Blood Borne Viruses- Hepatitis B,C Flashcards
What is Hepatitis
Where do hepatitis viruses replicate and what do they destroy
Inflammation of the liver due to systemic viruses that cause ‘collateral’ liver damage
Replicate in hepatocytes (Hepatotrophic), and destroy them
Compare Hep B and Hep C, in regards to;
Transmission
Incubation (Time to show symptoms)
Can they cause chronic illness?
Hep B;
- Blood/ sex/ vertical transmission
- Incubation period of 6 weeks to 6 months
- Can cause chronic illness
Hep C;
- Blood/ sex transmission
- Incubation period of 6 to 12 weeks
- Can cause chronic illness
Compare the Viral Structures of Hep B and Hep C
Hep B;
- Double stranded
- DNA
- Enveloped
Hep C;
- Single stranded
- RNA
- Enveloped
What are the 3 types of Jaundice
Name 1 cause of the first type, 4 causes of the 2nd. 2 causes of the 3rd
Prehepatic (Before liver):
- Haemolysis
Intrahepatic (In liver):
- Drugs
- Cirrhosis
- Alcoholic hepatitis
- Viral hepatitis
Extrahepatic (After liver):
- Common duct stones
- Carcinoma
Name 5 Liver Function Tests (LFTs)
- Bilirubin
- Liver Transaminases, ALT and AST
- Alkaline Phosphatase
- Albumin (Made in liver)
- Coagulation tests (INR and PT)
Compare the locations of damage if;
- High blood AST and ALT
- High blood ALP
High blood AST and ALT- Hepatocyte damage
High blood ALP- Biliary tract cell damage
If a patient present with high bilirubin and ALT, what kind of jaundice does he have
Intrahepatic jaundice
How common are symptoms in acute Hep B
Identify 5 symptoms
up to 50% have no/ vague symptoms
- Jaundice
- Fatigue
- Abdominal pain/ Nausea/ Vomiting
- Anorexia
- Arthralgia
What are the 3 Antigens/ Antibodies associated with Hep B
Other than detecting antigens/ antibodies what else can be detected
Surface antigen- HBsAg
Surface antibody- HBsAb
E antigen- HBeAg
E antibody- HBeAb
Core antigen- HBcAg (Doesn’t appear in blood)
Core antibody- HBcAb (IgM OR IgG)
Can also look for HBV DNA (By PCR)
Which Hep B antigen is undetectable in blood, where can it be detected
What are the 2 types of this antigen, which type disappears and what is this a sign of
HBcAg (Core antigen) can’t be detected in blood, can be found in Liver Cells
IgM and IgG, IgM disappears- sign of Chronic/ cleared infection
Outline the 6 steps of Antigen/ Antibody appearance in Hep B serology, after infection
Which antigen is given as part of the Hep B vaccination
- HBsAg- Given in vaccine
- HBeAg (Highly infectious)
- HBcAb (IgM)
- HBeAb (E antigen disappears)
- HBsAb (Virus cleared + Recovery)
- HBcAb (IgG) (Persists for life)
Define Chronic Hep B Infection
25% of chronic infection leads to what?
Can Chronic Hep B be cured? Why?
Persistence of HbSAg after 6 months
Leads to cirrhosis
Can’t be cured, as HBV integrates into host genome
Describe the treatment for Chronic Hep B
Not everyone with Chronic Hep B needs treatment, give 3 examples of this group of people
Anti-virals for life (Suppress replication)
Inactive carriers;
- Low Viral Load
- Normal LFTs
- No liver damage
Discuss the presence of HBsAg, HbcAb and HBsAb during;
- Acute infection
- Past (Cleared) infection
- Chronic infection
- Never infected, BUT vaccinated
Acute infection;
- HBsAg positive
- HBcAb positive (IgM)
- HBsAb positive OR negative (More likely)
Past (Cleared) infection;
- HBsAg negative
- HbcAb positive (IgG)
- HBsAb positive
Chronic infection;
- HBsAg positive
- HbcAb positive (IgG)
- HBsAb negative (Hence acute-> Chronic)
Never infected, BUT vaccinated;
- HBsAg positive
- HbcAb negative
- HBsAb positive
What percentage of HCV infected people have no symptoms?
Name 4 symptoms
80%- No symptoms
Vague symptoms;
- Fatigue
- Anorexia
- Nausea
- Abdominal Pain
