Free «Hepatitis B» Essay Sample

Hepatitis B

A. The hepatitis B markers report from serum.

HBsAg positive shows the presence of particles of the hepatitis B virus, which indicates the infection. HBeAg negative means the clearance from active virus replication. Anti-HBeAb positive indicates the resolution of active infection.

B. Why hepatitis must be differentiated?

Hepatitis B differentiation is important because this may influence the treatment of the patient. When the hepatitis B virus is active, antiviral agents can be given. These medications interfere with the viral life cycle and disrupt it. As a result, the virus may be eradicated. It is also possible to detect the risk of hepatitis B progression, a co-infection with hepatitis C or D, some genotypes of the hepatitis B virus, and high viral load (according to PCR DNA). Antiviral treatment is also administered to these individuals. On the other hand, when virus activity is low, or the patient has few risk factors, only a follow-up with dietary prescriptions may be recommended. Finally, when tests for the hepatitis B infection are negative, and the individual’s occupation entails a risk of blood contact (for example, health care workers), vaccination can be considered. Antiviral treatment includes pegylated interferons and nucleos(t)ide analogues. The administration of these agents has serious side effects. For example, the thymidine analogue that blocks viral replication, lamivudine, leads to diarrhea, fatigue, pain or lethal pancreatitis. Pegylated interferon alfa 2a that stimulates inhibitory genes in infected cells and suppresses viral replication also causes fatigue, headaches, and nervousness. These medications are also expensive. In other words, hepatitis in patients must be carefully differentiated to choose an appropriate treatment scheme.

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C. Based on the presence of the HB markers, how is her disease classified?

The case scenario does not clarify the DNA HBV viral load and does not inform about liver enzymes. Thus, it is not possible to give a comprehensive medical description of the disease. From the presented information, it is a healthy young woman without complaints. I assume her liver tests (ALT, AST, bilirubin, GGT) are normal or nearly normal and may suspect that viral activity is low. There is no information about her medical history of jaundice. However, because she came to be a blood donor volunteer, she probably had no experience of clinical hepatitis. As noted in part A of this essay, her serum tests suggest the presence of hepatitis B virus antigens in the blood. However, the absence of HBe antigens indicates that virus activity is low. Moreover, her immune system has already produced antibodies to the viral enzyme, which is typical of the resolution of possible infection. In conclusion, Marwa was probably accidently infected with the hepatitis B virus in the past. It did not cause an active infection and shows low activity currently. The HB markers indicate the past medical history of an infection. It must be emphasized that the active hepatitis B infection is rarely possible in case of the HBeAg negative test.

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D. Why did the doctor think that Marwa’s family could also have been infected? Name the two routes of infections possible in her situation.

Hepatitis B is transmitted via a parenteral route. The virus travels from the infected person during sexual intercourse or at the time of childbirth. Thus, the husband and children are at risk to acquire it. The risk of transmitting the infection to someone else depends on virus concentration in the blood of the infected individual (the higher the concentration, the greater the risk of the infection) and trauma caused to mucous membranes. The virus will not enter the other body if the latter are intact. Thus, the baby may be born from an infected woman, and if the delivery is uncomplicated, the transmission will not occur. As a result, Marwa’s family is healthy. Albeit, her HBsAg positive indicates she is still risky for her husband. Should the HBsAg be negative, their contact were safer.

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E. What actions should the doctor recommend to Marwa to protect her family from getting the infection?

The doctor should strongly recommend vaccination and barrier contraceptives to her husband. Her children are not at risk to be infected because this is a blood-borne infection.

F. What serious complications can occur in long-term of Hepatitis B infection? Name at least two.

Hepatic cirrhosis is a lethal complication. It is a disease of a severe liver impairment when hepatocytes are substituted with the scar tissue. The liver fails to function, and the patient dies from hepatic coma. The scar tissue also makes the liver very stiff for the blood flow, portal hypertension develops, and variceal bleeding occurs. These are two key causes of death from hepatic cirrhosis. Moreover, almost 50% of all hepatocellular carcinomas develop in hepatitis B positive patients.

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