Hepatitis Flashcards
define hepatitis
inflammation of liver as a result of viral replication inside hepatocytes
on histology what would all types of hepatitis show?
interface necrosis
what must you do with all types of hepatitis?
report to public health
what is hepatitis A?
pircorna virus
in Hepatitis A: what is the virus type?
- acute
- single stranded RNA
in Hepatitis A: how is it spread?
- Face- oral spread
- contaminated water and food ( shellfish)
in Hepatitis A: what are the risk factors?
- travel
- eating shellfish
- homelessness- overcrowding
- living with people who have it
- poor sanitisation
in Hepatitis A: what are the phases?
- incubation- 2 weeks no symptoms
- prodromal - pre-icteric
- Icteric
- recovery
in the prodromal phase ( 1-2 weeks)-what are the symptoms of Hepatitis A?
- nausea and vomiting
- fever
-malaise - RUQ pain
in the icteric phase ( 3 months )-what are the symptoms of Hepatitis A?
-jaundice
-dark urine
- pale stool
-pruritus
-heapatosplenomegaly
how is hepatitis A diagnosed?
- bloods
- LFT
- Serology
what blood tests are done to diagnose HEP A?
- high ESR
- Leukopenia
what would LFT show in HEP A ?
- high bilirubin
- high ALT
what would serology show in HEP A ? (before/ after infection )
when under active infection - high HAV Igm antibodies
after infection - high anti HAV IgG antibodies
what is the treatment for HEP A?
- supporting care
-travellers vaccine
what are complications associated with HEP A?
- fulminant liver failure- rare
what is HEP B?
Hepadna virus
in HEP B: what is the virus type?
- double stranded DNA
- Acute and chronic
in HEP B: how is it spread?
- blood borne
- bodily fluids
- sharing needles
- vertical/ horizontal transmission
- dialysis
in HEP B: what are the symptoms in the prodromal phase ( 1-2 week)?
- nausea and vomiting
- fever
- malaise
- RUQ pain
in HEP B: what are the symptoms in the icteric phase ( few weeks- 6 months) ?
- jaundice
- dark urine
- pale stools
-prurritus - arthralgia
- urticaria
in HEP B: how is it diagnosed?
serology
in HEP B: what does the serology look for?
- Hb S Ag- ( s- surface antigen)
- Anti Hb S Ag
- Hb E Ag
- Anti Hb E Ag
- HBV DNA
- Hb C Ag ( c- inner core antigen)
- anti Hb C Ag
in HEP B: in serology when does Hb S Ag appear?
- in initial infection- 1-6 months
in HEP B: in serology when does anti Hb S Ag appear and what does it indicate?
- indicates immunity or vaccination
- appear 1-3 months after infection
in HEP B: in serology when does Hb E Ag appear?
infectivity and viral replication
in HEP B: in serology what does anti-Hb E Ag mean?
low activity and infectivity
in HEP B: in serology what does HBV DNA Show ?
viral load direct count
in HEP B: in serology what does Hb c Ag mean?
- not measured in practise
- exposed to HEP B or some point
in HEP B: in serology when does anti Hb C Ag appear?
- anti Hb C Igm- recent infection
- anti Hb C IgG- resolved or chronic infection
in acute HEP B what would serology show?
HbsAg
Igm Anti HBC Ag
in chronic HEP B what would serology show?
HbsAg
IgG anti HbAg
in carrier HEP B what would serology show?
HbsAg
IgG anti HbAg
in vaccine HEP B what would serology show?
anti HbsAg
In HEP B: what is the treatment?
-pegylated interferon alpha 2a
– anti viral properties
- tenofovir
-transplant
what is HEP C?
flavivirus
In HEP C: what is the virus type?
- single stranded RNA
- acute and chronic
In HEP C: How is it spread?
- blood borne
- bodily fluids
- IVDU !!( Intravenous drug users )
In HEP C: what are the symptoms in acute ?
-asymptomatic
or
- malaise
-fever
-myalgia
-arthalgia
- nausea and vomiting
- diarrhoea
In HEP C: what are the symptoms in chronic?
usual chronic liver signs
hepatosplenomegaly
in HEP C: what is done for diagnosis?
serology
what would be present in serology in HEP C when you have no infection?
- anti HC ab -ve
- Hc RNA -ve
what would be present in serology in HEP C when you have active infection?
- anti HC ab -ve
- Hc RNA +ve
what would be present in serology in HEP C when you have resolved infection?
- anti Hc Ab +ve
- HC RNA -ve
what would be present in serology in HEP C when you have acute infection- acute/chronic?
-anti Hc Ab +ve
- Hc Rna +ve
what is the treatment for hepatitis C?
- Direct Acting Antivirals ( DAA)
- oral ribavirin + NSSA- I, + NSSB- I
IN HEP D: what is the virus type?
-single stranded RNA
- acute and chronic
IN HEP D: what other hep does it depend on?
D- can only survive in patients with hep B
- it attaches itself to HbSAg
- HEP b + Hep D- HIGH cirrhosis + HCC ( Igm HDV + Im HBV)
IN HEP D what is the treatment, diagnosis, rf and symptoms the same as?
the same as hep b
what is the most common hep?
HEP E
IN HEP E: what is the virus type?
single stranded RNA
acute
IN HEP E: how is it spread?
- faeco-oral spread
-contaminated water - drugs
-undercooked pork
IN HEP E: what are the symptoms?
usually asymptomatic and self limiting
IN HEP E: what are the complications?
- chronic disease in immunosupressed
- fulminant liver disease
IN HEP E: how is it diagnosed?
serology
in non reactive HEP E- what is the serology?
anti HCV- negative
HCV RNA- negative
in current infection HEP E- what is the serology?
anti HCV- positive
HCV RNA- positive
in post infection HEP E - what is the serology?
anti HCV- positive
HCV RNA- negative
what is the treatment for HEP E?
supportive
self limiting
describe autoimune hepatitis
immune system attacks liver cells causing inflammation and damage
what are the risk factors for auto immune hepatitis?
- female
- other autoimmune diseases
- viral hepatitis
- HLA DR3 or DR4
who is more likely to get type 1 autoimmune hepatitis?
adult females
who is more likely to get type 2 autoimmune hepatitis?
younger females
what auto antibodies are involved in type 1 autoimmune hepatitis?
anti nuclear antibodies (ANA)
anti smooth muscle antibodies ( asma)
anti soluble liver ag
what auto antibodies are involved in type 2 autoimmune hepatitis?
anti liver kidney microsomes 1
anti liver cytosol antigen type 1
what are the symptoms for autoimmune hepatitis?
- 25% asymptomatic
-jaundice
-fever
-hepatosplenomegaly
how is autoimmune hepatitis diagnosed?
serology of antibodies
how is autoimmune hepatitis treated?
- corticosteroids
-immunosuppressants
-transplant
