PREVALENCE OF HEPATITIS VIRUS INFECTION AMONG PREGNANT WOMEN
TABLE OF CONTENT
Table of content………vii
1.1 BACKGROUND TO THE STUDY
1.2 STATEMENT OF THE PROBLEM
1.3 OBJECTIVES OF THE STUDY
1.4 RESEARCH QUESTIONS
1.6 SIGNIFICANCE OF THE STUDY
1.7 SCOPE/LIMITATIONS OF THE STUDY
LIMITATION OF STUDY
2.1 STRUCTURE OF HEPATITIS B VIRUS
2.2 THE GENOME AND IT ORGANISATION
2.3 TAXONOMY OF THE HEPATITIS B VIRUS
2.4 REPRODUCTION (REPLICATION) OF HEPATITIS B VIRUS
2.4.1. ADSORPTION OF VIRIONS
2.4.2 PENETRATION AND UNCOATING
2.4.3 REPLICATION OF HEPATITIS B VIRUS
2.4.4 SYNTHESIS AND ASSEMBLY OF HBV CAPSID
VIRION RELEASE OR RELEASE OF MATURE h b
2.5 ORIGIN OF THE TERM AUSTRALIAN ABORIGINE
2.6 MODE OF TRANSMISSION OF HEPATITIS B
2.7 HBV AND CELL DAMAGE (CYTOPATHIC EFFECTS)
2.8 HEPATITIS B VIRUS AND HEPATOCELLIULAR CALCINE
2.9 HEPATITIS B VIRUS INFECTION: ACTE CHRONIC
2.10 PREVENTION AND CONTROL
2.11 SITE OF INFECTION FOR VACCINATION
2.12 PEOPLE AT RISK OF CONTACTING THE VIRUS
3.0: MATERIALS AND METHODOLOGY
3.1 MATERIALS USED:
3.2 TEST FOR THE PRESENCE OF HEPATITIS B ANTIGEN
3.4 SERUM BILIRUBIN
RESULTS OF ALL INVESTIGATION (TESTS)
5.1 DISCUSSION CONCLUSION
CHAPTER ONE INTRODUCTION 1.1 BACKGROUND TO THE STUDY
Hepatitis is an inflammation of the liver characterized by the presence of inflammatory cells in the tissue of the organ (Ryder & Beckingham, 2001). It may occur with limited or no symptoms, but often leads to jaundice, anorexia (poor appetite) and malaise. Hepatitis is acute when it lasts less than six months and chronic when it persist longer. A group of viruses known as the hepatitis viruses cause most cases of hepatitis worldwide, but it can also be due to toxins (notably alcohol, certain medications and plants), other infections and autoimmune diseases. The hepatitis virus is found in the blood and other body fluids and is transmitted from person to person, the most common routes of infection includes blood transfusions and blood products where there is no screening for blood-borne viruses, medical or dental interventions in countries where equipment is not adequately sterilized mother to infant during childbirth, sexual transmission (in the case of hepatitis B), sharing equipment for injecting drugs, sharing straws, notes etc. for snorting cocaine (cocaine is particularly alkaline and corrosive), sharing razors, toothbrushes or other household articles, tattooing and body piercing if done using unsterile equipment (Ahmedin et al, 2004).
The hepatitis B virus is spread between people through contact with the blood or other body fluids (i.e. semen, vaginal fluid and saliva) of an infected person, while the hepatitis C virus is spread through direct contact with infected blood. Very rarely it can also be passed on through other body fluids (Redmond, 2007). Many people infected with hepatitis B or C rarely displays any symptom, although they can still transmit the virus to others.
Hepatitis B is a major disease of serious global public health proportion. It is preventable with safe and effective vaccines that have been available since 1982. Of the 2 billion people who have been infected with the hepatitis B virus (HBV) globally, more than 350 million have chronic (lifelong) infections. Over 20 million people have infected annually with this virus (Mohammed et al, 2003). Hepatitis C is a viral infection of the liver and is the most common blood-borne (direct contact with human blood) infection. The major causes of HCV infection worldwide are use of unscreened blood transfusions, and re-use of needles and syringes that have not been adequately sterilized. The world health organization (WHO) estimates that about 3% of the world populations (200 million people) have so far been infected with the Hepatitis C virus. Almost 50% of all cases become chronic carriers and are at risk of liver cirrhosis and liver cancer (Ahmad, 1998).
Viral hepatitis during pregnancy is associated with high risk of maternal complications. There is a high rate of vertical transmission causing fetal and neonatal hepatitis which can have serious effects on the neonate, leading to impaired mental and physical health later in life. A leading cause in maternal mortality is also said to be the most familiar cause of jaundice in pregnancy. Peri-natal transmission of this disease occurs if the mother has had acute Hepatitis B infection during late pregnancy, in the first postpartum or if the mother is a chronic HBsAg carrier. Hepatitis C transmission occurs predominantly around time of delivery and pregnancy. Using this background information, the epidemiology of viral hepatitis during pregnancy is essential for health planners and program managers. Thus, the current study aimed at investigating the prevalence and the possible predisposing factors for Hepatitis B and C viruses among pregnant women using the University of Benin Teaching Hospital as a case study.
1.2 STATEMENT OF THE PROBLEM Viral hepatitis during pregnancy is associated with high risk of maternal complications and has become a leading cause of foetal death. Hepatitis one of the major and common infectious diseases of the liver world wide is caused by a small enveloped DNA virus, the hepatitis B virus (HBV). Nigeria is classified among the group of countries endemic for HBV infection. Currently about 18 million Nigerians are infected. Many of these people may not be aware of the infection and hence fail to seek appropriate medical attention therefore progressing to chronic liver disease, cirrhosis and hepatocellular carcinoma. Similarly when pregnant women are involved they constitute a serious health risk not only to their unborn child but also the society at large.
1.3 OBJECTIVES OF THE STUDY The following are the objectives of this study:
To provide an overview on hepatitis virus infection. To examine the prevalence of hepatitis virus infection among pregnant women. To identify the consequences of hepatitis virus infection on pregnant women.
1.4 RESEARCH QUESTIONS
What is hepatitis virus infection? What is the prevalence of hepatitis virus infection among pregnant women? What is the consequences of hepatitis virus infection on pregnant women?
1.6 SIGNIFICANCE OF THE STUDY The following are the significance of this study:
The results from this study will educate the general public especially the pregnant women on the prevalence and prognosis of hepatitis virus infection of pregnant women. This research will be a contribution to the body of literature in the area of the effect of personality trait on student’s academic performance, thereby constituting the empirical literature for future research in the subject area.
1.7 SCOPE/LIMITATIONS OF THE STUDY This study will cover the prevalence of hepatitis virus infection with special focus on hepatitis B and C. LIMITATION OF STUDY Financial constraint- Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview). Time constraint- The researcher will simultaneously engage in this study with other academic work. This consequently will cut down on the time devoted for the research work.
REFERENCES Ahmad K. Hepatitis B in Viral Hepatitis: An overview: proceedings of seminar. AFIP Rawalpindi, Pakistan: 1998. pp. 16–19. Ahmedin J, Taylor M, Ram CT, et al. A New Section in Cancer Offering Timely and Targeted information. Can J Clin. 2004;54:23–25. Mohammed J, Hussain M, Khan MA. Frequency of Hepatitis-B and Hepatitis C infection in thalassaemic children. Pak Paed J. 2003;27:161–164. Redmond WA. Liver Microsoft Student [DVD] Microsoft Corporation. 2007 Ryder S, Beckingham I. ABC of diseases of liver, pancreas, and biliary system: Acute hepatitis. Br Med J. 2001;322:151–153.
CHAPTER TWOLITERATURE REVIEW2.1 STRUCTURE OF HEPATITIS B VIRUS The hepatitis B virus is a 42nm particle comprising an electron dense nucleocapsid or core, 27nm in diameter surrounded by an outer envelope of the surface protein (HBsAg – Otherwise called the Australian Antigen) embedded in membranous lipoprotein derived from the host cell (figured) the Australian antigen, that is the surface antigen is produced in excess by the infected hepatocytes, and is secrete in the form of 22 nm particles and tubular structures with the same diameter. In other words, serum from individuals infected with hepatitis B contains three distinct antigenic particles: a spherical 22nm particle, a 42nm spherical particle (containing DNA and DNA polymerize) called the DANE Particle, and tubular or filamentous particles of the same diameter with the spherical particles (22nm). The small spherical and tubular particles are the unassembled components of the Dane particles the infective form of the virus. The unassembled particles contain hepatitis B surface antigen (HBsAg) Australian antigen (Figure2). The 22nm particles are composed of the major surface protein in both non glycosylated and glycosylated form in approximately equimolar amount together with a minority component of the so called middle protein. The surface of the viron has a similar composition but also contains the large surface proteins. These large surface proteins are not found in the 22nm spherical particles (but maybe present in the tubular forms in highly viraemic individual) and their detection in serum correlates with viraemoa. The nuclecapsid of the Varian consists of the viral genome surrounded by the core antigen (HBsAg). The carboxyl terminus of the core protein is anginine rise and this highly basic domais is believe to interact with the genome (van Regenmortel et al, 2000)..