Each year, more is learned about various types of viral hepatitis and the treatment and control of each.  Hepatitis A, which confers immunity to future infection, is now thought to pose health consequences following recovery.  Hepatitis A seropositivity has been associated with a higher risk for coronary artery disease.  Preventive measures continue to include hand hygiene, food and water sanitation, and vaccines.  Short term protection is conferred with hepatitis A immune globulin two weeks before or after exposure.

Hepatitis B incidence (new cases) has been reduced with the availability of the HBV vaccine series. 

Hepatitis C, an enveloped RNA virus, mutates rapidly, making vaccine development difficult.  Known risks for Hepatitis C infection are exposure to blood and body fluids, including dialysis.  Education is the primary means to reducing risks of exposure, such as use of contaminated needles. Currently, treatment involves use of interferon, lamivudine, or famciclovir.  Treatment duration is up to 12 months with variable response.

Hepatitis D is a defective or incomplete RNA virus which requires the presence of hepatitis B to function.  HBV vaccination is the primary control method.

Hepatitis E, a single-stranded RNA virus, is uncommon in the US but found in outbreaks in other countries, including Mexico.  Travelers, particularly pregnant women, should avoid raw food and untreated water sources for prevention. 

Hepatitis F is no longer considered a separate type. What had been considered type F was a variant of Hepatitis C.

Hepatitis G was identified in the mid-1990s and appears to be similar to hepatitis C.  It is transmitted by body fluids and blood. Treatment is supportive care.  Patients may have persistent virus in their blood long after recovery.

Patients with chronic liver infection need health-protective habits including low-fat diets which may have protein restrictions and avoidance of alcohol, tobacco and illicit drugs.  Depression can be due to body chemistry changes, drug reactions, feelings about the illness, and fear of infecting others. 

(Durston D. Nursing2005;35(8):36-41)

Comment:  This general nursing practice article offers continuing education credit. School nurses can deliver current content to Health and Health Career classes on infectious disease and risky behaviors.      --J.O.