Hep B or D

Question 1

Hep B caused by

Answer 1

HBV, enveloped, double stranded DNA that follows acute or chronic cause

Question 2

When can someone get HDV?

Answer 2

Co-infects with HBV or superinfects carriers of HBV

therefore known as defective virus - you can only get it if you have hep B

Question 3

Risk factors

Answer 3

Intravenous drug use 
Sexual contact with HBV carrier 
Genetic (low viral clearance rare)
Infant of HBeAg+ve (active infection) mother 
Unscreened blood products

Question 4

Prodromal symptoms

Answer 4

Malaise
Anorexia
headache
NVD
RUQ pain
Serum sickness like fever, arthralgia, polyarthritis, urticaria, maculopapular rash
Jaundice with dark urine and pale stools

Question 5

Prodromal symptoms

Answer 5

Acute
Pyrexia
Jaundice
tender hepatomegaly 
splenomegaly
cervical lymphadenopathy

Question 6

Chronic signs

Answer 6

Asymptomatic unless you have chronic liver disease e.g. liver failure

Question 7

Investigations

Answer 7

Bloods (similar to HAV and HEV), increased prothrombin time (severe cases)
Serology

Question 8

Serology

Answer 8

Look up

Question 9

Vaccination contains

Answer 9

antibody against antigen

HBsAb

Question 10

Active vaccination contains

Answer 10

Recombinated HBV virus

Question 11

Management

Answer 11

Acute - symptomatic & bed rest, notifiable disease

Chronic HBV - IFN alpha pegylated
nucleoside to slwo dna replication

Question 12

Complications

Answer 12

Fulminant hepatic failure (80% mortality)
Chronic HBV - esp in children
Cirrhosis (20-30 percent of those with chronic HBV get cirrhosis)
Hepatocellular carcinoma
Extrahepatic immune complex disorders (glomerulonephritis, polyartertis nodosa)
HDV superinfection

Question 13

Hep B is acute or chronic?

Answer 13

Can be both, if more than 6months, chronic

Question 14

Transmission of hep B

Answer 14

Permucousal (sexual, blood transfusions, being born to hep B infected mother)
Percutaneous (sharing needles)