Hepatitis Flashcards
What is the main manifestation of hepatitis viruses?
Liver disease
How is hepatitis A spread?
Faecal/oral route
Where is hepatitis A present?
Faeces - mainly
Urine - to a lesser extent
Not spread through blood contact
How do young children often present with hepatitis A?
They are often asymptomatic
At which age bracket is hepatitis A likely to be symptomatic?
Older children to young adults
Which coloured blood bottle (vial) top is used for blood samples to test for any type of hepatitis?
Yellow
Which antibody class can be detectable for hepatitis A?
IgM
Where is hepatitis E most common?
Tropics
How is hepatitis E spread?
Faecal/oral route
Hepatitis E is a zoonosis
True or false
True
It can be a zoonosis and this is often expected for cases in the UK
In the tropics it can spread from person to person
Is there a vaccine for hepatitis E?
No
When can hepatitis D be present?
Only with hepatitis B
How is hepatitis B transmitted?
- Sex
- Mother to child
- Blood
Tattoos, use of needles for drug use and unscreened transfusions are all indicative of which type of hepatitis?
B and C
How does the risk of acute versus chronic infection differ with increasing age?
Acute - increases with age
Chronic - decreases with age
Which antigen signifies a patient is both infected and infectious?
HBsAg+
Which timeframe signifies chronic hepatitis infection?
6 months
An IgM test is of what use when it is known the patient has hepatitis?
It can aid in the differentiation between acute and chronic infection
What does anti-HBe signify?
There is low infectivity
Why do Canada, Alaska and Greenland have unusually high prevalence of hep B for being developed countries?
They have high indigeous populations
In hep B, what does the presence of IgM confer about the length of time a patient has had the infection?
It is more commonly presented in recently infected individuals
Which antibody is present when an individua has immunity against hep B?
Anti-HBs
Which antigen is present in the blood of all infectious individuals with hep B?
HBsAg
As well as HBsAG, which antigen is present in patients who are very infectious?
Hepatitis B e antigen (HBeAg)
Highly infectious individuals can have which three signs present in there blood test?
- HBsAg
- HBeAg
- High hep B viral DNA load
Of the two, which is there a vaccine for, hep B or hep C?
Hep B
Which is the most common cause of acute viral hepatitis?
Hep E
Why does hepatitis B infection often lead to hepatocellular carcinoma?
Chronic infection leads to chronic hepatitis which will eventually progress to cirrhosis making the liver much more susceptible to cancer
Is a spontaneous cure seen in hepatitis C?
No
(but it is seen in hep B)
What is not given in the management of acute viral hepatitis?
Antivirals
How is chronic viral hepatitis treated?
Antivirals
Vaccination (against other hep viruses), influenza and pneumococcal (if cirrhotic)
Decreased alcohol intake
Which parents are treated as priority when there are many patients with hepatitis?
Those with cirrhosis
What is interferon alfa?
Part of the immune response to viral infection
It is given as injection therapy after being pegylated
Used with ribavirin to treat hepatitis C
What are the side effects of interferon alfa?
Flu like symptoms
Thyroid disease
Autoimmune disease (SLE)
Psychiatric disease
What is a side effect of ribavirin, an antiviral?
Haemolytic anaemia
How can chronic hepatitis B be treated?
Peginterferon
or
Suppressive antiviral drug such as entecavir, tenofovir
What is a sustained virologcal response (SVR) to hep C?
Loss of HCV RNA in blood sustained to 6 months after the end of therapy
What is the major problem with newer antiviral aiming to replace peginterfero and ribavirin?
They are very expensive
Once chronic infection is established, which type of hepatitis will not see a spontaneous cure?
Hepatitis C
There is a vaccine for hepatitis C
True or false?
False
There is no vaccine for hepatitis C
