quality of life.
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