hep b and c Flashcards
is there a vaccine for hepatitus
Vaccine only available for hepatitis A and B
No HIV and hep C vaccine available
which is a dna virus
hep b
hep c is rna
which hep has PEP
no PEP = hep c
PEP = hep B
most infective hep
most infective = hep b
which hep is chronic
c
majority will recover from which hep
b
dane particle
infectious component of hep B
1 of 3 particles that make up hep b
how long is the incubation period of hep b
2-3 months
are there usually symptoms for hep b
no, but sometimes could have jaundice
normal course of hep b infection
- infection
- incubation period of 2-3 months
- no symptoms usually
- recovery with clearance of antigens and creation of hep b core and surface antibodies within 6 months
Chronic carriage of hepb
- infected
- incubation period of 2-3 months
- Hep b surface antigens persists
- no surface antibodies
if you recover from hep b or get vaccinated, what antigens/ antibodies do you have
you will get SURFACE antibodies if you recover or get vaccinated and you will not have any surface antigens left,
in chronic hep b, there is surface antigens that do not clear
what is given for Vaccination for hep b
3 doses of surface antigen
for PEP of hep b, what is given
- for unvaccinated : HBIG + hep b vaccine 3 doses
- for vaccinated : HBIG + booster
HBIG
hep b immunoglobulin
how to treat hep b?
- antivirals
what % of hep c is chronic
75% -> some may go on to cirrhosis and liver failure
Acute course of hep c
- infection
- long incubation period of 6-12 weeks
- little to no symptoms
- production of antibodies after months
- RNA removed
in acute or chronic hep c is antibodies produced
both
in acute or chronic is hcv rna removed
in acute, there is no rna
in chronic, there is rna
how to test for active infection of hep c
rna positive
Treatment for hep c
- No PEP
- DAAs direct acting antiviral agents
what will make a patient with hep c more likely to develop chronic hep c
HIV and alcohol
what is the definition of occupational exposure
- percutaneous eg sharps contaminated with blood
- splashing of bodily fluids onto broken skin
- mucocutaneous exposure eg contamination of eyes nose mouth
- human bite that breaks the skin
whic bbv has highest risk?
- HBV 30% risk for unvaccinated
- HCV 3%
- HIV 0.3%
hbv most infective
which BBV most common?
- HCV 1%
- HBV 0.12% of uk population
- HIV 0.8%
HOW TO MANAGE occupational exposures?
AWARE
apply pressure and allow bleed
wash dont scrub
assess type of injury
risk of source blood
establish contact
when assessing the injury, what two things do you loook out for?
- high risk material? is there blood
- is it a significant injury
- percutaneous sharps
- mucocutaneous
- broken skin
- human bite
what injury is considered NOT significant?
superficial graze and intact skin
what is U=U?
undetecable viral load = untransmissible HIV
What does establis contact mean in AWARE?
REPORT promptly to a senior member of staff
call occupational health provider
record injury in accident book and official reporting
follow up with prophylaxis counselling and prevention
post exposure prophylaxis for hbv vs hiv
HBV
- immunoglobulin HBIG + vaccine or booster within 24 hours of first dose of vaccine but not after 7 days from exposure
HIV
- antiretroviral therapy + PEP within 24 hours
when to follow up for prophylaxis?
12 weeks from PEP
Negative test at 12 weeks provides very high level of confidence of freedom from infection
Prevention for BBV
- vaccination for hbv
- awareness
- eliminating unnecessary needles
- no recapping
- PEP
- PPE
- sharps containers
- recording and reporting
- work practices
- hand hygiene
- risk assessment
- national infection prevention and control manual
- staff training on how to handle contaminated sharps MOST IMPORTANT IN PREVENTION
- safer sharps devices
in the 2013 health and safety regulations, what do they say for sharps
- safe use and disposal
- training for employees
- respond effectively if injury
- review procedures
- notify asap
HEP B workers may return to work and perform exposure prone procedures if they ?
viral load less than 200um/L and
monitoring every 12 months,
on antiviral therapy
HEP C workers may return to work and perform exposure prone procedures if they ?
RNA negative (ie non active infection) 6 months after end of antiviral therapy
hiv workers may return to work and perform exposure prone procedures if they ?
viral load less than 200copies/ml
antiretroviral therapy,
subject to plasma viral load monitoring every 3 months and be supervised
How long can hep b survive in dry blood
1 week or more
Modes of transmission
Parenteral
Sexual
Perinatal
What percentage of hepatitis b patients recover
90-95%
HBIG provides what % of protection
70-75%
What are the most common treatment drugs for hepatitis b
There are 7 antivirals on the market
Main one is nucleoside and nucleotide
Why is there no vaccine available for hep c?
Variability of the genome
How long can hep c survive on inanimate surfaces?
Up to a week
Incubation period vs clinical latency
Incubation period = time between inoculation and symptom expression
Latency = time between inoculation and infectiousness
But for HIV when they refer to years of clinical latency, they r referring to the time period between getting HIV and showing symptoms
When is hepatitis c classified as chronic
After 6 months, if RNA is present still then it is classified as chronic
Tests for hepatitis c
Hep c antibodies
Hep c rna
Viral load
Viral genotyping
What do direct acting antiviral agents target
They target HCV encoded proteins essential for viral replication
How long does HIV survive outside the body or on surfaces
Easily killed by heat, does not surface long on surfaces or outside the body
