5. Viral Hepatitis Flashcards
How is hepatitis A contracted?
Faecal-oral spread
Contaminated food and water
How long is the incubation for hepatitis A?
30 days
What are the risk factors for contracting hepatitis A?
Travel to endemic countries
Household and sexual contacts (especially MSM)
Food outbreaks
How is hepatitis E contracted?
Undercooked pig and game
Processed pork, shellfish
Handling animals
Contaminated water
What are the genotypes of hepatitis E?
1 and 2 in humans
3 and 4 in pigs, but spread to humans
How long is the incubation period for hepatitis E?
40 days
How are hepatitis B and C contracted?
Perinatally
Sexually
Parenterally
What are the risk factors for hepatitis B?
IVDU Haemodialysis Sharing toothbrushes and razors Needlestick injuries Tattoos and piercings
Which of the hepatitis viruses is a DNA virus?
Hep B
What is the infectious part of the hep B virus known as?
Dane particle
What is the incubation period for hep B?
1-6 months
How long is the incubation period for hep C?
2 months
Who is more likely to be asymptomatic in hepatitis A and B?
Younger, more symptomatic in adults
What prodrome is associated with hepatitis A?
Fever
Appetite loss and nausea
Fatigue
RUQ pain
What are the symptoms of hepatitis A acute infection?
Dark urine
Pale stools
Jaundice
What are the symptoms of acute hepatitis E infection?
90% are asymptomatic
Genotype 1 can be fatal in pregnancy
What patient group are more likely to have chronic hepatitis E?
Immunosuppressed
What are risk factors for mortality in hepatitis E?
Liver transplant
Genotype 3
What are the outcomes of acute hepatitis B infection?
Resolution
Liver failure
Chronic infection (especially in infant infections)
How is chronic hepatitis B defined?
HBsAg present for over 6 months
What complications are associated with chronic hepatitis B?
Cirrhosis
Hepatocellular cancer
Reactivation in immunosuppression
What patient group gets hepatitis D?
Only those with hepatitis B
more severe acute disease and higher risk of cirrhosis
In hepatitis C, what factors increase the risk of cirrhosis and hepatocellular carcinoma?
Alcohol, hep B, HIV
What extrahepatic complications are associated with hep C?
Mixed cryoglobulinaemia Diabetes Thyroiditis Rheumatological eg. PAN Dermatological
How is acute hep A infection diagnosed?
anti Hep A IgM
RNA in stool and serum
How is hep A vaccination seen on serology?
anti Hep A IgG
What will be present on serology if a person has a current hep B infection?
HBsAg
What will be present on serology is a person has infectious hep B?
HBeAg
HBV DNA
What will be present on serology if a person is vaccinated against hep B?
Anti-HBs
How is hep A infection prevented?
Hygiene
Vaccine for travellers and close contacts
What type of vaccine is the hep A vaccine?
Inactivated
What is the treatment of hep E?
Acute= symptomatic Chronic= reduce immunosuppression and antivirals
What is the treatment for chronic hep B?
Antivirals
Monitor for liver cancer
Transplant
Education and vaccination
What markers are used to see if antiviral therapy is effective in chronic hep B?
Hep B DNA is below detectable levels
e antigen seroconverted to e antibody
What methods are used to monitor for liver cancer?
ultrasound
AFP
What type of vaccine is the hep B vaccine?
Cloned surface antigen: HBsAg
What is the goal of chronic hep C treatment?
Sustained virological response: no RNA detected at end of treatment or 12 weeks post treatment
What does chronic hep C treatment depend on?
Genotype and co-infection
What is the treatment for hep C?
Direct acting antivirals and interferon
