hep Flashcards
whats the pathophysiology of hepatitis
- virus enters hepatocytes
- inflammatory and immune reactions lyse infected and neighboring cells
- direct antibody attack on viral antigens causes further destruction
- edema of interstitium leads to decrease blood flow, scarring, and fibrosis
define compensated cirrhosis
liver is scarred, but functions; no major complications
define decompensated cirrhosis
liver is heavily scarred and doesnt function properly;
development of major complications
what are 5 major coplications of decopensated cirrhosis
- ascites
- SBP
- variceal hemmorrhage
- hepatorenal syndrome
- hepatocellular carcinoma
how is + anti-HCV, + HCV RNA interpreted
have acute or chronic HCV depending on clinical context
how is + anti-HCV, - HCV RNA interpreted
resolution of HCV
OR
acute HCV during period of low-level viremia
how is - anti-HCV, + HCV RNA interpreted
early acute HCV or chronic HCV in setting of immunosuppressed state or false positive
how is - anti-HCV, - HCV RNA interpreted
absense of HCV infection
what is HBsAg?
hepatitis B surface antigen:
1st detectable serum antigen in acute infection; also present in chronic infections
what is anti-HBs
Hepatitis Surface antibody:
present after recovery from acute infection or after vaccination.
Confers protective immunity
what is anti-HBc
Total hepatitis B core antibody:
appears with onset of symptoms and persists for life
indicates previous or ongoing infection
not used to distinguish acute or chronic
what is IgM anti-HBc
IgM antibody to Hep B core antibody:
indicates acute infection
what is HBeAg
Hepatitiis B e antigen:
denotes ongoing active viral replication
what is anti-HBe
Hepatitiis B e antibody:
may indicate peak replication has passed
what is contained in a hep B virion envelope
hepatitis B surface antigen
what is contained in a hep B virion core
HBcAg/ HBeAg (nucleocapsid)
Double stranded circular DNA
DNA polymerase
what are the two single antigen hep B vaccines
Recombivax HB
Engerix-B
what are the 3 combo hep B vaccines
Combivax
Pediarix
Twinrix
who should receive a combo hep B vaccine
people exposed to HBsAg + source by:
- acute blood exposure
- sexual exposure
- household exposure
- perinatal exposure
- give w in 7 days
what are 3 goals of HBV treatment
- increase chance of seroconversion
- prevent progression to cirrhosis and HCC
- minimize further injury in pts with ongoing liver damage
seroconversion is the change of _______ to _______
HBeAg to anti-HBe
