21.0 - hepatitis

Question 1

hepatitis

Answer 1

infection of hepatocytes, causing inflammation of the liver

Question 2

5 main viruses infecting the liver

Answer 2

Hep B, C, D, A, E

Question 3

predominantly blood borne, vertical or sexual transmission potentially causing chronic disease

Answer 3

B C and D

Question 4

predominantly enteric transmission and does not cause chronic disease

Answer 4

A and E

Question 5

other viruses causing hepatitis

Answer 5

epstein Barr, cytomegalovirus, yellow fever virus and other

Question 6

transmission Hep A

Answer 6

faecal oral via food or water

Question 7

hep A infection

Answer 7

can be severe but self limiting

Question 8

hep B transmission

Answer 8

infected blood or body fluids

• IV drug use
• sex
• vertical ( mother infant)

Question 9

infection with Hep B

Answer 9

leads to chronic hepatitis, risk depends on age when infected
neonates 90-95%
children 50 %
adults 5%
some develop cirrhosis or hepatocellular carcinoma

Question 10

hep C transmission

Answer 10

infected blood or body fluids

• IV drug use
• vertical (mother - infant)

Question 11

hepatitis C infection

Answer 11

most acute cases asymoptamatic

75-85% of cases develop chronic infetion

Question 12

hep D virus transmission

Answer 12

infected blood or body fluids

• IV drug use
• sex
• vertical (mother-infant)

Question 13

hep D infection

Answer 13

a defective virus, needs presence of HBV two replicate.

co infects with HBV or supenrinfects those with HBV

Question 14

hep E transmission

Answer 14

faecal-oral via food or water

Question 15

hep E infection

Answer 15

self limiting
uncommon in australia
mainly returned travellers

Question 16

acute hepatitis

Answer 16

all of the hepatitis viruses can cause this

Question 17

acute hepatitis progression

Answer 17

incubation - variable time
prodrome - 1-2 weeks pre jaundice
clinical jaundice - variable time
recovery period - 2-12 weeks post icteric phase

Question 18

prodrome clinical presentation

Answer 18

anorexia, nausea, vomiting, arthralgia, myalgia, fever, headache

Question 19

clinical jaundice clinical presentation

Answer 19

jaundice, hepatomegaly, occasional splenomegaly

Question 20

hep A virus summary

Answer 20

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

Question 21

hepatitis E virus

Answer 21

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

Question 22

hep E virus can be complicated by

Answer 22

severe hepatic necrosis with fatal fulminant hepatitis occurring in 1-2% of cases and in 20% of pregnant women

Question 23

hep E virus found in

Answer 23

india, asia, africa, and Central America

in australia, mainly seen in returned travellers

Question 24

hep C virus

Answer 24

transmitted via blood

sexual transmission is uncommon

Question 25

hep D virus

Answer 25

delta agent

a defective virus that relies in HBV for replication and expression

Question 26

HDV co infection

Answer 26

can infect a person simultaneously with HBV

Question 27

HDV superinfection

Answer 27

infecting a person already infected with HBV

Question 28

HDV and HBV

Answer 28

HDV contributes to severity

increases likelihood of severe, aggressive HBV infection and may accelerate progression to cirrhosis

Question 29

HDV is found in

Answer 29

in endemic areas - meditteranean, Northern Africa, Middle East, transmission is usually sexual or vertical
in non endemic areas, transmission is usually via blood