3.13.4. Liver + Biliary Tree Disease - Viral Hepatitis - D Flashcards

1
Q

What causes Hepatitis D infection?

A

A Parenteral Virus (HDV)

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2
Q

How does HDV enter into the Bloodstream?

A
  1. It is a Parenternal Virus -
    Transmitted through Blood-Blood contact
  2. It is a Co/Super-infection and is transferred with HBV
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3
Q

How are most Blood-Blood (Parenternal) Viruses transmitted?

A
  1. I.V. Drug Abusers

2. Sex

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4
Q

What type of disease does HDV cause?

A

Chronic Liver Disease

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5
Q

What is the Structure of the Hepatitis D Virus?

A

This does not code for its own Protein Coat, it is enveloped by the HBsAg (Hepatitis B Surface Antigen)

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6
Q

What is the result of the Hepatits D Virus being enveloped by the HBsAg (Not coding for it’s own protein coat)?

A
  1. It makes it very difficult to treat
  2. It has the same pathology as Hepatitis B
  3. It has the same Anti-bodies produced against the HBsAg, exept for the Hepatitis D Virus itself, which is the Anti-HDV Antibody
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7
Q

What are the Clinical Signs of Hepatitis D?

A
  1. Hepatomegaly
  2. Lymphadenopathy
  3. Deranged Enzymes
  4. Jaundice
  5. Hepatitis B infection
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8
Q

Why does Hepatomegaly occur?

A

Due to the Inflammation of the Liver caused by the HBV / HDV infection

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9
Q

Why does Lymphadenopathy occur?

A

This is due to the Immune response to the HBV / HDV infection

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10
Q

Why do Deranged Enzymes appear?

A

Due to the potential impairment of the Hepatic Function

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11
Q

What type of Jaundice occurs?

A

Intrahepatic

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12
Q

Why does Jaundice occur?

A

Due to the damage of Hepatocytes, they cannot effectively deal with Bilirubin and so there is a back-up into the Blood

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13
Q

What are the Symptoms of HDV infection?

A

The same as HBV infection:

  1. Nausea and Vomiting
  2. Anorexia
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14
Q

Why does Nausea and Vomiting occur in an HBV / HDV infection?

A

Due to this being an infection of an Accessory Organ of the Alimenatry Tract, this is the body’s natural response

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15
Q

Why does Anorexia occur?

A

Due to the associated Nausea and Vomiting

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16
Q

What investigations are necessary for HDV infection?

A
  1. Blood Inflammatory Markers (PCR and ESR)
  2. Serum ELISA looking for the Anti-HDV Antibody
  3. Serum ELISA looking for the HBsAg (Hepatitis B Surface Antigen)
17
Q

What is the Treatment of HDV infection?

A

PEGylated Interferon

18
Q

What is the action of PEGylated Interferon?

A

This causes the T-Helper Cells (associated with the HDV Infection) to become T2-Helper Cells - Invoking a quicker and more Powerful Immune Response

19
Q

What will the PEGylated Interferon do?

A

Prevent the Spread of the Disease

20
Q

How long can PEGylated Interferon be given for?

A

1 year

21
Q

What can advanced stage HDV lead to?

A

Liver Cirrhosis