hepatitis Flashcards
causes
alcoholic hepatitis NAFLD viral autoimmune drug induced e.g. paracetomal overdose
presentation
abdo pain fatigue pruritis myalgia N+V jaundice fever (if viral)
typical LFT findings
raised transaminases
raised bilirubin
hepatitis A - route of transmission
faecal-oral route
hepatitis A - presentation
nausea + vomiting anorexia jaundice dark urine + pale stools hepatomegaly
hepatitis A - clinical course
resolves w/o treatment in ~1-3mo
hepatitis A - Mx
analgesia
vaccination for prevention
hepatitis A - type of virus
RNA
hepatitis B - type of virus
DNA virus
hepatitis B - route of transmission
direct contact with blood/bodily fluid
sex
sharing needles
vertical transmission
hepatitis B - clinical course
most people fully recover within 2mo
10% go on to become chronic hepB carriers
hepatitis B viral markers - surface antigen (HBsAg)
indicates active infection
hepatitis B viral markers - HBeAg
E antigen
marker of viral replication, implies high infectivity
hepatitis B viral markers - HBcAb
core antibodies
implies past or current infection
hepatitis B viral markers - HBsAb
surface antibody
implies vaccination or past or current infection
hepatitis B viral markers - HBV DNA
direct count of viral load
hepatitis B screening: previous infection
HBcAb
hep B screening - active infection
HBsAg
how can HBcAb differentiate between acute, chronic and past infections
IgM implies active infection: high titre if acute and low titre if chronic
IgG indicates past infection where HBsAg is negative
hep B vaccination
test for HBsAb to confirm response
3 doses
included in 6in1
hep B management
- low threshold for screening those at high risk
- screen for other blood borne viruses and STDs
- notify public health
- antiviral medication
Hep C - virus type
RNA virus
Hep C - route of transmission
blood and bodily fluids
Hep C - vaccination
none available
Hep C - disease course
1 in 4 make full recovery
3 in 4 become chronic
Hep C - complications
liver chirrosis
hepatocellular carcinoma
Hep C - testing
Hep C antibody = screening test
HCV RNA to confirm diagnosis, calculate viral load and assess genotupe
Hep C - Mx
direct acting antivirals
Hep D - virus
RNA virus
can only survive in patients with HBV
hep E - virus type
RNA
hep E - route of transmission
faecal oral route
hep E - clinical course
usually produces mild illness + is cleared in a month without treatment needed
rarely progresses to chronic (more so in immunocompromised)
