7.4 Viral Hepatitis

Question 1

Approx global prevalence of hepatitis

Answer 1

3.3%

Question 2

Which countries have the highest vs lowest prevalence of hepatitis?

Answer 2

• Highest in India and Africa
• Lowest in Australia, USA, Canada, and UK

Question 3

Which kinds of viral hepatitis are acute vs chronic?

Answer 3

• A and E are acute (bookends)
• Rest are chronic

Question 4

Describe the type of genetic material in each type of viral hepatitis

Answer 4

• A, C, E are positive sense RNA
• B is DNA
• D is negative sense RNA

Question 5

Which types of hepatitis virus have an envelope? What’s the memory trick for this?

Answer 5

• Envelope for B, C, and D, not A or E
• Acute ones need to act fast; don’t have time to get out of an envelope

Question 6

Which two kinds of viral hepatitis are carcinogenic?

Answer 6

B and C.

Question 7

Primary mode of transmission for each kind of viral hepatitis?

Answer 7

Hep A: Faecal-oral
Hep B: Fluids (blood, semen etc.)
Hep C: Primarily bloodborne
Hep D: Fluids (blood, semen etc.)
Hep E: Faecal-oral

Question 8

Describe the impact of chronic hepatitis infection on the liver cells

Answer 8

1. At first, acute infection
2. When infected, there is inflammation, causing infiltration of immune cells
3. Over time, inflammation can become chronic, leading to scarring of the liver
4. Scarring can progress to cirrhosis
5. In some cases, this can lead to hepatocellular carcinoma

Question 9

Prevention strategies for all types of viral hepatitis…

Answer 9

• Faecal oral: plumbing, good hand hygiene, ensuring that water/food sources are not contaminated
• Fluids: safe sex, don’t share needles
• Vaccination

Question 10

Hepatitis A disease progression

Answer 10

• Most will recover within 3 months
• Almost everyone recovered within 6 months

Question 11

Hepatitis E disease progression

Answer 11

Typically resolves within 2-6 weeks

Question 12

Describe the two disease courses of hepatitis B

Answer 12

Acute: elevation in liver enzymes (the body is reacting), leads to clearance of virus within approx. 6 months

Chronic: asymptomatic at first (body isn’t reacting). Over decades, can progress to cirrhosis.

(In both instances, symptoms are worsened if Hepatitis D also occurs)

Over 6 months is acute

Question 13

Describe the two disease courses of hepatitis C

Answer 13

Acute (20%): fever, fatigue, nausea/vomiting

Chronic (80%): Chronic liver inflammation and cirrhosis/hepatocellular carcinoma

Over 6 months is acute

Question 14

Outline the treatment options for hepatitis

Answer 14

• A & E: nothing
• B & C (if chronic): antivirals, interferon injections, liver transplant

Question 15

Why is screening for hepatitis important?

Answer 15

• Early treatment can prevent liver damage
• Without screening, asymptomatic patients may transmit the disease

Question 16

What are some public health challenges related to hepatitis?

Answer 16

• Lack of awareness (hepatitis, needle hygiene, safe sex all contribute)
• High cost of antiviral medications
• Weaker health infrastructure in low income countries