viral hepatitis (VH), a viral inflammatory disease of the liver caused by one of the hepatitis viruses: A, B, C, delta, E, F, G, or H. All have chronic forms except hepatitis A. The disease is transmitted sexually and through blood transfusions and is common among people with behavior risks or human immunodeficiency virus infection. Speed of onset and probable course of the illness vary with the kind and strain of virus, but the characteristics of the disease and its treatment are the same. See also hepatitis A, hepatitis B, hepatitis C, hepatitis D. ▪ OBSERVATIONS: Diagnosis is made through antibody (A + C) or antigen (B + D). Characteristic of viral hepatitis are anorexia, malaise, headache, pain over the liver, fever, jaundice, clay-colored stools, dark urine, nausea and vomiting, and diarrhea. Laboratory analyses reveal increased amounts of aspartate aminotransferase (AST) and bilirubin and an abnormal coagulation of the blood. Severe infection, especially with hepatitis B virus, may be prolonged and result in tissue destruction, cirrhosis, and chronic hepatitis or in hepatic coma and death. ▪ INTERVENTIONS: Treatment is with alpha-interferon. Depending on the specific type of hepatitis, treatment with alpha-interferon is effective in 40% of patients with chronic hepatitis B virus infection. Improvement in liver function has been noted in 50% of the patients infected. Treatment is also largely supportive. It includes bed rest; isolation, if necessary; fluids; a low-fat, high-protein, high-calorie diet; special skin care if pruritus is present; emotional support; vitamins B12, K, and C; and monitoring of liver and kidney function. Sedatives, analgesics, antiemetics, and steroids may be ordered. However, the patient is carefully observed for adverse reaction to medication because the liver may not be able to break down and detoxify the drugs. Decrease in the amount or frequency of administration or change of the medication may be necessary. ▪ PATIENT CARE CONSIDERATIONS: The person is taught the importance of rest and avoiding fatigue, washing the hands carefully after urinating or defecating to avoid spreading the virus, eating well, following written dietary instructions after discharge, and avoiding alcohol, usually for at least 1 year. The patient is encouraged to have certain blood tests performed periodically, including AST and serum bilirubin, to report any symptoms of recurrence immediately, and to avoid contact with people having infections. The person is told not to donate blood and not to take over-the-counter drugs without medical consultation.
