OSSSC Nursing Disease Guide

Communicable · High priority

Viral hepatitis

Core disease facts with the linked government programme, prevention and treatment or cure reality.

TypeViral diseases — caused by hepatitis A, B, C, D or E viruses.

Image-based identification

Electron micrograph of hepatitis B virions
What to identifyThe complete infective hepatitis B virion is the 42-nm Dane particle; smaller spheres and filaments are excess surface antigen.Image credit: CDC — public domain

Government programmes, schemes and services

  • Programme: National Viral Hepatitis Control Programme: Provides awareness, prevention, free screening, diagnosis, counselling and treatment, with elimination of hepatitis C as a public-health problem targeted for 2030.
  • Programme: Universal Immunisation Programme: Prevents hepatitis B through the birth dose and subsequent hepatitis-B-containing vaccine doses in the national schedule.
  • Surveillance: National Viral Hepatitis Surveillance Programme: Tracks hepatitis trends and outbreaks to guide prevention and public-health action; it is distinct from the treatment programme.

Prevention

  • Prevent: Hepatitis B birth dose and full vaccination, safe blood/injections, sterile equipment, safer sex, sanitation for hepatitis A/E

Treatment and cure reality

  • Treat: Hepatitis A/E are usually self-limited; chronic hepatitis B is controllable, not usually cured; hepatitis C is usually curable with direct-acting antivirals.

Must remember

  • Hepatitis A and E: Mainly faeco-oral; linked to contaminated food/water.
  • Hepatitis B, C, and D: Mainly blood/body-fluid transmission; hepatitis B also commonly spreads perinatally.
  • Hepatitis D: Requires hepatitis B virus for replication; preventing hepatitis B also prevents hepatitis D.
  • Chronic infection: Hepatitis B and C are the principal viral causes of cirrhosis and hepatocellular carcinoma.
  • Vaccines: Available for hepatitis A and B; no vaccine for hepatitis C.
  • Hepatitis B birth dose: Give as soon as possible, preferably within 24 hours of birth.
  • Hepatitis C: Direct-acting antiviral drugs can cure most infections; a reactive antibody test indicates exposure and requires a nucleic-acid test to establish current infection.
  • Hepatitis E pregnancy trap: Can be particularly severe in pregnancy.
  • National Viral Hepatitis Control Programme: Launched on 28 July 2018.
  • Programme target: Elimination of hepatitis C as a public-health problem by 2030.
  • World Hepatitis Day: 28 July.