3 - Paeds - Gastro - Viral Hepatitis Flashcards
clinical features - LFTs? what is normal? Common Sx? less common?
AST/ALT elevation
conjugation normal
N+V, abdo pain, lethargy, jaundice
large tender liver, splenomegaly
Hep A - type of virus? transmission? Sx?
RNA virus
faecal oral trans
may be aSx but most have mild illness and recover 2-4weeks
Hep A - some develop.. ? diagnosis by? Tx?
some get cholestatic hepatitis/fulminant hepatitis
diagnosis by IgM Ab to virus
no trt
HNIG prophylaxis to contacts or vaccine within 2wks
Hep B - type? transmission?
DNA virus
trans - perinatal, transfusion, needlestick, dialysis, sexual, horizontal familial spread
Hep B - Sx?
aSx in infants - 90% become chronic carriers
older children may be aSx or have classic viral hep features
Hep B - % of older kids who become chronic carriers? % who go to fulminant hepatic failure?
5-10% become chronic carriers
1-2% get fulminant hep failure
Hep B diagnosis + treatment?
HBV antigens and Abs, IgM Abs to Anti-HBc +ve in acute infection, HBsAg +ve = chronic
no trt
Chronic Hep B - of infants who are infected vertically from mum…% get chronic HBV LD ? % get cirrhosis? long term risk of? what is done to prevent this?
30-50% > chronic HBV LD
10% > cirrhosis
long term risk of hepatocellular CA
all mothers antenatally screened for HBsAg and babies of + mums receive Hep B vaccination course
Hep C - type of virus? high prevalence in who? rarely gives what? but most become what?
RNA virus
in IVDUs
rarely acute infection but most > chronic carriers
Hep C - if chronic carrer, 20-25% lifetime risk of what?
trt?
cirrhosis/hepatocellular Ca
combo of pegylated interferon and ribavirin (not <4y as may resolve)
Hep D - type? depends on what ? Occurs as ??? OR ??? % of chronic HDV > cirrhosis?
defective RNA virus
depends on HBV for replication
occurs as co-infection OR superinfection causing acute exacerbation of chronic HBV
50-70%
Hep E - type? trans?
RNA virus
enteral trans usually by contaminated water
