monografia de hepatitis

7/25/2019 Monografia de Hepatitis

1/29

ASOCIACIONUNIVERSIDAD

PRIVADASAN JUAN BAUTISTA

TEMA:

HEPATITIS

CURSO: PATOLOGIA ESPECIAL

DOCENTE: Dr. ANTONIO TRAVEZAN

CICLO: VII

TURNO: Diurno

SEMESTRE: 2016 - I

FECHA: 15 d !"ri# d 2016

SEDE: I$!

ALUMNOS: CARPIO HUAUYA, NANCY

HUACHIN MANTARI, YELITZA

HUAMAN SALINAS, MARIA FERNANDA

LOPEZ RAMOS, ISABEL

MAVILA CORDERO, RONY

MONTOYA ESPINOZA, MARITZA

SALINAS SALCEDO, CHRISTIAM

VALENCIA VENTURA, RHAYSHA GABRIELA


2/29

RESUMEN

En sentido estrito, !"s #e$"titis %&ri"s onstit'(en 'n on)'nto de $"to!o*&"s de

ori*en in+eioso "'s"d"s $or ino %ir's #'"nos +i!o*en-ti"ente "!e)"dos

.'e #"n oinidido en des"rro!!"r 'n "'s"do tro$iso #"i" !os #e$"toitos/ En

sentido 0s "$!io, e! t-rino in!'(e t"1i-n !"s #e$"titis "*'d"s $or in+ei2n

$or otros %ir's .'e no son t&$i"ente #e$"totro$os, $ero .'e $'eden ori*in"r es"

en+ered"d oo 'n" o$!i"i2n de !" in+ei2n $ri"ri" "*'d", de !" is"

+or" .'e ori*in"n otr"s/ Los %ir's de !" #e$"titis B ( C #"n des"rro!!"do

estr"te*i"s de $ersisteni" .'e !es $eriten est"1!eer in+eiones r2ni"s en 'n

ierto $orent")e de !os indi%id'os " !os .'e in+et"n/ L" #e$"titis %&ri" r2ni", !"

irrosis #e$0ti" ( e! "rino" #e$"toe!'!"r $ri"rio son !"s $rini$"!es

onse'eni"s !&ni"s de esos +en2enos de $ersisteni" %ir"!, .'e res$onden "

dos e"nisos $rini$"!es3 !" ind'i2n de in'noto!er"ni" ( !" eer*eni" (

se!ei2n de 't"ntes de es"$e " !" res$'est" in'nit"ri"/

Patologa Especial Pgina 2


3/29

INTRODUCCIN

L"s #e$"titis "+et"n "! #&*"do/ Los seres #'"nos neesit"n .'e s' #&*"do est-

s"no/ Este 2r*"no dese$e4" '#"s +'niones $"r" "ntener!os %i%o/ E! #&*"do

o1"te !"s in+eiones ( detiene !"s #eorr"*i"s/ E!iin" edi"entos,

dro*"s ( otr"s s'st"ni"s t25i"s de! torrente s"n*'&neo/ T"1i-n "!"en"

ener*&" .'e $'ede 's"rse en "so nees"rio/

L" #e$"titis es 'n" en+ered"d in+eios" de! #&*"do "'s"d" $or distintos %ir's (

"r"teri6"d" $or nerosis #e$"toe!'!"r e in+!""i2n, se "r"teri6" $or iterii"( #e$"toe*"!i" ( e!e%"i2n de "r"dores 1io.'&ios de d"4o #e$0tio/ Est" es

$rod'id" $or 7!ti$!es "*entes etio!2*ios son "ti%id"d so1re e! #&*"do ( est"s

ori*in"n !" "!+or"i2n on nerosis de ese 2r*"no/

L" #e$"titis es 'n" en+ered"d %ir"! .'e "+et" $riordi"!ente "! te)ido #e$0tio/

Est0 en tod"s s's +or"s, es !" 0s o7n d'r"nte !" "do!eseni"/

P'ede o'rrir en e! tr"ns'rso de otr"s in+eiones 8SIDA, onon'!eosis,itoe*"!o%ir's9: oo t"1i-n tr"ns+'i2n de s"n*re, $or e! 'so de "*')"s

ont"in"d"s ( $or 'n" ino'!"i2n de !" e1r"n" 'os" 8re!"iones se5'"!es

( ondiiones de #"iiento9

DEFINICIN:Es 'n" en+ered"d "r"teri6"d" $or !" !esi2n e in+!""i2n

di+'s" de! #&*"do, 1!o.'e" e! $"so de !" 1i!is .'e $rod'e e! #&"*do "!

deso$oner !" *r"s" ( "!ter" !" +'ni2n de! #&*"do de e!iin"r !"s to5in"s

de !" s"n*re, de $rod'ir di%ers"s s'st"ni"s i$ort"ntes ( de "!"en"r (

distri1'ir !" *!'os", %it"in"s ( iner"!es/



4/29

ETIOLOGIA DE HEPATITIS VIRICA:

En sentido estrito, !"s #e$"titis %&ri"s res$onden " in+eiones $rod'id"s $or

ino %ir's #'"nos di+erentes ( +i!o*en-ti"ente "!e)"dos entre s&, .'e se

onoen oo %ir's de !" #e$"titis A, B, C, D ( E 8VHA, VHB, VHC, VHD ( VHE9/

En todos !os "sos, !os #e$"toitos onstit'(en s's -!'!"s #os$ed"dor"s

$rini$"!es ( !"s di"n"s 7!ti"s de !" in+ei2n, si 1ien son "$"es de in+et"r

otr"s -!'!"s/ En 'n sentido 0s "$!io, in!'(en t"1i-n '"dros "*'dos de

en+ered"d #e$0ti" de1idos " otros %ir's #'"nos no es$e&+i"ente

#e$"totro$os, $ero .'e $'eden $rod'ir di#os '"dros oo 'n" o$!i"i2n de

!" in+ei2n/ Los %ir's #er$es, en es$ei"! e! itoe*"!o%ir's #'"no ( e! %ir's de

E$stein;B"rr, son !os 0s +re'enteente in%o!'r"dos, $ero se #"n desrito

#e$"titis "*'d"s "soi"d"s " in+eiones $or %ir's #er$es si$!e , %ir's de !"

%"rie!";62ster , %ir's de !" r'1-o!" , $"r%o%ir's #'"no B


5/29

EPIDEMIOLOGA DE LA HEPATITIS EN EL PER

L" Or*"ni6"i2n M'ndi"! de !" S"!'d8OMS9 "!ert" so1re e! inreento de "sos

de He$"titis A, en i!!ones de %&ti"s $or "4o/ Est" en+ered"d s'e!e ser

"sinto0ti" en ni4os, $ero $'ede o$!i"rse ( *ener"r #e$"titis +'!in"nte, on

ries*o de ene+"!o$"t&"/

En n'estro $"&s, e! Ministerio de S"!'d#" detet"do este "4o tres 1rotes de

He$"titis A en 6on"s de$o1re6", siendo !" "'s" $rini$"! !" +"!t" de ser%iio

s"nit"rio ( re*!"s de #i*iene 10si"s oo e! !"%"do de "nos/

?L" He$"titis A es 'n" en+ered"d #e$0ti" .'e se ontr"e "! in*eriroid"so

to"r 1e1id"s ont"in"d"s on "teri" +e"! 8Hees9 de 'n" $erson" in+et"d"/

E! e"niso de tr"nsisi2n es de ti$o oro;+e"!, "soi"do " ondiiones

de+iientes de s"!'1rid"d ( "!" #i*iene $erson"!/ E! !"%"do de "nos es 'n" de

!"s edid"s $re%enti%"s .'e $'ede interr'$ir e! i!o de tr"nsisi2n de !"

en+ered"d?/

E! ries*o de He$"titis A on!!e%" no so!o " o$!i"rse on ene+"!o$"t&" sino

t"1i-n on est"do de o" ( "!ter"iones de o"*'!"i2n 8s"n*r"do9, de

res'!t"dos +"t"!es oo !" enion"d" ?#e$"titis +'!in"nte?/ E! 7!tio 1rote

en Per7re$ort"do $or MINSA +'e en C#ont"!es @ L" Li1ert"d 8)'nio de este "4o9

on enor inideni" de "sos 8>9 en re!"i2n "! "4o $"s"do, $ero i*'"! i$!i"

ries*o en 6on"s on "!"s ondiiones de #i*iene $erson"! ( s"!'1rid"d/ ?L"

$re%"!eni" de #e$"titis A en e! Per7 se esti" .'e es sii!"r " !" de otros $"&ses

en des"rro!!o, #"( est'dios .'e re$ort"n t"s" de $re%"!eni" .'e %"r&"n entre e!

( == de !os *r'$os/

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6/29

MARCO TEORICO

L! %&!'i'i(( un! in)$$i*n +ir!# ,u &rodu$ #! in)#!!$i*n d# %/!do $oo

$on($un$i! d ('! ( "#o,u! # &!(o d #! "i#i( ,u &rodu$ # %/!do !#

d($o&onr #! /r!(! ( !#'r! #! )un$i*nd# %/!do d #iin!r #!( 'o3in!( d

#! (!n/r d &rodu$ir di+r(!( (u('!n$i!( i&or'!n'( d !#!$n!r di('ri"uir

#! /#u$o(! +i'!in!( inr!#(.

Causas

L! in)$$i*n ('4 &rodu$id! &or +!rio( 'i&o( d +iru( &or ##o ( $!r!$'ri!n #!%&!'i'i( A C D (/7n # 'i&o d +iru( $!u(!n' n $!d! $!(o.

L! 8&!'i'i( A 9in)$$io(! ( $on'!/i! &or +! or!# )$!# ! 'r!+( d

$ir'o( !#in'o(9$ru('4$o( !/u!o !'ri!#($on'!in!do(. En'r # $on'!/io

#! !&!ri$i*n d (n'o!( 9&rodo d in$u"!$i*n 'r!n($urrn d 15 ! 50 d!(.

L! 8&!'i'i( 9(ri$! ( $on'!/i! &or #! (!n/r 9(!n/r o !/u;!( $on'!in!d!(

&or # (udor (n (!#i+! o #4/ri!( ($r$ion( +!/in!#( ! 'r!+( d %rid!(

o u$o(!(. T!"in ( 'r!(i' ! 'r!+( d #! !$n'! !# )'o ! 'r!+( d

$on'!$'o( (3u!#(.

L! C D (on d &!r$id!( $!r!$'r('i$!( ! #! .

1. Hepatitis A

L! %&!'i'i( A ( un! n)rd!d d# %/!do. L! %&!'i'i( %!$ ,u # %/!do (

in)#! d; d )un$ion!r $orr$'!n'.


7/29

Causa de la Hepatitis A

L! %&!'i'i( A ( $!u(!d! &or un +iru(.


8/29

Tnr r#!$ion( (3u!#(!n!#( $on un! &r(on! in)$'!d!.

E( &o(i"# ,u $on'r!i/! #! %&!'i'i( A !# "(!r ! un! &r(on! in)$'!d!.

>?uin( Pudn Con'r!r #! 8&!'i'i( A@

Cu!#,uir &r(on! &ud $on'r!r #! %&!'i'i( A. Pro !#/un!( &r(on!( (on 4(

&ro&n(!( ,u o'r!(:

L!( &r(on!( ,u +i+n $on !#/uin ,u 'in %&!'i'i( A.

Lo( ni=o( ,u !(i('n ! /u!rdr!(.

L!( &r(on!( ,u 'r!"!;!n n un! /u!rdr! d ni=o(.

8o"r( ,u 'inn r#!$ion( (3u!#( $on o'ro( %o"r(.

L!( &r(on!( ,u +i!;!n ! o'ro( &!((.

S%"t!as

Podr! (r ,u

S (in'! $!n(!do.

Tn/! n4u(!(.

L d )i"r.

Pird! # !&'i'o.

Tn/! do#or d ('*!/o.

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9/29

L d di!rr!.

A#/un!( &r(on!( &r(n'!n

O($ur$iin'o d #! orin!.

E3$rn'o d $o#or$#!ro.

Co#or !!ri##n'o d #o( o;o( #! &i#.

A#/un!( &r(on!( no &r(n'!n nin/7n (n'o!.

2. Hepatitis &

L! %&!'i'i( ( un &ro"#! /r!+ d (!#ud ,u !)$'! ! &r(on!( d 'od!( #!(

d!d( n E('!do(


10/29

r$i"i* un! 'r!n()u(i*n d (!n/r !n'( d ,u %u"ir! di(&oni"#

;or( !n4#i(i(d (!n/r 91B5

n!$i* n un! d #!( r/ion( n$ion!d!( !rri"!

( &!$in' o 'r!"!;! n un! in('i'u$i*n &!r! &r(on!( $on &ro"#!(d

d(!rro##o

('!r4 r$#uido n un! in('i'u$i*n $orr$$ion!# &or un #!r/o 'i&o

(!# d# &!( %!$i! 4r!( n #!( ,u 3i(' un !#'o ndi$ d %&!'i'i( .

C! se p#!pa*a el H&,$

E# 8V ( n$un'r! n #! (!n/r n $ir'o( )#uido( $or&or!#( d #!( &r(on!(

in)$'!d!( $on %&!'i'i( . E('o( )#uido( (on: (uro (n ($r$ion( +!/in!#(

(!#i+!. E# 8V no ( n$un'r! n # (udor #!( #4/ri!( #! orin! o #!(

($r$ion( r(&ir!'ori!(. E# $on'!$'o $on !un $!n'id!d( &,u=!( d (!n/r

&ud $!u(!r in)$$i*n.

L! %&!'i'i( ( &ro&!/! d #!( (i/uin'( !nr!(:

(3o (in &ro'$$i*n

u(o d dro/!( &or in$$i*n

dur!n' # &!r'o d #! !dr !# %i;o

$on'!$'o $on (!n/r o ##!/!( !"ir'!( d un! &r(on! in)$'!d!

ordi($o( %u!no(

$on'!$'o $r$!no n'r &r(on!( ,u $o&!r'n #! i(! +i+ind! o

!r'$u#o( d u(o &r(on!# '!#( $oo n!+!;!( d r!(ur!r o $&i##o( d

din'(

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11/29

!# !('i$!r !#in'o( &!r! d!r#o( ! un "" o $o&!r'indo /o! d

!($!r

A# u(!r !/u;!( (in ('ri#i!r &!r!: !"rir !/u;ro( n #!( or;!( in$'!r(

dro/!( %!$r( '!'u!;( o n !$u&un'ur!

!# u(!r #! i(! !/u;! d +!$un! n 4( d un! &r(on!

L! %&!'i'i( NO ( &ro&!/! d #!( (i/uin'( !nr!(:

$on'!$'o $!(u!# '!# $oo d!r( #! !no

$or !#in'o( &r&!r!do( &or un! &r(on! &or'!dor!

!# "(!r n #!( ;i##!( o !# "(!r n ($o

!# $o&!r'ir u'n(i#io( d (! !'o( o '!!(

!# +i(i'!r n (u( %o/!r( ! &r(on!( in)$'!d!(

;u/!r $on un ni=o in)$'!do

('ornudo( o 'o(

Cu-les s!" l!s s%"t!as de la Hepatitis &$

L! !or! d #!( &r(on!( ,u $on'r!n %&!'i'i( $u!ndo (on ""( o ni=o( no

#u$n o ( (in'n n)ro( &!r! n!d!. D #! i(! !nr! 4( d #! i'!d d#o( !du#'o( ,u $on'r!n %&!'i'i( nun$! &r(n'!n nin/7n (n'o! o (=!#(d

#! n)rd!d. Cu!ndo r$i"n #o( r(u#'!do( d #o( !n4#i(i( d (!n/r indi$!ndo

,u 'u+iron o 'inn #! n)rd!d ( (or&rndn. Si #!( &r(on!( &r(n'!n

(=!#( o (n'o!( ('o ( #o ,u &ro"!"#n' &ud!n o"(r+!r:

&rdid! d !&'i'o

&i# o;o( !!ri##o( 9i$'ri$i!

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12/29

n4u(! +*i'o

)i"r

d"i#id!d $!n(!n$io )!#'! d nr/! &!r! 'r!"!;!r &or (!n!( o ((

do#or !"doin!# o d #!( $oun'ur!(

orin! o($ur!

. Hepatitis C

L! %&!'i'i( C ( un! n)rd!d d# %/!do $!u(!d! &or # +iru( d#

i(o no"r ( +iru( &ud $!u(!r un! in)$$i*n '!n'o !/ud! $oo

$r*ni$! $u! /r!+d!d +!r! n'r un! do#n$i! #+ ,u dur! !#/un!(

(!n!( un! n)rd!d /r!+ d &or +id!.

E# +iru( d #! %&!'i'i( C ( 'r!n(i' ! 'r!+( d #! (!n/r #!( $!u(!(

d in)$$i*n 4( $oun( (on #!( &r4$'i$!( d in$$i*n &o$o (/ur!(

#! ('ri#i!$i*n in!&ro&i!d! d ,ui&o di$o n !#/uno( n'orno( d

!'n$i*n (!ni'!ri! #! 'r!n()u(i*n d (!n/r &rodu$'o( (!n/uno( (in

!n!#i!r.

,%as De C!"ta*i!

Dro/!( &or +! in'r!+no(! 0F

Sin $!u(! !&!rn' 0F

Con'!$'o %'ro(3u!# 6F

Con'!$'o n # %o/!r F

Con'!$'o o$u&!$ion!# 2F



13/29

Ca#a)te#%sti)as

8&!'i'i( +ir!# d &or &ron*('i$o &or (u !or )r$un$i! d n)rd!d

)u#in!n' o $r*ni$!.

S $!r!$'ri! &or in)$$i*n #+ o !(in'o4'i$o $on u ini$io in(idio(o d i$'ri$i!

!#('!r /nr!#.

Gu!rd! r#!$i*n n # !du#'o $on # $!r$ino! %&!'o$#u#!r &ro no ( %!

do('r!do n # ni=o.Tind ! #! $roni$id!d %!('! n un 50F &udindo 'rin!r

n $irro(i(.

En #! u;r/('!n' !)$'!d! ,u &r(n' ''u#o( !#'o( &ud 'r!n(i'ir #!

in)$$i*n !# %i;o.

. Hepatitis D

E( un 'i&o d +iru( ##!!do %&!'i'i( D. So#o $!u(! (n'o!( n &r(on!( ,u

'!"in 'inn un! in)$$i*n d %&!'i'i( .

Causas

E# +iru( d #! %&!'i'i( D 9V8D (*#o ( n$un'r! n &r(on!( &or'!dor!( d# +iru(

d #! %&!'i'i( . E# V8D &ud &or!r un! n)rd!d %&4'i$! n &r(on!(

,u 'n/!n un! in)$$i*n &or %&!'i'i( r$in' 9!/ud! o &ro#on/!d! 9$r*ni$!

!$'u!#. E(' +iru( &ud in$#u(o $!u(!r (n'o!( n &r(on!( ,u &or'!n # +iru(

d #! %&!'i'i( &ro ,u nun$! 'u+iron (n'o!(.

L! %&!'i'i( D in)$'! ! !#rddor d 15 i##on( d &r(on!( n 'odo # undo

( &r(n'! n # 5F d #o( indi+iduo( &or'!dor( d %&!'i'i( .

Lo( )!$'or( d ri(/o !"!r$!n:

A"u(!r d dro/!( in'r!+no(!( 9IV o in$'!d!(

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14/29

E('!r in)$'!d! dur!n' # "!r!o 9#! !dr # &ud &!(!r # +iru( !#

""

Por'!r # +iru( d #! %&!'i'i(

8o"r( ,u 'inn r#!$ion( (3u!#( $on o'ro( %o"r(

R$i"ir u$%!( 'r!n()u(ion( d (!n/r

S%"t!as

L! %&!'i'i( D &ud %!$r ,u #o( (n'o!( d #! %&!'i'i( (!n 4( )ur'(.

Lo( (n'o!( &udn in$#uir:

Do#or !"doin!#

Orin! d $o#or o($uro

!'i/!

I$'ri$i!

Do#or !r'i$u#!r

In!&'n$i!

N4u(!(

V*i'o(

/. Hepatitis E

L! %&!'i'i( E ( un! do#n$i! &or #o /nr!# !u'o#ii'!d! &ro &ud

$on+r'ir( n un! %&!'i'i( )u#in!n' 9in(u)i$in$i! %&4'i$! !/ud!.

E# +iru( d #! %&!'i'i( E ( 'r!n(i' &or +! )$!#-or!# &rin$i&!#n' ! 'r!+(

d !/u! $on'!in!d!.

L! %&!'i'i( E ( un! n)rd!d %&4'i$! $!u(!d! &or # +iru( d #!

%&!'i'i( E un +iru( ARN ono$!'n!rio &o(i'i+o (in $u"ir'!.



15/29

E# +iru( ( 'r!n(i' &rin$i&!#n' ! 'r!+( d# !/u! d ""id!

$on'!in!d!. E# r(u#'!do ( &or #o /nr!# un! in)$$i*n !u'o#ii'!d!

,u ( r(u#+ n -6 (!n!( &ro ! +$( ( 'r!n()or! n un!

)or! )u#in!n' d %&!'i'i( 9in(u)i$in$i! %&4'i$! !/ud! ,u &ud

$ondu$ir ! #! ur'.

T#a"sisi"

E# +iru( d #! %&!'i'i( E ( 'r!n(i' &rin$i&!#n' &or +! )$!#-or!# $oo

$on($un$i! d #! $on'!in!$i*n )$!# d# !/u! d ""id!. O'r!( +!( d

'r!n(i(i*n ,u '!"in ( %!n o"(r+!do (on:

#! 'r!n(i(i*n !#in'!ri! &or in/('i*n d &rodu$'o( dri+!do( d

!ni!#( in)$'!do(

#! 'r!n()u(i*n d &rodu$'o( (!n/uno( in)$'!do(

#! 'r!n(i(i*n +r'i$!# d un! "!r!!d! !# )'o.

Aun,u ( $on(idr! ,u # %u(&d n!'ur!# d# +iru( d #! %&!'i'i( E ( #

%o"r ( %!n d'$'!do !n'i$ur&o( $on'r! ( +iru( u o'ro( ('r$%!n'

r#!$ion!do( n &ri!'( n +!ri!( o'r!( (&$i( !ni!#(.

L! %&!'i'i( E ( un! n)rd!d 'r!n(i'id! &or # !/u! d !% ,u %!!

%!"ido "ro'( i&or'!n'( !'ri"uido( ! !#in'o( o !/u! $on'!in!do(. L!

in/('i*n d !ri($o $rudo o &o$o $o$ido ( o'r! +! d in)$$i*n n !#/uno(

$!(o( (&or4di$o( r/i('r!do( n on!( ndi$!(.

Lo( )!$'or( d ri(/o d #! %&!'i'i( E ('4n r#!$ion!do( $on #!( d)i$in$i!(

d #o( (i('!( d (!n!in'o n !i!( on!( d# undo $on #!

di(in!$i*n d# +iru( $!u(!n' ! 'r!+( d #!( %$(.

Cl%"i)a En)rd!d !/ud! $on i$'ri$i!

Anor3i!

i"r

D$!iin'o $on !#('!r /nr!#



16/29

Do#or !"doin!#.

8&!'o/!#i!

Ar'r!#/i!(.

Mor'!#id!d

HEPATITIS NO ,IRALES

1.0 HEPATITIS T2ICA

E# %/!do &or (u #o$!#i!$i*n ('r!'/i$! n'r #! $ir$u#!$i*n &or'!# #! (i('i$! (

un *r/!no $#!+ n # d('ino d #o( )4r!$o( n # or/!ni(o !# &!r'i$i&!r n #!

"io'r!n()or!$i*n d 'od!( #!( (u('!n$i!( #i&o(o#u"#( 9)4r!$o( o'ro(

3no"i*'i$o(.

Di$%o ($n!rio d #! %o*('!(i( in'rn! (i'7! !# *r/!no $oo di!n! d

)n*no( d 'o3i$id!d ,ui$!.

L! 'o3i$id!d %&4'i$! $!u(!d! &or )4r!$o( ( !$'u!#n' un &ro"#! d (!#ud

d i&or'!n$i! $r$in' un d(!)o d &rir ordn d #! %&!'o#o/! odrn!.

No n +!no #! %&!'o'o3i$id!d( $!&! d rd!r 'od!( #!( +!rid!d( d

n)rd!d %&4'i$! !/ud! $r*ni$! ( $!r$ !7n d !r$!dor( (&$)i$o(

d 'o3i$id!d %&4'i$! !i$!"#( ! #! &r4$'i$! $#ni$!. Por o'r! &!r' un! &ro&or$i*n

no d(&r$i!"# d #!( r!$$ion( %&4'i$!( ! )4r!$o( (on /r!+( in$#u(o

)!'!#(. En O$$idn' #o( )4r!$o( 9in$#undo # &!r!$'!o# (on r(&on(!"#(

d 4( d# 50F d #o( $!(o(.

Eti!pat!*e"ia

En'r #o( )4r!$o( $or$i!#i!do( u &o$o( (on $!&!$( d &rodu$ir #(i*n

%&4'i$! n )or! d&ndin' d #! do(i( &or ##o ( #( dnoin!

%&!'o'o3in!( in'rn($!(. E# &!r!$'!o# # 4$ido !$'i#(!#i$#i$o (on #o( ;o(

4( r&r(n'!'i+o(. L! inn(! !or! d #o( )4r!$o( n u(o ori/in!n



17/29

r!$$ion( %&!'o'*3i$!( d $!r4$'r i&rd$i"# n (u;'o( ,u r$i"n do(i(

'r!&u'i$!(.

E(' 'i&o d r!$$ion( (on $on(idr!d!( $oo idio(in$r4(i$!( ( d$ir d&ndn

d #! (in/u#!rid!d 7ni$! in'r!n()ri"# d# %u(&d.

Lo( $!ni(o( in+o#u$r!do( n #! n$ro(i( di()un$i*n %&!'o$#u#!r( d

n!'ur!#! '*3i$! (on ($!(!n' $ono$ido(.

E# &ro$(o d "io'r!n()or!$i*nd o#$u#!( n!'i+!( $o&rnd r!$$ion(

u(u!#n' o3id!'i+!( $!'!#i!d!( &or # $i'o$roo P-50 9CHP (/uid!( d

d(!$'i+!$i*n d #o( &o(i"#( '!"o#i'o( r!$'i+o( /nr!do( $on # $on$ur(o d

o'ro( (i('!( ni4'i$o( ,u in$#un #! $on;u/!$i*n $on 4$ido /#u$ur*ni$o o

(u#)!'o &*3ido %idro#!(! o /#u'!'ion )in!#n' 3&or'!$i*n d# $o&u('o !#

'orrn' $ir$u#!'orio &!r! (u )i#'r!do &or # /#oru#o rn!# o !# $!n!#$u#o &!r! (u

'r!n(&or' !# (i('! "i#i!rDur!n' (' &ro$(o # d!=o %&4'i$o ( &ud&rodu$ir &or di+r(!( +!( BJ ,u in$#un #! )or!$i*n d n#!$( $o+!#n'(

9!du$'o( n'r # '!"o#i'o r!$'i+o &ro'n!( $#u#!r( #! /nr!$i*n d

('r( o3id!'i+o &or # $on(uo d /#u'!'ion.

D )or! indir$'! #o( !du$'o( )or!do( &udn d!=!r '!"in #!( $#u#!(

or/!n#!( %&4'i$!( !#+o$!r un! r(&u('! %uor!# di!d! &or !n'i$ur&o( o

$i'o'o3i$id!d dir$'! 9#in)o$i'o( T &r+i! 3&o(i$i*n n #! "r!n! %&!'o$i'!ri!

$on # $on$ur(o d #!( o#$u#!( d# (i('! !or d %i('o$o&!'i"i#id!d 9M8C.

E( i&or'!n' (=!#!r ,u !"o( $!ni(o( &odr!n o&r!r d )or!

$on$urrn'.


18/29

$oo un! in)$$i*n +ir!# o n)rd!d (i('i$!. E( &o(i"# !(ii(o ,u

!#/uno( &o#ior)i(o( r!ro( n $i'o,uin!( !n'iin)#!!'ori!(9IL- &ud!n 3i$!r #!

in$!&!$id!d d !#/uno( (u;'o( &!r! r(o#+r # &ro$(o un! + ini$i!do

9!d!&'!$i*n #! $on(i/uin' !&!ri$i*n d d!=o 8&4'i$o.

in!#n' !#/uno( )4r!$o( o '!"o#i'o( /nr!do( dur!n' (u "io!$'i+!$i*n

&udn !#'r!r #!( &ro'n!( d 'r!n(&or' $!n!#i$u#!r i&idindo # )#u;o "i#i!r.

A#/uno( d)$'o( /n'i$o( n #o( 'r!n(&or'!dor( &udn )!$i#i'!r # &ro$(o

$oo (u$d $on #! u'!$i*n MDR- ,u %!$ ! #!( u;r( &or'!dor!(

(u($&'i"#( ! #! $o#('!(i( /('!$ion!# &o(i"#n' ! #! $o#('!(i( indu$id! &or

('r*/no(.

En ('! 7#'i! '!"in %! (ido in+o#u$r!d! un! u'!$i*n d AC ,u $odi)i$! #!

"o"! 3&or'!dor! d (!#( "i#i!r( 9SEP. S %!n idn'i)i$!do o'r!( +!ri!n'( d

/n( ii$!do( n # '!"o#i(o %&4'i$o d #o( )4r!$o( #! r(&u('!

!d!&'!'i+! ! #! #(i*n %&4'i$! ,u in$rn'!n #! (u($&'i"i#id!d ! &!d$r

%&!'o'o3i$id!d '!n'o n ('udio( d /n( $!ndid!'o( 9$on %i&*'(i( &r+i! $oo

n ('udio( !io( d# /no! 9(in %i&*'(i( ! $riori. E('o( 7#'io( 'inn #!

+n'!;! d ,u d'$'!n +!ri!n'( r!r!( !)$'!ndo ! /n( ,u no %u"ir!n (ido

($o/ido( n un ('udio d /n( $!ndid!'o( &ri'n !"rir nu+!( %i&*'(i(

&!'o/ni$!(.

P#ese"ta)i" )l%"i)!pat!l*i)a 3 )lasi4i)a)i" de las lesi!"es

L! 'o3i$id!d %&4'i$! &ud &r(n'!r( $on !ni)('!$ion( $#ni$!( &!'o#*/i$!(

,u +ir'u!#n' +o$!n $!d! +!rid!d d n)rd!d %&4'i$! $ono$id! $u!

in'n(id!d &ud o($i#!r d(d #+!$ion( !(in'o4'i$!( d #!( ni!(

%&4'i$!( %!('! in(u)i$in$i! %&4'i$! !/ud! /r!+ 9I8AG d $ur(o )u#in!n'. L!



19/29

)or! d &r(n'!$i*n 4( $o7n ( un $u!dro $#ni$o ,u (iu#! #! %&!'i'i(

+ri$! !/ud! $on i$'ri$i! n4u(!( !('ni! !#('!ro do#or !"doin!# &ro (on

&o(i"#( o'r!( &r(n'!$ion( ,u in$#un #! %&!'i'i( o $o#('!(i($r*ni$! $irro(i(

%&4'i$! n)rd!d +noo$#u(i+! in$#u(o no!(i!(. Aun,u n 'or! #!

%i('o#o/! %&4'i$! (r! #! %rr!in'! 4( !&ro&i!d! &!r! d)inir # &!'r*n d

#(i*n r!r! + ('4 di(&oni"# n # on'o !$'u!# 3i(' un $on(n(o !io

r(&$'o ! ,u #! ;or )or! d d)inir #! #(i*n %&4'i$! '*3i$! ( u'i#i!ndo #o(

+!#or( d !ino'r!n()r!(!( (ri$!( d #! "i#irru"in! !(4'i$!.

A( &odr! d$ir( ,u %! %&!'o'o3i$id!d $u!ndo n &r(n$i! d un )4r!$o

(o(&$%o(o (in o'r! 3i$!$i*n !&!rn' ( d'$'!n !#/un! d #!( (i/uin'(

!no!#!(: ! !un'o d #! !#!nino!ino'r!n()r!(! 9ALT 4( d $in$o +$( #

#i' (u&rior nor!# 9LSN " !un'o d #! )o()!'!(! !#$!#in! 9A 4( d do(

+$( # LSN o $ !un'o d #! ALT 4( d 'r( +$( # LSN $on;un'!n' $on

un !un'o d #! "i#irru"in! (ri$! 'o'!# 4( d do( +$( # LSN. E# u"r!# d

ALT &!r! d)inir un $!(o d %&!'o'o3i$id!d( %! #+!do ! $in$o +$( # LSN

9)rn' ! do( +$( # LSN d# $on(n(o &r+io &!r!: ! rdu$ir # n7ro d

)!#(o( 9&. ;.: #+!$ion( odr!d!( d 'r!n(!in!(!( !(o$i!d!( ! #! n)rd!d

%&4'i$! /r!(! no !#$o%*#i$! " 3$#uir #o( $!(o( d K!d!&'!$i*n 9#+!$ion(

odr!d!( d 'r!n(!in!(!( ,u !$!"!n r(o#+indo( ! &(!r d #! $on'inu!$i*n

d# 'r!'!in'o i(oni!id! !(&irin! ('!'in!(. E# 'i&o d #(i*n r(u#'!n' (

$#!(i)i$!r4 n )un$i*n d #! r#!$i*n 9R n'r # in$rn'o d ALT)o()!'!(!

!#$!#in! n %&!'o$#u#!r $o#('4(i$!o i3'!. Lo( +!#or( (ri$o( d

!(&!r'!'o!ino'r!n()r!(!9AST &odr!n r!!r ! #o( d ALT n #o( $!(o( n

#o( ,u ('! 7#'i! no (' di(&oni"# &ro #! +!#id d ('! &ro&u('! no %! (ido

)or!#n' do('r!d!. En #! &r4$'i$! $#ni$! #! 'o3i$id!d %&!'o$#u#!r

r&r(n'! !&ro3i!d!n' un 55F #! $o#('4(i$! un 21F #! i3'! un 25F d

#o( $!(o(. E('o( &!'ron( &udn no $oin$idir (i'ri$!n' $on #!( #(ion(

('ru$'ur!#( n # %/!do d'rin!d!( &or #! "io&(i! %&4'i$! !un,u r)#;!n

d )or! i&r)$'! !#/uno( &!'ron( (&$)i$o( 9&. ;.: #(ion( +!($u#!r(

$r*ni$!( no!(i!( '$. 3%i" un! "un! $orr#!$i*n n /nr!# $on #! #(i*n



20/29

%&4'i$! (u"!$n' ( 3$#n' ! )$'o( &ron*('i$o( L! #(i*n %&!'o$#u#!r

9$i'o#'i$! $i'o'*3i$! !/ud! ( d)in (i/uindo ('o( $ri'rio( $oo un! ALT

(u&rior ! 5 LSN o R (u&rior o i/u!# ! 5. En o$!(ion( $o3i('n !ni)('!$ion(

d %i&r(n(i"i#id!d '!#( $oo )i"r 3!n'! $u'4no o o(ino)i#i!&ri)ri$! ,u

(u/irn !#r/i! )!r!$o#*/i$!. L! 3&r(i*n %&!'o$#u#!r d #! %&!'o'o3i$id!d

( 4( )r$un' n u;r( ;*+n( (' &r)i# 9#(i*n %&!'o$#u#!r n u;r(

$o&or'! un !or ri(/o d +o#u$i*n /r!+ n &r(n$i! d i$'ri$i!.

8i('o#*/i$!n' &udn n$on'r!r( /r!do( +!ri!"#( d in)#!!$i*n n$ro(i(

&ro # &rdoinio $n'ro#o"u#i##!r d #!( #(ion( #! &r(n$i! d un in)i#'r!do

in)#!!'orio ri$o n o(in*)i#o((u/irn un! 'io#o/! '*3i$!. L! n$ro(i(

$n'ro#o"u#i##!r ( (&$i!#n' &roinn' n $!(o( d in'o3i$!$i*n $on !#/un!(

%&!'o'o3in!( in'rn($!( '!#( $oo # &!r!$'!o# o $o$!n!. En ('!(

$ir$un('!n$i!( #o( ni+#( (ri$o( d 'r!n(!in!(!( (u#n ('!r

3'r!ordin!ri!n' #+!do( 9100 +$( o 4( # LSN (i'u4ndo( n # r!n/o d#! %&!'i'i( i(,ui$!.

Dia*"sti)!

L! di(&oni"i#id!d d !r$!dor( o#$u#!r( d 'o3i$id!d %&4'i$! !i$!"#( ! #!

&r4$'i$! $#ni$! &!r$ !7n #;!n!. Por ##o # di!/n*('i$o d

%&!'o'o3i$id!d$on'in7! (indo un d(!)o &!r! # $#ni$o. So#o n o$!(ion( u

$on$r'!( ( &o(i"# )$'u!r un di!/n*('i$o $on$#un' d %&!'o'o3i$id!d.

E##o in$#u #! d'rin!$i*n d ni+#( !(4'i$o( d !#/un!( %&!'o'o3in!(

in'rn($!( $oo &!r!$'!o# o A(&irin!.

R$in'n' ( %! $ouni$!do #! u'i#id!d d #! d'$$i*n d

!du$'o(&!r!$'!o#-$i('n! &or $ro!'o/r!)! #,uid! #$'ro,ui$! d !#'!

&r(i*n. Con (' 'odo ( %!n &ro&or$ion!do +idn$i!( d #! ii$!$i*n d#

&!r!$'!o# $oo !/n' $!u(!# %!('! n un 0F d #o( $!(o( d in(u)i$in$i!



21/29

%&4'i$! !/ud! /r!+ d $!u(! d($ono$id!. En $!(o( !i(#!do( $on )4r!$o(

,u n (u !or! )uron r'ir!do( d# r$!do ( %!n d'$'!do ''u#o( d

!n'i$ur&o( $ir$u#!n'( /nr!#n' $on'r! #! )r!$$i*n i$ro(o!#n$!r/!d! d#

'!"o#i(o d# $o&u('o.

D i/u!# odo ( %!n u'i#i!do n #! "7(,ud! d +idn$i!( d !#r/i!

)!r!$o#*/i$! &ru"!( d 'r!n()or!$i*n #in)o$i'!ri! 9$on(i('n'( n #! 3&o(i$i*n

d (uro d# &!$in' !# )4r!$o (o(&$%o(o.

Aun,u un! r(&u('! &o(i'i+! %! (ido $#4(i$!n' $on(idr!d! $oo un!

+idn$i! (&$)i$! d ,u # )4r!$o ( r(&on(!"# d# d!=o %&4'i$o '!#

r(&u('! &ud r)#;!r r!n' un! 3&o(i$i*n &r+i! !# di$!n'o.

En 7#'i! in('!n$i! #!( &ru"!( d 'r!n()or!$i*n #in)o$i'!ri! in +i'ro (on di)$i#(

d ('!nd!ri!r ($!(!n' r&rodu$i"#( no %!n !#$!n!do !$&'!$i*n $#ni$!

T#ataie"t! 3 p#e5e")i" Medidas *e"e#ales

L! &rin$i&!# did! 'r!&u'i$! 9,u d" 'o!r( n $u!#,uir n)rd!d

%&4'i$! n +!#u!$i*n ( #! indi!'! (u&r(i*n d $u!#,uir 'r!'!in'o)!r!$o#*/i$o no (n$i!# ! ,u 3i('n &ru"!( d ,u # )!$'or &riordi!# n

un! +o#u$i*n d(-)!+or!"# ( #! &r(i('n$i! d# !/n' $!u(!# un! + ini$i!d! #!

i$'ri$i!. P!r! #o( &!$in'( $on r!$$i*n %&4'i$! idio(in$r4(i$! d# 'i&o

%&!'o$#u#!r$#ni$!n' !&!rn' 9i$'ri$i! #! &ro$$i*n d or'!#id!d 9o (u

!r$!dor (u"ro/!do #! n$(id!d d 'r!n(!n' no ( in)rior !# 10F. P!r$

&rudn' &or '!n'o ri'ir !# %o(&i'!# ! &!$in'( $on (o(&$%! d %&!'o'o3i$id!d

,u &r(n'n ('!( $!r!$'r('i$!(.

T#ataie"t! de la i"t!6i)a)i" )!" pa#a)eta!l

L! in/('i*n d do(i( 3$(i+!( d &!r!$'!o# &ro&or$ion! #! 7ni$! &o(i"i#id!d d

un 'r!'!in'o (&$)i$o d #! n)rd!d %&4'i$! '*3i$!: #! !dini('r!$i*n d N-

!$'i#$i('n!. L! 'o3i$id!d %&4'i$! !/ud! &or &!r!$'!o# ( &rodu$

%!"i'u!#n' n un ($n!rio d in/('i*n !(i+! $on )in( !$$idn'!#( o

(ui$id!( !un,u '!"in d !nr! $r$in' n un $on'3'o d do(i(



22/29

'r!&u'i$!( #+!d!( &or &riodo( &ro#on/!do( d 'i&o o $ir$un('!n$i!( d

indu$$i*n i$ro(o!# 9!#$o%o# o d$i*n d /#u'!'ion 9d(nu'ri$i*n. Aun,u #!

N-!$'i#$i('n! ('4 indi$!d! n 'odo &!$in' $on +idn$i! d (o"r3&o(i$i*n !#

&!r!$'!o# $on ind&ndn$i! d# 'i&o 'r!n($urrido d(d #! i(! &!r! ,u

!#$!n$ #! 43i! )i$!$i! d" !dini('r!r( dur!n' #!( &rir!( 2 %or!(

9&r)ri"#n' !n'( d ,u %!!n 'r!n($urrido o$%o 'r!( #! in/('i*n ! ,u #!

or'!#id!d ( in$rn'! (u('!n$i!#n' ! &!r'ir d (' on'o.

7.0 OTRAS HEPATITIS NO ,IRALES

HEPATITIS POR TO2INAS

En'r #o( '*3i$o( ( n$un'r!n:

A!ni'! &%!##oid( ,u ( u %&!'o'*3i$! &udindo $!u(!r n$ro(i(!(i+! )!##o %&4'i$o.

T'r!$#oruro d $!r"ono $#oro)oro 'ri$#oro'i#no 'odo( #o(

or/!no$#or!do( &rodu$n ('!'o%&!'i'i(. Ci#indro(&ro&(in! un! 'o3in! d #! $i!no"!$'ri!

C#indro(&ro&(i(r!$i"or(ii o'r!( "!$'ri!( d# i(o /nro. o()!'o( "#!n$o( 'o3in! indu('ri!# '!"in u(!d! n #! /urr! ,ui$!.

HEPATITIS DE CAUSA AUTOINMUNE

Anor!#id!d n # 8LA 'i&o II d #! (u&r)i$i d #o( %&4'o$i'o( o !#'r!$i*n n #

(i('! inun &o(' in)$$ion( +ir!#( &udn &ro+o$!r un! r!$$i*n !u'oinun

d# 'i&o $#u#!r n $on'r! d# ';ido %&4'i$o.

DESRDENES META&LICOS



23/29

A#/un!( !#'r!$ion( '!"*#i$!( &udn &ro+o$!r d!=o &or !$uu#!$i*n d

(u('!n$i!( ! ni+# d #o( di+r(o( ';ido( d# or/!ni(o n'r ##o( # %/!do. L!

%o$ro!'o(i( #! n)rd!d d i#(on ( $!r!$'ri!n &or &ro+o$!r %&!'i'i(.

O&STRUCTI,A

L! o"('ru$$i*n &ro#on/!d! &or $4#$u#o( $4n$r o &!r4(i'o( 9)!($io#! %&4'i$!

&ud &ro+o$!r d!=o in)#!!$i*n ! ni+# d# %/!do.

HEPATITIS ALCOHLICA

Produ$ido &or #! in/('! d !#$o%o#. R(u#'! n # d!=o dir$'o d"ido !# ('r(

o3id!'i+o ! ni+# d #o( %&!'o$i'o(.

Su &ron*('i$o ( +!ri!"# ndo d(d $!(o( !u'o#ii'!do( %!('! (i'u!$ion( 4(

(+r!(.

HEPATITIS IS'U8MICA

L! %&!'i'i( i(,ui$! ( $!u(!d! &or #! di(inu$i*n n # )#u;o (!n/uno %!$i!

#o( %&!'o$i'o(. u(u!#n' ( d"ido ! #! di(inu$i*n n #! &r(i*n (!n/un!

9(%o$ $ono$ido '!"in $oo (%o$ %&4'i$o. Lo( &!$in'( $on %&!'i'i(

i(,ui$!( /nr!#n' ( n$un'r!n n !# ('!do d"ido ! #! $!u(!

(u"!$n' !# (%o$ 9,u &ud (r d ori/n %&4'i$o (!n/r!do !(i+o o )!##! d#

$or!*n. R!r!n' #! %&!'i'i( i(,ui$! &ud (r $!u(!d! &or &ro"#!(

#o$!#( n #o( +!(o( (!n/uno( 9'!#( $oo 'ro"o(i( o ('no(i( d #! !r'ri!

%&4'i$! #! $u!# ( #! r(&on(!"# d #! ##/!d! d #o( nu'rin'( !# ';ido

%&4'i$o. En # &r)i# %&4'i$o ( &ud o"(r+!r un !un'o 'r!n(i'orio 9%!('! 10

d!( d dur!$i*n d #!( GOT GPT #!( $u!#( 3$dn #o( 1000


24/29

En !#/uno( $!(o( #! d)i$in$i! d !#)!-1 !n'i'ri&(in! &ro+o$! !$uu#!$i*n d

&ro'n!( n # r'$u#o ndo!(4'i$o &ro+o$!ndo d!=o in)#!!'orio ! ni+# d #o(

%&!'o$i'o(.

ESTEATOHEPATITIS NO ALCOHLICA

8&!'i'i( in'rodu$id! n nu('ro or/!ni(o n #! $u!# no in'r+in # $on(uo d

!#$o%o#.

TRATAMIENTO

1. Hepatitis A

No 3i(' 'r!'!in'o (&$)i$o &!r! #! %&!'i'i( A !/ud! '&i$! # r&o(o n $!!

o"#i/!do no ( (n$i!# &!r! #! r$u&r!$i*n $#ni$! $o'! &ro u$%o(

&!$in'( ( n$un'r!n ;or (i r('rin/n (u !$'i+id!d )(i$!. A#/uno( !u'or(

r$oind!n # r&o(o n $!! %!('! ,u ( nor!#i$n #!( &ru"!( d

)un$ion!in'o %&4'i$o #! di'! (u# (r nor!# no %! indi$!$i*n &!r! di'!(

!#'!( n $!r"o%idr!'o( "!;!( n &ro'n!( #! di(inu$i*n d /r!(!( (

!$on(;!"# $u!ndo %!!in'o#r!n$i! ! ('!( #o( $!(o( d &r(n'!$i*n "i)4(i$!o %&!'i'i( $o#('4(i$! d"n r$i"ir # i(o 'r!'!in'o n #! (/und! )!( d

(n'o!( #+!$i*n d &ru"!( "io,ui$!( ( d$ir r&o(o n $!! %!('! ,u

('!( ( nor!#i$n di'! nor!# o "!;! n /r!(!( (i %! indi$!$i*n &!r! ##o. Lo(

('roid( ('4n indi$!do( (o#!n' n !#/uno( $!(o( d %&!'i'i( $o#('4'i$!

&ro#on/!d!

7. Hepatitis &

In'r)r*n !#)!



25/29

Lo( in'r)ron( (on un! )!i#i! %'ro/n! d &ro'n!( $on &ro&id!d(

!n'i+ir!#( inunoodu#!dor!(. E# IN !#)! !$'7! di!n' in'r)rn$i! $on #!

!d%rn$i! d# +iru( ! #! $#u#! %&4'i$! indu$ #! (n'(i( d &ro'n!(

in'r!$#u#!r( ri"onu$#!(!( rdu$indo #! (n'(i( d RNA &ro'n!( !d4(

d !i)i$!r #! r(&u('! inun di!d! &or #in)o$i'o( T $i'o'*3i$o( $#u#!(

n!'ur!# i##r 9NQ. E# in'r)r*n !#)! 2" )u !&ro"!do &or #! DA n 12 &!r! (u

u(o n %&!'i'i( $r*ni$! . L! do(i( r$ond!d! ( d 5 i##on( d unid!d(

9


26/29

8A/ n/!'i+i!$i*n d# 8V DNA '!n'o n &!$in'( 8A/ &o(i'i+o( $oo

8A/ n/!'i+o( in$#u(o $on ;or! d #! %i('o#o/! %&4'i$! n "io&(i!( d

$on'ro#.

9. Hepatitis C

E3i('n do( )or!( d in'r)r*n &/i#!do di(&oni"#( !$'u!#n' &!r! (u u(o

(u"$u'4no (!n!#: #! )or! d 0 D d in'r)r*n !#)! 2! 98o))!nn- L! Ro$%

Cor& #! d 12 D d in'r)r*n !#)! 2" 9S$%rin/ P#ou/% Cor&. L! &rir! (

$or$i!#i!d! $oo #i('! &!r! u'i#i!$i*n ind&ndin' d# &(o $or&or!#

in'r!( ,u #! 7#'i! r,uir )oru#!$i*n &or Q/. d &(o 9i$ro/r!o( /

(!n!. E# in'r)r*n &/i#!do n $u!#,uir! d (u( do( )or!( 4( # !n'i+ir!# d

u(o or!# ri"!+irin! ( %! $on+r'ido n # nu+o ('4nd!r d 'r!'!in'o &!r! #!

%&!'i'i( $r*ni$! C.

L! '!(! d r(&u('! +ir!# (o('nid! &!r! # 'r!'!in'o $o"in!do &or J(!n!( ( d 56F &!r! # in'r)r*n &/i#!do !#)! 2! 5F &!r! in'r)r*n

&/i#!do !#)! 2" n &!$in'( $on /no'i&o 1. A"o( %!n do('r!do $#!r!n'

(u (u&riorid!d $on r(&$'o !# in'r)r*n $on+n$ion!# !$'u!#n' %! ('udio(

n $ur(o $o&!r!ndo !"!( )or!( d in'r)r*n &/i#!do n'r (. Lo( &!$in'(

$on /no'i&o 2 * &udn r$i"ir (*#o 2 (!n!( d in'r)r*n &/i#!do J00 /

d ri"!+irin! di!rio( in'r!( ,u #o( &!$in'( $on /no'i&o 1 9#o( 4(

)r$un'( n$(i'!n J (!n!( #!( do(i( d ri"!+irin! r$ond!d!( (on

n'r 1 000 1 200 /d.

. Hepatitis E

No 3i(' 'r!&i! )$'i+! &!r! #! %&!'i'i( D !/ud! # 'r!'!in'o ('4

(n$i!#n' orin'!do ! &!$in'( $on in)$$i*n $r*ni$! &or 8DV. L!( '!(!( d

r(&u('! $o'! (o('nid! !# in'r)r*n !dini('r!do &or 12 (( (on

nor( ,u n #o( &!$in'( $on in)$$i*n $on 8V (o#!n'. No 3i('n

('udio( &u"#i$!do( !$r$! d# u(o d #!i+udin! o !d)o+ir di&i+o3i# n ('o(



27/29

&!$in'( !un,u (u u'i#i!$i*n (r! r!on!"# n #! &r4$'i$! $#ni$! !# in%i"ir #!

ri$!$i*n d# 8V.

Dia*"sti)! Di4e#e")ial

L! "7(,ud! d #! &r(n$i! d )!$'or( d ri(/o &!r! %&!'i'i( +ir!# ( un! &!r'

(n$i!# d #! +!#u!$i*n d# &!$in' $on i$'ri$i! #+!$i*n !/ud! d

!ino'r!n()r!(!(. E# $on'!$'o $on i$'ri$o( n # &!(!do r$in' #! in/('! d

$oid! &o'n$i!#n' $on'!in!d! un! %i('ori! d +i!; ! on!( ndi$!(

&!r! %&!'i'i( +ir!# d" (r in+('i/!do.


28/29

%&!'i'i( +ir!# (on #!( in)$$ion( &or L&'o(&ir! C!ndid! ru$##! M$o"!$'ri!

Pnuo$'i(.

E( u i&or'!n' o"'nr $on $uid!do #o( !n'$dn'( d #o( di$!n'o(

!dini('r!do( !# &!$in' &u('o ,u u$%o( )4r!$o( !#/uno( !n('(i$o(

&udn &rodu$ir %&!'i'i( !/ud! o $o#('!(i(.

O'r! (i'u!$i*n $#ni$! ,u &ud (iu#!r un! %&!'i'i( !/ud! ( #! in(u)i$in$i!

+n'ri$u#!r dr$%! &or $on/('i*n %&4'i$! &!(i+! o #o( (ndro( d

%i&o&r)u(i*n $oo # ,u !$o&!=! %i&o'n(i*n /r!+ o in(u)i$in$i! +n'ri$u#!r

i,uird!. En ('! !i! +!rid!d d 'r!('orno( %! ,u in$#uir '!"in 'odo(

!,u##o( ,u in'r)irn n # r'orno +no(o !# $or!*n $oo # i3o! !uri$u#!r

#! &ri$!rdi'i( $on('ri$'i+! #! o"('ru$$i*n d #!( +n!( (u&r! %&4'i$!( 9 (ndro

d udd C%i!ri o #! n)rd!d +n o$#u(i+!.

L!( !ni)('!$ion( $#ni$!( (u#n di)rn$i!r ('o( 'r!('orno( +!($u#!r( d #!

%&!'i'i( +ir!#.

ANEXOS

ANEXO 01: Patoge!a "e# $!%&' "e #a (e)at!t!' A



29/29

ANEXO 0*: SINTOMATOLOGIA DE HEPATITIS +

ANEXO 0,: TRANSMISION DE HEPATITIS + - C

monografia de hepatitis

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