Hepatitis Flashcards
Hepatitis A incubation period
2-4 weeks
Type of virus found in Hepatitis A
RNA picornavirus
Spread of Hepatitis A
faecal-oral spread
Can Hep A cause chronic disease?
No
Clinical features of Hep A
- flu-like prodrome
- RUQ pain
- tender hepatomegaly
- jaundice
- deranged LFTs
A vaccine against Hep A exists. TRUE/FALSE?
TRUE
How long after the initial Hep A vaccine should you have a booster?
6-12 months later
Who should receive Hep A vaccination?
- Travelling to prevalent area
- chronic liver disease
- haemophilia
- MSM
- IVDU
- Occupational risk (Lab, sewage worker, large residential area, work with primates)
Hepatitis B incubation period
6-20 weeks.
Type of virus found in Hep B
double-stranded DNA hepadnavirus
Hep B spread
- infected blood or body fluids
- vertical transmission from mother to child
Clinical features of Hep B
fever
jaundice
elevated liver transaminases.
Complications of Hep B infection
- chronic hepatitis
- liver failure
- hepatocellular carcinoma
- glomerulonephritis
- polyarteritis nodosa
- cryoglobulinaemia
When are children in the UK vaccinated against Hep B?
2, 3 and 4 months of age
What at risk groups should be vaccinated against Hep B
- healthcare workers
- IVDU
- sex workers
- prisoners
- family contacts of an individual with Hep B
- regular blood transfusions
- CKD who may need RRT
- chronic liver disease patients
Management of Hep B
1st line: pegylated interferon-alpha
Other antiretrovirals:
- tenofovir
- entecavir
- telbivudine
Groups at risk of Hep C infection
IVDU
blood transfusion prior to 1991 (e.g. haemophiliacs).
What type of virus is Hep C
RNA flavivirus
Transmission of Hep C
Blood/body fluid
Vertical transmission
Incubation period of Hep C
6-9 weeks
Is there a vaccine for Hep C?
No
Clinical features of Hep C
Asymptomatic in some
Transient rise in LFTs
jaundice
fatigue
arthralgia
Diagnostic investigation for Hep C
HCV RNA
- anti-HCV antibodies
Chronic hepatitis C may be defined as the persistence of HCV RNA in the blood for how long?
6 months
Complications of chronic Hep C
- arthralgia/arthritis
- Sjogren’s
- cirrhosis
- hepatocellular cancer
- cryoglobulinaemia
- porphyria cutanea tarda
- glomerulonephritis
Management of Chronic Hep C
- depends on viral genotype
- combination of protease inhibitors
(e.g. daclatasvir + sofosbuvir or sofosbuvir + simeprevir) with or without ribavirin are used
Complications/ side-effects of treatment for chronic Hep C
ribavirin
- haemolytic anaemia
- cough
- teratogenic
interferon alpha
- flu-like symptoms
- depression
- fatigue
- leukopenia/thrombocytopenia
What type of virus is Hep D?
single stranded RNA virus
=> incomplete RNA virus that requires hepatitis B surface antigen to complete its replication and transmission cycle
Transmission of Hep D
- similar to Hep B
=> exchange of bodily fluids
patients may be infected with hepatitis B and hepatitis D at the same time.
Difference between coinfection and superinfection
Co-infection: Hep B + D infection at same time
Superinfection: Patient with Hep subsequently develops a Hep D infection.
Superinfection of Hep D on top of Hep B brings a higher risk of what complications?
- fulminant hepatitis
- chronic hepatitis
- cirrhosis
Diagnostic test for Hep D
- reverse polymerase chain reaction of hepatitis D RNA
Treatment currently used for Hep D
Interferon (poor evidence base)
What type of virus is Hepatitis E?
RNA hepevirus
Transmission of Hepatitis E
faecal-oral route
Incubation period of Hep E
3-8 weeks
In what areas is Hep E prevalent?
Central and South-East Asia,
North and West Africa,
Can Hep E cause chronic disease or lead to an increased risk of cancer?
No
Is there a vaccine for Hep E?
vaccine is currently in development, but is not yet in widespread use
