4.4 Viral hepatitis Flashcards
What type of virus is Hep A?
Non enveloped Simple enteric RNA virus
What type of virus is Hep B?
Blood borne enveloped DNA virus
What type of virus is Hep C?
Blood borne enveloped RNA flavivirus
What are the symptoms of acute hepatitis
Anorexia Nausea Vomiting Dark urine (bilirubinuria) Jaundice Tender soft liver Malasie and fatigue NO fevers, rigors or sore throat
How do you diagnose acute hepatitis?
Clinical illness History LFTs (ALT >500) Hepatitis serology Virology when you suspect HCV but not anti-HCV
What is the incubation of HAV?
3-6 weeks
What is the diagnosis of HAV?
IgM anti-HAV
IgG anti-HAV = past infection
What type of vaccination is HAV?
heat inactivated preparations of live attenuated virus with 2 injections over 6 months
What are the outcomes of HAV?
Acute hepatic flare is rare
Prolonged cholestasis in 5-10%
chronic infection does not exist
Indications for HAV vaccination?
Overseas travel
Occupation, family exposure
COmmunity outbreaks
patients with chronic liver disease: Heb B or C
Gamm globulin (ISG) for recent exposure or imminent overseas travel (< 4 week) - painful
How is HEV spread and what is the diagnosis?
enteric - waterborne
anti-HEV to diagnose
What does HBV express?
excess surface protein (HBsAg) can have negative HBeAg
What will you see in serology with HBV recovery?
HBsAg -
Anti-HBc + (core antibody = infection)
Anti-HBs (detected after vaccination)
What will you see in acute HBV serology?
HBsAg+
HBeAg+
HBV DNA very high
What happens with HBV in babies?
Effects usually mild but will be chronically infected