Hep B Flashcards
hepatitis meaning
inflammation of the liver
viremia
viruses circulating in blood at some stage of the disease
not all viruses do this
Ability to diagnose viremia depends on…
LENGTH of viremia
Methods to diagnose viremia
1) antibodies
-IgM, IgG
2) PCR
-nucleic acids - RNA or DNA
Causes of hepatitis (many)
infectious
-viral*, bacterial, fungal, parasitic
non-infectious
-alcohol, drugs, autoimmune, metabolic diseases/obesity
Most common hepatitis viruses
A, B, C
Main route of transmission for Hepatitis A
fecal-oral
environment, sewage, poor hand washing, daycares
Most common route of transmission for Hep A
contaminated food and water (90%)
*seafood
T or F: Hepatitis A is stable in the environment.
TRUE
very very very stable
have to boil for 1 minute
Where in the world is Hepatitis A prevalent?
Asia
Africa
Middle East
Northern Canada
parts of South America
What is the single most important determinant of Hep A illness severity?
AGE
adults - jaundice!
teens - acute phenotype
Symptoms of Hep A
fever
malaise
appetite loss
nausea
abdominal pain
jaundice (adults!)
The incubation period for Hep A is
a) short
b) long
b) long
2 to 7 weeks
Diagnosis of acute Hep A infection
IgM
Diagnosis of past Hep A infection
IgG
Hep A prevention
vaccination
IgG
Hep C
big cause of liver transplants in Canada
T or F: Those that acquire Hep C at a younger age tend to do better than those that acquire it later in life.
TRUE
Natural history of Hep C infection
acute –> chronic –> cirrhosis –> transplant or death
can resolve initially or stabilize at each stage
T or F: Most patients with chronic Hep C are asymptomatic.
TRUE
Top 3 causes of Hep C transmission
1) injection drug use***
2) sexual
3) tranfusion (prior to screening)
Risk of Hep C infection after a needle stick
4 to 10%
Diagnosis of Hep C
1) anti-HCV serologic screening
2) PCR
Hep C prevention
NO vaccine
screen blood, reduce high-risk behaviour, precautions
Hep C treatment
really good antivirals now***
Hepatitis B
v common in North America!
acute symptomatic or asymptomatic disease that will lead to immunity or may develop a chronic carrier state
T or F: The earlier Hep B is acquired, the greater the chance of developing a chronic infection.
TRUE
highest risk in infants
Hep B modes of transmission
1) parenteral
-IV drug users, HCW
2) sexual
-sex workers, MSM
3) perinatal
-can give antibiotics
Bodily fluids with HIGH concentration of Hep B
blood
serum
wounds
Bodily fluids with MODERATE concentration of Hep B
semen
vaginal fluid
saliva
Bodily fluids with LOW/UNDETECTABLE concentration of Hep B
urine
feces
sweat
tears
breast milk
Needle-stick diseases that you can get, from most infectious to least (3)
1) Hep B**
2) Hep C
3) HIV
Hep B diagnosis
serology obviously!!!!
Components of Hep B serology (3)
1) surface protein
2) core protein
3) e-antigen
1st step of interpreting Hep B serology
surface antibody
+: immune!
2nd step of interpreting Hep B serology
core antibody
+:
IgM: acute infection
IgG: past or chronic infection
-: vaccinated (if surface antibody is +)
3rd step of interpreting Hep B serology
envelope antigen
+: active replication, infectivity
-: virus no longer replicating
The Hep B vaccine only contains…
SURFACE antigen
