21.0 - hepatitis Flashcards
hepatitis
infection of hepatocytes, causing inflammation of the liver
5 main viruses infecting the liver
Hep B, C, D, A, E
predominantly blood borne, vertical or sexual transmission potentially causing chronic disease
B C and D
predominantly enteric transmission and does not cause chronic disease
A and E
other viruses causing hepatitis
epstein Barr, cytomegalovirus, yellow fever virus and other
transmission Hep A
faecal oral via food or water
hep A infection
can be severe but self limiting
hep B transmission
infected blood or body fluids
- IV drug use
- sex
- vertical ( mother infant)
infection with Hep B
leads to chronic hepatitis, risk depends on age when infected
neonates 90-95%
children 50 %
adults 5%
some develop cirrhosis or hepatocellular carcinoma
hep C transmission
infected blood or body fluids
- IV drug use
- vertical (mother - infant)
hepatitis C infection
most acute cases asymoptamatic
75-85% of cases develop chronic infetion
hep D virus transmission
infected blood or body fluids
- IV drug use
- sex
- vertical (mother-infant)
hep D infection
a defective virus, needs presence of HBV two replicate.
co infects with HBV or supenrinfects those with HBV
hep E transmission
faecal-oral via food or water
hep E infection
self limiting
uncommon in australia
mainly returned travellers
acute hepatitis
all of the hepatitis viruses can cause this
acute hepatitis progression
incubation - variable time
prodrome - 1-2 weeks pre jaundice
clinical jaundice - variable time
recovery period - 2-12 weeks post icteric phase
prodrome clinical presentation
anorexia, nausea, vomiting, arthralgia, myalgia, fever, headache
clinical jaundice clinical presentation
jaundice, hepatomegaly, occasional splenomegaly
hep A virus summary
faecal oral route trasmitted virus
enhanced by overcrowding and poor personal hygiene
subclinical infections contribute to virus perpetuation
infected individuals develop a hepatic illness with jaundice with resolves spontaneously
virus is present in blood, bile, and faeces during the late incubation period and is excreted in the stools until jaundice has resolved
clinical and biochemical recovery typically occurs after 1-2 months
rarely, complicated by fatal fulminant hepatitis, occurring in <1% of cases
hepatitis E virus
enterically transmitted virus
animal reservoirs, especially swine, contribute to virus perpetuation
infected individuals develop a hepatic illness which resolves spontaneously
excreted in the stools during late incubation period
clinical and biochemical recovery occurs after 1-2 months
hep E virus can be complicated by
severe hepatic necrosis with fatal fulminant hepatitis occurring in 1-2% of cases and in 20% of pregnant women
hep E virus found in
india, asia, africa, and Central America
in australia, mainly seen in returned travellers
hep C virus
transmitted via blood
sexual transmission is uncommon
