4 Hepatitis Flashcards
What are the two most common types of hepatitis virus cause acute hepatitis infection?
Hep A and E
How does a person present with acute hepatitis infection?
They have “flu-like” symptoms, jaundice, painful liver, elevated liver function test results
How does chronic hepatitis present?
Most times asymptomatic, but physical exam can show portal hypertension, and either normal or elevated LFTs
What hepatitis infection can resolve spontaneously? (acute or chronic)
Acute
Does Hepatitis B cause acute or chronic hepatitis?
Both. 30% of time it’s acute, 70% of time it’s chronic
What type of hepatitis causes only chronic hepatitis?
Hepatitis C virus
What kind of virus is Hep A?
Non-enveloped single-stranded RNA virus
In developing countries, who is more likely to get Hep A infection, and how?
Children are most likely to get HAV via fecal-orally (and/or through food)
What is the usual incubation period for HAV?
28 days
like the movie!
What are some risk factors for hepatitis A infection?
child being in day care, international travel, man to man sexual intercourse, and IV drug users
Who presents with symptoms during HAV infection?
Adults are almost always symptomatic, only 30% of kids are symptomatic
Who gets vaccinated against HAV?
children at 1 y.o., international travelers, homosexual males, IVDUs, pts with HIV
What kind of virus is Hepatitis E?
Non-enveloped, single-stranded RNA virus
How is HEV transmitted?
spread via fecal contaminated water
How does HEV infection present compared to HAV?
They present nearly identical to one another
What kind of virus is HBV?
Enveloped DNA virus: partially dsDNA and ssDNA
What is the surface antigen for Hep B?
HBsAg
What is HBcAg?
Hep B core nucleocapsid protein (antigen)
What does HBxAg bind to?
p53, inhibiting apoptosis and tumor prevention
In areas of high prevalence of HBV, what is the most common route of transmission?
From mother to infant during birth
90% infxn rate
The neonatal HBV vaccine is how effective?
95% efficacy
administered to infant after birth
What is the most common way for a healthcare worker getting HBV?
Via blood from needle pricks or accidents
about 30% chance of infection if exposed to blood
In areas of low prevalence, what is the most common route of transmission for HBV?
Sexually, especially between two men
What percentage of adults infected by HBV will develop chronic hepatitis?
70%, but this rate decreases with the increasing age of patient
Are men or women more likely to get chronic HBV?
Women more likely to have chronic HBV, men more likely to present with symptomatic, acute HBV
What are two manifestations of chronic HBV?
cirrhosis and hepatocellular carcinoma (HCC)
What would you test for to diagnose HBV?
HBsAg
DO NOT test for HBcAg because it’s intracellular
What does HBeAg signify?
it’s a marker signifying replication and infectivity of the HBV
What two signs should you see to treat HBV?
HBeAg concentration and disease (typically inflammation or necrosis of liver)
If you don’t have HBV, what hepatitis virus are you guaranteed not to have?
Hepatitis D virus
it infects 10% of HBV patients
What is the only approved treatment for HDV?
IFNa
What type of virus is the hepatitis C virus?
Enveloped RNA virus
Hepatitis C must be transmitted through what?
Blood
If you suspect a patient has Hep C, what two tests should you perform to diagnose?
HCV antibody test first. If positive do an immunoassay to test if the virus is actively present
If your patient is positive for Hep C, what two things should you always test for next?
HIV and Hep B
New drugs that cure HCV target what part of the virus?
polymerase and protease enzymes
