g. Transfusions. Avoid unnecessary transfusions for the hepatitis patient.
Post- transfusion infections are possible and should be avoided.
h. Blood Donors. Use volunteer rather than paid blood donors. Screen
prospective donors for hepatitis B surface antigen and Australia antigen (HBsAg).
i. Vaccinations. There is a vaccine to protect against type B hepatitis.
Immune globulins offer some protection against type A hepatitis. The protection in both
instances is usually less than three months.
7-9.
VARIANTS OF ACUTE VIRAL HEPATITIS
a. Anicteric Hepatitis. This is a minor flu-like illness without jaundice. It may
be only a clinical manifestation of acute hepatitis, especially in children.
b. Recrudescent Hepatitis. This type of hepatitis occurs in a small number of
hepatitis patients during the recovery phase of their illness. Generally, patients recover
well from recrudescent hepatitis. Rarely, the patient develops chronic hepatitis
afterward.
c. Fulminant Hepatitis. This type of hepatitis is a rare syndrome usually seen
in type B hepatitis, NANB hepatitis, or drug injury hepatitis. The patient experiences
rapid clinical deterioration. Adults do not usually survive despite heroic measures.
Children have a better chance for survival. Meticulous nursing care and careful
management of specific complications provide the best hope for recovery. Remarkably,
those who do survive this disease recover completely. Cases of fulminant hepatitis
have been documented in Korea.
7-10. CHRONIC HEPATITIS
Chronic hepatitis is the term for a spectrum of disorders which merge into acute
hepatitis or cirrhosis of the liver. Acute hepatitis includes chronic persistent hepatitis
and chronic active (aggressive) hepatitis.
a. Chronic Persistent Hepatitis. This form of hepatitis is a benign disorder
which a patient may get after having had typical acute hepatitis. The disease may last
for at least six months. Most patients recover. The disease is often detected in young
drug abusers. Treatment is not necessary. Neither diet nor activity needs to be
restricted.
MD0581
7-5