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Infection > Blood Borne Viruses > Flashcards

Blood Borne Viruses Flashcards

1
Q

Hepatitis B consequences if left untreated

A
  • Liver cirrhosis in 10% of cases

- Hepatocellular carcinoma

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2
Q

Hepatitis C consequences if left untreated

A
  • Liver cirrhosis in 80% of cases

- Hepatocellular carcinoma

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3
Q

Percentage of the global population with Hep B and Hep C

A

5-8%

3%

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4
Q

Hepatitis A: symptoms, transmission, incubation, chronic illness?

A
  • Nausea, vomiting, jaundice
  • Faeco oral
  • 2 to 6 weeks
  • Does not develop into chronic illness
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5
Q

Hepatitis B: symptoms, transmission, incubation, chronic illness?

A
  • Jaundice, fatigue, abdominal pain, anorexia/nausea/vomiting, anthralgia (pain in joint)
  • blood, sex, vertical
  • 6 weeks to 6 months
  • Chronic illness may develop
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6
Q

Hepatitis C: symptoms, transmission, incubation, chronic illness?

A
  • high temperature, tiredness, loss of appetite, nausea, vomiting, may not have symptoms
  • Blood, sex
  • 6 to 12 weeks
  • Chronic illness may develop
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7
Q

Hepatitis D: symptoms, transmission, incubation, chronic illness?

A
  • Can only propagate in the presence of the hepatitis B virus
  • Blood, sex, vertical
  • 6 weeks to 6 months
  • Chronic illness will only develop with Hep B
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8
Q

Hepatitis E: symptoms, transmission, incubation, chronic illness?

A
  • Nausea, vomiting, jaundice
  • Faeco oral
  • 2 to 6 weeks
  • Chronic illness is uncommon but possible
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9
Q

What type of virus is Hepatitis B?

A

DNA, double stranded, enveloped

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10
Q

What type of virus is Hepatitis C?

A

RNA, single stranded, positive strand, enveloped, icosahedral

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11
Q

What type of virus is Hepatitis E?

A

RNA, single strand, positive strand, non enveloped, icosahedral

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12
Q

What type of virus is Hepatitis A?

A

RNA, single strand, positive strand, non enveloped, icosahedral

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13
Q

Production and excretion of bilirubin

A
  • Haemoglobin is broken down into bilirubin by the reticuloendothelial system
  • Bilirubin travels in the bloodstream, attached to albumin
  • Bilirubin is broken down into conjugated bilirubin in the liver, by UDP glucuronyl transferase
  • Conjugated bilirubin is either excreted in urine or transported in bile to the small intestines
  • It is then excreted in faeces (Viral hepatitis slide 10)
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14
Q

Types of jaundice

A

Prehepatic and cholestatis (intrahepatic, extrahepatic)

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15
Q

Liver function tests

A
  • Bilirubin
  • Liver transaminases (Alanine transaminase, aspartate aminotransferase) HEPATOCYTE DAMAGE
  • Alkaline phosphatase BILIARY TRACT CELL DAMAGE
  • Albumin (synthesised in the liver)
  • Tests of coagulation (clotting factors are synthesised in liver)
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16
Q

How is hepatitis B most commonly transmitted?

A

Vertical transmission, 75% globally

  • Sexual contact
  • IV drug users
  • Close household contacts
  • Needlestick injuries
17
Q

Hepatitis B serology types

A
  • HBsAg and HBsAb
  • HBeAg and HBeAb
  • HBcAg (cannot detect in blood, only in liver) and HBcAb (IgM and IgG)
  • HBV DNA (PCR)
18
Q

Order of appearance of Hepatitis B serology

A

1) Surface antigen - rise in ALT
2) Followed by e-antigen - highly infectious
3) Core antibody (IgM)
4) Followed by e-antibody - heralds disappearance of e-antigen and infectivity
5) Surface antibody - clearance of virus
6) Core antibody (IgG) - persists for life

19
Q

Definition of chronic Hep B infection

A

Persistence of HBsAg after 6 months

  • Becomes chronic in <10% if infected as an adult
  • 90% if infected in infancy
20
Q

Treatment for Hep B

A
  • No cure as it integrates into host genome
  • Life long anti virals
  • Not required for everyone (low VL, normal LFTs, no liver damage)
21
Q

Vaccination for Hep B

A
  • Genetically engineered surface antigen
  • 3 doses, boosters if required
  • Produces surface antibody response ( >10 adequate, >100 long term protection)
22
Q

Who is most at risk of acquiring Hep C?

A

Intravenous drug users, >90% of those with Hep C in the UK

  • Infants born to HCV+ mothers
  • Sexual contact (higher if HIV co infected)
  • Blood transfusions prior to 1991
  • Needlestick injuries
23
Q

What percentage of those infected with Hep C will develop the chronic disease?

A 
80%
Of those some will develop chronic liver disease/cirrhosis, resulting in:
- Decompensated liver disease
- Hepatocellular carcinoma
- Transplant
- Death
24
Q

Symptoms of Hep C?

A 
80% will have no symptoms
The rest:
- Fatigue
- Anorexia
- Nausea
- Abdominal pain
25
Q

Blood tests to diagnose Hep C

A
  • Anti Hep C antibody
  • Remains positive life long, even after clearance, not protective
  • Viral PCR
26
Q

Treatment for Hep C

A
  • Can be cured
  • Directly acting antiviral drug combo
  • 8 to 12 weeks
  • 90% chance of cure
  • No vaccine
27
Q

Risk of transmission of HIV, Hep C and Hep B from needlestick injury

A

HIV - 1/300 (much lower if patient is on ARVs or VL is indetectable)
Hep C - 1/30
Hep B - 1/3 (much lower if recipient has been vaccinated)

Infection (8 decks)

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