4-13. COURSE AND PROGNOSIS
This is a more severe disease than infectious hepatitis. Recovery may take
many months. Case fatality rates of 10 percent have been observed in some
outbreaks. Generally, the fatality rate is 1 to 10 percent.
4-14. TREATMENT AND NURSING CARE
The general treatment is similar to the treatment for infectious hepatitis. The
patient should have sufficient fluids, good nutrition, and bed rest. If the patient exhibits
dyspepsia and malaise, he may be administrated alkalies, belladonna, and antimetics.
A newly available gamma globulin seems to reduce the severity of hepatitis type B
following needle-stick or contact exposure. This can be administered following
exposure by ingestion, inoculation, or splash on involved exposure surface. This
gamma globulin seems to lessen the severity of the disease. Since recovery and
convalescence is slow and prolonged, psychosocial stimulation should be provided.
The most important preventive measure is careful attention to donor quality at
blood banks. A reagent called Hepatitis Associated Antibody (anti-Australia antigen,
human) is now available for screening blood for Australia antigen. The reagent will
detect only about 25 percent of the units of antigen-containing blood. Drug addicts
should be educated to the dangers of unsterilized syringes and needles. Physicians
should avoid the use of unnecessary blood and blood products. All surgical instruments
must be meticulously autoclaved before reuse. A hepatitis B vaccine is now being
tested and should soon become available.
Section IV. OTHER TYPES OF HEPATITIS
4-16. VIRAL HEPATITIS NON-A/NON-B
This type of hepatitis is a viral infection that at present does not have an
identified agent or antigenic markers.
a. Epidemiology. More than 80 percent of the cases of post-transfusion
hepatitis viral infections are of this type. Generally, transmission is associated with
blood transfusions or with personnel in renal dialysis units. It is also associated with
parenteral drug abusers and appears to be bloodborne. Etiology is not known, but it
frequently appears in young women.