hepatitis Flashcards
is there a vaccine for HAV
YES- KILLED
HAVRIX
what can kill HAV
coking and boiling can kill for 1 at least 1 min but freezing does not
incubation period for hep A
15-45 days average 28 days
how long does virus excretion occur after symptoms in hep a
up to 3 weeks and children may excrete longer than adults
rf for hep a
poor sanitation
caring for someone who is ill
travelling to an endemic area + not immunised
having a sexual partner who is infected
diagnosis
HAV IG M ANTIBOIDES BY EIA
can also do a stool culture but rarely done
is there a post exposure prophylaxis for HAV
immune globulin within 2 weeks for household members etc or day care centres or food prepared by infected food handler
Nb1 its more effective the earlier you take it, best is within 3 days up to 7 days for it to be effective
HAV vaccine
killed whole virus vaccine
2 doses given at least 6 months-
6-12 months after first dose
IM vaccine in the thigh for small kids but older kids is
there is a vaccine for kids after 12 months to 18 years
then another for adults
who should consider taking the vaccine
homosexuals
travelling to an endemic area
drug users
even after exposure to virus single dose of vaccine within 2 weeks has prtoective effects so the vaccine is hIGHLY EFFECTIVE
name of vaccine for HAV
HAVRIX
VAQTA
PAEDEETRIAC FORMULATIONS FOR HAV
more than 12 months -18 years
endemic areas of hep b
sub saharran africa
some countries in Eastern Europe
antigens of hep b
Hb sAg (surface ag)
core antigen
HBs (protective)
how long can hep b survive outside Body
up to 7 days - in room temp environment such as dried blood spots etc
epidemioloigcal measures for hep B
disinfect items and sterilise, and use disposable;e items
NAME OF HEP B VACCINE
EMNERGIX
CI HEB B VACCINE
people allergy to yeast
people with a history of anaphylaxis to previous vaccine because remember 3 doses
can you get energix when pregnant
yes
protective levels of iG G fot HAV
> 20
souce of infection (students get confused in exam) for HAV
HUMANS (anthtoponosis )
majority of infections with hAV are
aymptomaic
anecdote for HAV
roma community, bad sanittion levels, rubbish everywhere and flies were spreadign the virus around
informed the local authorities cleaned the rubbish, did disinfection, disinection didnt work so vaccinated all kids from 1-18 in octobe and 1 month later saw a delcine
when is a person with HAV most contagious
B4 THE ONSET OF JAUNIDICE after jaundice indectiousness decreases
what types of prophylaxis is there for A
PRE - vaccine
POST- immunoglobulin
HBV vrsu
only dna virus
has 8 different genotypes in different geographical distributions e.g in europe its D&A
why do we work so hard to prevent hep b transmission to newborns
because a lot of times the baby will be aymptomati but chronicity is a BIG ISSUE and we wont know till we see the long effects like cirrhosi /cancer
in high ednemic regions of HBV what facilities this
mothers passing to kids
chroncity values for HBV
adults 5-10%
children - up to 90%
whcih was the first anti cancer vacccine
1st is HBV
2ND hpv
what are protective levels for HBV anti HBS antibodies
at least 10 units per ml
what is Hb e
a marker of viral replication
whats the different in contacts for hep a and hep b
hep A with contacts you only test them who have elevated lIVER ENZYMES, then we should look for the antibodies. otherwise its not routine as there are cases where people are contacts and have no jaundice, no elevated liver enzymes but have positve serology!
unlike hbv you always check contacts for the surface antibody. and if hbsAg is present it means YOU ARE INFECTIOUS
WHO recomendatiosn for hAV
High : does not recommend as a lot people are asymptomatic (africa) as expesive
intermediate - who recommends in vaccination calendar. elderly popualtion will almost 100% have it
low- no essential need to implmelnt as there are only small outbreaks that pop up and they are quiclky containes
which type of hep do we use antiviral drugs
C- and with this we can completely treat
country with the most hep c and why
EGYPT because of schisotosmiasis, people got treated inhopsitals and the wipment were not sterilised etc
how many genotypes of hep c
6 and more than 100 sub types which makes vaccine impossible
risk groups for hEP C
people recieving transfusions (mainly in past)
dialysis
people with multiple sexual partners
iv drugs
risk of mother to pass to kid HCV
up to 5%
what’s the tricky thing about diagnosis of hcv
the antibody detection is delayed so even if someone is acutely infected they can still test negative
what is the first marker for HCV diagnosi s
the RNA is first (not antibody) because after 2 -3 weeks then the serolgy will be pstive
anecdote of hCV
nurses used the smae syringe to flush saline and a group of patients caught it
source of infection for HCV
anthropontoci
risk for HCV on percutanoeus injury
lower than hep b which was 7-30%
hcv is 7% up to
which is more likely to be chronic
hep c
perenctage of chroncicity of c and b
b - 5-10% adults
c- up to 60-70%
generation of hep b vaccines
- plasma dervied vaccine (very cheap and still used in some poor countries today )
- recombinant(using yeast )
regimen for vaccination of hep b vaccine
3 doses or another oprion for 4 dose regimen
1- today
2- 1 month later
3. 6 month later
or kids can recieve the hexavalent combo for DPT and polio, immediately after birth is first dose
route for hbv injection
IM - deltoid
which disease is mainly associated with sex
HBV
which disease is mainly associated with PARENETERAL SPREAD
HCV
what makes pregz women more likely to transmit to kids
if they have the HbE antiegen
when having intercourse who is more likely to carry the infection
the risk is higher if a man has a partner(3-4 x more) as higher viral load in semen
when having intercourse who is more likely to carry the infection
the risk is higher if a man has a partner(3-4 x more) as higher viral load in semen
immunity for hbv
lifelong like a
what constitutes a chronically infected person
> 6 months
window period
all viruses would have a window period where even if the person is + the serology appears negative so that’s means potentially blood donors could transmit the disease e.g all donors are tested for surface antigen and depending on which methods of screening u use you can shorten the window period
main route of spread for HEV
Fecal oral and WATER
IN EXAM MAKE SURE YU LIST THE DIFFERNECES WITH A AND E DONT JUST COPY THE SAME ESSAY
ANECDOTE for HEV
outbreak in kashmir , they initially thought it was A, but then realised that A has lifelong immunity and majority of these people had already been infected with A In past - a russian scientist tested the theory by infecting himself
nb point about HEV
VERY HIGH FATALITY IN PREGNANT WOMEN IN DEVELOPING COUNTRIES
WHIC DISEASE IS CALLED 2 FACE AND WHY
HEV
face 1 - developing - water- anthroponotic - types 1 +2
face 2 - developed- animals -zooinotic types 3 and 4 raw and undercooked pork
developing- younger people affected 15-30
developed - older >50
which heapattophic virus has been spotted being chronci rarely
hev in the case or organ transplants where people are taking immunosuppresants
measures fo HEV
make sure to use enough heat for sausages, meatballs etc
chlorine can kill
which virus has links to GBS studies shown
HEV
DIAGNOSIS FOR HEV
2 step approach dependant on if you are immunocompetent or immunocomprimised
competent: test for IGm and if psotive then test for Rna + (means acute)
if compromised: test for IGm and if its negative should still test for Rna and if its negativev means there is no recent infection
and if rna is positve then confirm with pcr
