Global Perspectives Flashcards
Which hepatitis is a DNA virus?
Hep B
Which hepatitis types are spread by body fluids + blood?
Hep B + C
Which hepatitis types are food + water borne?
Hep A + E
Which hepatitis is only found in association with hep B?
Hep D
What are the signs and symptoms of acute hepatitis?
- Fever, malaise
- Nausea, vomiting, diarrhoea
- Jaundice, dark urine
- Right upper quad pain
- Tender enlarged Liver
What is Hep A/E’s course and diagnosis?
- Incubation 2-6 weeks
- Anti HAV/HEV IgM = recent infection - persists 6 months
- Anti HAV/HEV IgG = past infection/immunisation - remains for lifetime
How is Hep A vaccinated against?
Active - inactivated single dose IM injection, booster at 6 months > life long immunity
Passive - HNIG from someone with high titre anti-HAV IgG
How is Hep (B + D) & (C) transmitted and what are the risk groups?
Transmission - Horizontal + Vertical (C) - Blood transfusion - IV drug use, needle-stick - Sexual - Hospitals Risk Groups - Children of mothers with chronic HBV/HCV - Dialysis, organ transplant - Prisoners - Drug injectors - Multiple sex partners - Travelors to endemic region - Tattoos + piercings (C)
What is the course and diagnosis of Hep C?
- Asymptomatic during acute stage
- Most develop chronic
- Silent killer > end stage LD decades after infection
- Effective curative treatment available
What is the course of acute hepatitis?
- Spontaneous viral clearance by immune system
- Within weeks
- Hep A, E, B (unless acquired in infancy)
What is the course of chronic hepatitis?
- Viral persistance > 6months
- Hep B + C
What is the main complication of chronic viral hepatitis?
- Liver fibrosis/cirrhosis
- End stage LD = portal hypertension/ascites (low albumin = low osmotic pressure), bleeding oesophageal varices, liver failure
- Hepatocellular carcinoma
What is the structure of Hep B?
- HBsAg = surface antigen - used to gain entry into hepatocyte
- HBcAg = core antigen - nucleocapsid
- HBeAg = marker of high HBV replication
What lab diagnosis is used to detect acute HBV infections?
HBsAg
HBeAg
Anti-HBcAg IgM
What lab diagnosis is used to detect chronic HBV?
HBsAg
HBeAg
Anti-HBcAg IgG
Anti-HBeAg IgG