prevalence of viral hepatitis B among patients in National Orthopedic Hospital
Enugu was studied. The samples comprised that of men , woman and children 200
in numbers, all patient of orthopedic Hospital Enugu. Laboratory investigation
done were this HBs tested
which 110 patient out of the 200 patients tested positive, and liver function tests found abnormal in
almost all the patients that tested positive to HBsAG routine test.
The commonest clinical presentations were fever and jaundice seen in Jo patient
out of the 110 patients. The infection was
highest amongst young adult 21-30 years of age. This accounted for 17.5%
of the positive patients population it was lowest amongst children 1-10 and old
people 60-70 which made up 5% of the
infected population. The study also gave the general view of the group of
individual affected whether children or adult, and the wid expired of the
repetitious B. Hepatitis B one of the major cause of human suffering in the
world despite a though understanding of its transmission and prevention and
control by use of vaccine was found to be prevalent in National Orthopedic
Hospital Enugu among the patients.
TABLE OF CONTENT
1.1: introduction to hepatitis b
Purpose of study
Statement of problem
Limitation of study
Structure of hepatitis b virus
The genome and its organization
Taxonomy of the hepatitis b virus
Reproduction (repcication) of hepatitis bb virus
Origin of the term “ Australian aborigine”.
Mode of transmission of hepatitis b
Hbv and cell damage (Cytopathic effects)
Hepatitis b virus and hepatocellular, carcin0ns
Hepatitis b virus infection: acute and chronic
Prevention and control
Site of injection for vaccination
People at risk of contacting the virus
3.1: materials used
Test for the presence of hepatitis b and
Principle for the above test
Principle for the test above
5.1 discussion and conclusion
LIST OF TABLE
Table 1: age distribution of the
infected population 33
Table 2: Sex distribution of the
infected population 33
Table 3: Area distributions of the
infected population 33
Table 4: The six categories of
patients showing the number of Infected persons 33
Table 5: Result of the test using
the six categories of patients 34
TO HEPATITIS B
Viral hepatitis is a disease as
old as the history of Medicine. Hepatitis was described in the Babylonian
Talmud in the fifty century BC, and was referred to by Hippocratic over 2000
years ago. Despite this ancient knowledge, it was not until 1963, that the
first human Repetitious virus was isolated, Hepatitis B. This was followed
quickly by the purification of Hepatitis A in 1973, and more recently by the
isolation of viruses C, D, E and G. These viruses are known to infect the human
liver (Anderson et al; 2001).
However, there are more
than twenty other viruses, which infect the human liver. These are not
considered “Repatitis viruses” as these other viruses tend to infect organs
other than the liver more seriously’. These include common viruses such as
Cytomegalovirus (CMV), Mumps, Rubella, Epstein-Barr virus (EBV) as well as rare
ones such as Rassa fever and yellow fever viruses.
Any infection that results in inflammation of the
liver is called Repatitis (Greek Repaticus, liver). Incidentally, not all
“hepatitis” is caused by viruses. “HEPATITIS” means “inflammation of the
liver”, and can be caused also by other types of infection (bacteria fungi
etc); toxic drugs; poisons; alcoholism and so on (Drexott etal; 2005).
But of interest is one Repatitis
virus – one of the most common infections diseases, causing an estimated
1.5millon deaths world wide each year – Hepatitis B. Hepatitis B is caused by
the Repatitis B virus (HBV), a double – stranded circular DNA virus of complex
structure. Hbv is class ivied as an orthoropadnavirus within the family
hepadnaviridae. HBV was originally recognized as the age responsible or serum
Repatitis the most common form of partially transmitted viral Repatitis and an
import cause of acute and chronic infection of the liver. This why hepatitis b
is some times called seum Repatitis. The virus was formerly and anilines
referred to as Australian antigen. The reason being that it was first isolated
room the blood of an Australian aborogie and is associated with HBV. (procott
et al 2005.
B remain one of the major cause of human suffering in the world despite a
through understanding of its transmission and prevention. Serum form undivided
infected with hepatitis B contains three district antigen particles: a spherical 22nm particle, a 42
nm spherical particle ( counting
DNA and DNA polymer able) called the Dane particle, and tubular or filamentous
particles that vary in length. The small spherical and tubular particles are the unassembled component of the Dane
particle- the infective form of the virus. The unassembled particles. Contain
hepatitis B surface antigen (HBsAg) whose presence in the blood is
(a) an indicator of Repatitis B infection (b) the basis for the large scale
screening of blood for the hepatitis B virus, and (c) the basis for the first
vaccine for human use developed by recombinant DNA technology (Evans, 1997
The Hepatitis B virus is
normally transmitted through blood transfusion, contaminated equipment, drug
users unsterile needles, or any body secretion (saliva, soren, sweat, breast
milk, urine) The virus also can pass
from the blood of an infected mother through the placenta to infect the fetus. Each year an estimated 200, 000
people in Nigeria are infected with Australian Antigen (HBV) about 1000 person
die yearly from hepatitis related cirrhosis and about 5000 die from HBV related
liver cancer. (HBV is second only to tobacco as a known cause of rumen cancer).
Worldwide, HBV infects over 200 million people (Schlesinger & Schlesinger,
2001). The clinccal signs of Repatitis B vary widely, most cases are
symptomless. However, sometime fever, loss of appetite, abominal discomfort,
nausea, fatigue, and other symptoms gradually appear following an incubation
period of 1 to 3 months. The virus infects liver Hepatic cells and causes liver
tissue degeneration and the release of liver associated enzymes (transaminases)
into the blood team. This is followed by jaundice, the accumulation of
bilirubin (a breakdown product of raemoglobin in the skin and other tissue with
a resulting yellow appears. The distinctive yellow jaundice the Hepatitis B
usually imparts to its victims skin
has made it an rasity detectable disease
through recorded history. Frequently, acute hepatitis B in anicteric and
symptomatic, although acute liver failure may develop. The virus persists in
about 10 percent of infected immouno compent adults, and in as many 90 percent
of infants infect peninatally depending on the ethnic group of the mother.
About 350 million people worldwide are persistent carries of hepatitis B.
actually one in twenty infection results in chronic hepatitis, defined as
persistent hepatitis virus six mouths after the onset of the acute illness.
Chronic HBV infection can be entirely begin with normal liver blood tests
(“Chronic Carrier State”) or may be an aggressive inflammatory process
(“Chronic active hepatitis”), which can lead to severe scarring (“Cirrhosis).
Approximately 25 percent of all
patients with chronic hepatitis will progress to cirrhosis and about 20 percent
of those with cirrhosis will develop hepatocellular carcinoma. That is to say,
the risk of liver cancer (hepatoma) is high in cirrhosis caused by HBV.
Hepatocellular carcinoma is one of the most common
cancers worldwide (Seeger & manor; 2000)
During the first phase of
chronicity, virus replication continues in the liver and replicative
intermediates of the viral genome may be detected in DNA extracted from liver
hiopsies. Makers of virus replication in serum include HBVDNA (this indicated
virus presence and activity), DNA polymerize (determines the presence of HBVDNA
in liver cell, and a soluble antigen, hepatition.be antigen (\HbeAG), which is
secreted by productively infected hepatocytes. In those infected at a very going
age this phase may persist for life but, more usually, virus levels decline
over time. Eventually, in most individuals, there is immune clearance of
infected hepatocytes associated with seroconverision low replication, the viral
senome may integrate into the chromosomal DNA of some hepatocytes and these
cells may persist and expand closely. Rarely , seroconversion to anti-HBs
follows clearance of virus replication but, more frequently, HBSAg persists
during a second phase of chronicity as a
result of the expression of integrated viral DNA.
With respect to replication of the HBV, the
fundamental process of viral infection
is the expression of the viral replication cycle in a rost cell. The steps for
the infection process involving HBV usually include the following:
contact and enter susceptible cell.
Replicate within the cell.
Sprea d to adjacent cells.
Cause cellular injury.
Engender a host immune response
Be either cleared from the body of the host, establish
a presistnt infection , or kill the host.
Be shed back
into the environment (prexote it al; 2005).
of viral spread very, but the most roates include bloodstream. The presence of
viruses in the blood is called VIREAMA>HBV
is spread through blood, body secretion, needles, placenta as well as sexually.
This os to say that transmission as through parental routes. Therefore,
transmission of HBV can occur from
person to person as a result of
transfer of blood by any prouder which breaks the skin or mucous members HBV
spread mainly parentally, in most cases seen in adults , HBs
(Australian Antigen) has been identified in almost every body fluid f infected
persons- saliva tears semen, cerebrospinal fluid, ascetic fluid, breast milk
synovial fluid, gastric juice, urine and rarely in faces. This disease is,
therefore, a major occupational hazard of medical personnel. It is
commonly seen in people who receive multiple blood transfusion or
blood product intravenous drug abusers, homosexuals and the sexually
for study can never be over emphases having considered the above, this study
serves the following purpose or
To obtain a
general view of the group of individual affected whether children or adults.
To show circumstances which dispose to viral hepatitis
and suggest means of reducing the incidence.
To review the management of these patients with
regards to vestigation done and treatment.
To understand the complex or exorbitant nature of the
structure of the hepatitis B virus as well as the debilitating effect it has on
Also compare and contrast primary data from this study
with secondary from the library
To how rate of progression to chronicity as well as
make known the daily activities that will not result in contacting HBV.
done to known the existence or widespread of this disease among patience in
Nation Orthopedic Hospital Enugu. Or to understand and show the prevalent
Hospital in question .the significance of this study can never be over
emphasicum this is because in developing countries such as HBV is indisputable
essential in the life of that country especially in their hospitals. Many
children are infected by hepatitis B virus at on early age a significant
portion of apparently healthy individual are chronic carriers of HBsAg,
that is the Australia Antign. The significance of this study is seen in the
light of having a better knowledge and understanding or better still widening
our scope of the chronically and pathogenically of HBV.
A study of
this nature surely must have problem which result in it. Hepatitis B is a viral
disease that is spread through all body fluids,
that is to say that one can contact this disease by exchange to body fluid
with infected person. Looking at our society and hospital there are
cases where by unscreened blood is
transfixed to a patient case of multiple sex
partner people having unprotected sex, making use of sharp objects
without any care. All these dispose to viral hepatitis B. and gives risk to a
study of such .
SCOPE OF STUDY
As a result
of time factor, the scope of this study was narrowed down to fit Witter the
time limit. Due to this fact, this study was lenicted only among patients in National Orthopedic
Hospital Enugu. There fore, the scope or the delimitation, which infect in the
area of coverage of this study is National Orthopedic Hospital Enugu.
Hepatitis B is prevalent among
patients in National Orthopedic
H1 Hepatitis B is not
prevalent among patients in National
Orthopedic Hospital Enugu.