The Clinical Presentation And Pathophysiology of Hepatitis B Paper

The Clinical Presentation And Pathophysiology of Hepatitis B Paper

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Hepatitis B infection is a global health concern, especially in developing regions. According to Revill et al. (2020), the hepatitis B virus is passed through body fluids like semen, vaginal secretions, and blood, damaging the liver. Hence, due to the condition’s lethal effect, the World Health Organization recommends vaccinating infants against hepatitis B within 24 hours of delivery. The vaccination is later adjusted to two or three vaccines for vaccination series completion. Hence, it is always important for parents and other caregivers to ensure that children are vaccinated against Hepatitis B since the condition has no cure. Hence, the presentation aims at describing the clinical presentation and pathophysiology of Hepatitis B. The Clinical Presentation And Pathophysiology of Hepatitis B Paper

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When assessing patients for hepatitis B, clinicians need to acknowledge the patient’s sexual history, illicit drug use, occupational history, and any known contact with an individual with the hepatitis B virus. As Revill et al. (2020) posit, the symptomatology spectrum of hepatitis B tends to vary depending on and mainly presents in two phases, acute and chronic hepatitis B. The acute phase is within an incubation of one to six months. In the acute phase, anicteric hepatitis is more predominant even though most patients with acute hepatitis B are asymptomatic with patients. In that case, anicteric hepatitis patients are more likely to develop chronic hepatitis than patients with icteric hepatitis. Musa et al. (2019) state that icteric hepatitis is linked to the prodromal period that presents serum-sickness-like syndrome. Some symptoms include vomiting, nausea, anorexia, fatigue, myalgia, and epigastric and right upper quadrant pain. Also, patients with sub fulminant and fulminant hepatitis may present the following symptoms, mental confusion, gastrointestinal bleeding, sleep pattern disturbances, and coma The Clinical Presentation And Pathophysiology of Hepatitis B Paper.

Patients that present chronic hepatitis B tend to have an inactive chronic infection that has no active disease evidence or is immune tolerant. That is because the disease tends to have prolonged for more than six months, and the patients are at a higher risk of liver cirrhosis, liver cancer, or liver failure. According to Musa et al. (2019)The Clinical Presentation And Pathophysiology of Hepatitis B Paper, individuals that present chronic hepatitis B are generally asymptomatic, but most of them recover fully regardless of the severe symptoms for adults. However, children and infants may develop chronic hepatitis B infection. In such a situation, individuals with hepatitis B need to acknowledge that they need to take precautions to prevent the virus spread like abstaining from sex until they get vaccinated against the condition. Therefore, patients that present chronic and active hepatitis B, particularly during the replicative state, may experience symptomatology like fatigue, anorexia, mild upper quadrant pain, and nausea. Also, if progressive liver disease is present, the main symptoms include hepatic encephalopathy, hepatic decompensation, mental confusion, sleep pattern disturbance, and somnolence.

Hepatitis B virus is regarded as a hepadnavirus whose virion contains double-shelled particle that is 42-nm spherical and composed of small rods and spheres that have an average of 22nm in width. The virus is exceedingly resistant and can withstand extreme humidity and temperatures that may attack the hepatocytes. According to Revill et al. (2020), HBV can survive for approximately 15 years at -20°C. The viral genome is a double-stranded circular DNA associated with DNA polymerase, with an icosahedral nucleocapsid and lipid envelope surrounding it. Within these layers, numerous antigens are crucial for disease progression and identification. Also, within the nucleocapsid, there is a pre-core hepatitis B e antigen (HBeAg) and hepatitis B core antigen (HBcAg), while the envelope holds hepatitis B surface antigen (HBsAg) (Musa et al., 2019)The Clinical Presentation And Pathophysiology of Hepatitis B Paper.

The second-strand DNA synthesis completes in the nucleus, where gaps within the strands get repaired to help yield covalently closed circular supercoiled DNA molecule, which acts as the four viral RNA transcription templates. Such transcripts are later polyadenylated and delivered to the cytoplasm, where translation occurs (Musa et al., 2019). Such translation involves pre-core antigen and nucleocapsid, envelope S (small), L (large), and M (medium), transcriptional transactivating proteins X, and Polymerase. From these, the envelope proteins are crucial membrane proteins within the endoplasmic reticulum lipid membrane. Consequently, the 3.5kb species that tend to span the whole genome and are known as pre-genomic RNA (pgRNA) are then placed together with the hepatitis B virus protein kinase and Polymerase within core particles, and it is served as a negative-strand DNA reverse transcription template (Revill et al., 2020). In such a case, the RNA converts to DNA within these particles. As a result, the mature, viral, and new nucleocapsids may follow any intracellular pathways (Musa et al., 2019)The Clinical Presentation And Pathophysiology of Hepatitis B Paper. One pathway leads towards secretion and formation of new virions, with the other leading towards viral genome amplification within the cell nucleus.

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The presentation has assessed the clinical presentation and pathophysiology of hepatitis B. From the clinical manifestation and pathogenesis of hepatitis B, it is clear that they occur due to virus interaction with the host immune system. Such interaction may lead to adverse effects like the development of liver cirrhosis, liver injury, and other complicated conditions like hepatocellular carcinoma. Also, it has been evident that patients can develop either acute or chronic hepatitis B, where they can present as symptomatic or asymptomatic. Hence, individuals need to adhere to the World Health Organization’s recommendation on vaccination, particularly for young children The Clinical Presentation And Pathophysiology of Hepatitis B Paper