Hepatitis Flashcards
How many types of hepatitis are there?
5
What viral hepatitis strains are reportable diseases?
Hepatitis A, B, and C
What are acute forms of viral hepatitis?
Hepatitis A-E
What are the chronic forms of viral hepatitis?
Hepatitis B, C, and D
What transmission route is hepatitis spread?
Fecal-oral route
- Contaminated food, water
- Person-to-person contact
- International travel (endemic areas)
- Sexual activities
What are the risk factors for Hepatitis A?
- MSM
- Drug use
- Homelessness
- Occupational exposures
What is the incubation period for Hepatitis A?
2 weeks - 6 months (average 30 days)
Is Hepatitis A more severe in kids or adults?
Adults
What is a specific symptom in hepatitis A?
Aversion to smoking
What are symptoms of Hepatitis A?
- Malaise, myalgia, arthralgias
- URI symptoms
- Aversion to smoking
- Anorexia
- N/V, diarrhea or constipation
- RUQ pain or epigastric pain
What can be some positives on physical exam with Hepatitis A?
- Low grade fever
- Hepatomegaly
- Splenomegaly
- Lymphadenopathy
- +/- Jaundice
Will AST/ALT be elevated in Hepatitis A?
Yes
Can you test Hepatitis A serology?
Yes, IgM or IgG
What is the vaccine recommendation for Hepatitis A?
Now recommended for all children at 12-23 months, but up to 18
What is the treatment for Hepatitis A?
- Self limited with improvement in 2-3 weeks
- Frequent hand washing to prevent spread
- Symptomatic treatment
How is Hepatitis E transmitted?
Fecal-oral transmission
What populations are at risk for Hepatitis E?
- Pregnant women
- Underlying liver disease
- HIV
- Immunosuppressed
Is Hepatitis E typically asymptomatic?
Yes, immunocompromised patients will show symptoms most commonly
What are some extra-hepatic manifestations of Hepatitis E?
- Arthritis
- Pancreatitis
- Thrombocytopenia
- Guillain-Barre
- Peripheral neuropathy
What are the prevention strategies for Hepatitis E?
- No vaccine
- Sanitation
- Purified water or boiling/chlorinating
What is the treatment for Hepatitis E?
- Self-limited
- Symptomatic treatment (rest, fluids, avoid ETOH)
How is Hepatitis B transmitted?
Blood borne
Hepatitis B fomites can remain on surfaces for how long?
7 days
Can Hepatitis B be vertically transmitted?
Yes
What is the incubation period of Hepatitis B?
6 weeks to 6 months (average 12-14 weeks)
A positive HBsAg and HBeAg indicates what
Viral infection, either acute or chronic
What is the treatment of acute hepatitis B?
- Usually self limited (lasts 16 weeks)
- Symptomatic relief
- If signs of acute liver failure (encephalopathy, coagulopathy) than transplant
Acute Hep B infection lasts roughly how long?
2-3 weeks
How is chronic Hepatitis B defined?
- Infection persisting longer than 3-6 months (3-6 months of AST/ALT elevations)
*High rates of chronic hep B in infants who receive via vertical transmission
What is the treatment for chronic hepatitis B?
Treatment is only indicated if the individual is actively replicating the virus –> antivirals
What are the preferred antiviral treatments for chronic hepatitis B?
Entecavir and Tenfovir
What Hepatitis strain is Hepatitis D a co-infection of?
Hepatitis B
What are the symptoms of Hepatitis D when it is superimposed on chronic HBV?
- Provokes fulminant hepatitis
- Decompensation
- Hastens progression to cirrhosis
- More likely to get HCC
Hepatitis C is commonly co-infected with what other virus?
HIV
What are the risk factors for Hepatitis C?
IVDU
Sexual contact
Occupational exposures
Blood transfusions prior to 1992
Who should be periodically screened for Hepatitis C?
- IVDU
- Dialysis patients
- High risk co-morbidities (HIV)
Is there a vaccine for Hepatitis C?
No
What is the treatment for acute Hepatitis C?
- None
- Consider PEG interferon +/- ribavirin if no spontaneous clearance by 3 months
What are the first line antivirals for chronic hepatitis C?
Ledipasivir and Sofosbuvir (Harvoni)
*Response is dependent on genotype
